Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Mohan Z Mani

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On Sep 2018




Prof. Somashekhar Nimbalkar

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Prof. Somashekhar Nimbalkar
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Chairman, Research Group, Charutar Arogya Mandal, Karamsad
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Ex-Member, Governing Body, National Neonatology Forum, New Delhi
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Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



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Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
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Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
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Professor and Head
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Saraswati Dental College
Lucknow
On Sep 2018




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Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




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Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Original article / research
Year : 2022 | Month : April | Volume : 16 | Issue : 4 | Page : DC01 - DC05 Full Version

From Bench to Bedside: A Retrospective Study on the Utility of Rapid Antigen Testing for Coronavirus Disease from Firozabad, Uttar Pradesh, India


Published: April 1, 2022 | DOI: https://doi.org/10.7860/JCDR/2022/55224.16224
Lekha Tuli, Rohit Patawa

1. Associate Professor, Department of Microbiology, Autonomous State Medical College, Firozabad, Uttar Pradesh, India. 2. Guest Faculty, Department of Statistics, University of Allahabad, Allahabad, Uttar Pradesh, India.

Correspondence Address :
Dr. Lekha Tuli,
Associate Professor, Department of Microbiology, Autonomous State Medical College, Firozabad-283203, Uttar Pradesh, India.
E-mail: tuli_lekha@rediffmail.com

Abstract

Introduction: Ever since the Coronavirus Disease-2019 (COVID-19) pandemic hit, there have been constant efforts to develop rapid, sensitive and specific diagnostic methods to detect the virus in order to curb the further spread of the disease. There is an array of tests available for the detection of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Time being a very crucial factor and Rapid Antigen Testing (RAT) is very helpful in detecting the virus.

Aim: To discuss the importance of rapid antigen testing among symptomatic and asymptomatic cases in different age groups and gender with association to infection.

Materials and Methods: This retrospective study was conducted in Department of Microbiology, Autonomous State Medical College and SNM Hospital, Firozabad, Uttar Pradesh, India, from April 2020 to August 2021. A total of 16,258 samples were collected from symptomatic patients having Influenza Like Illness (ILI), Severe Acute Respiratory Illness (SARI), those seeking hospitalisation, contacts (symptomatic and asymptomatic) and travellers were subjected to antigen detection by the Standard Q COVID-19 antigen kit following proper precautions. The cases were divided into Group A of patients who presented with symptoms ≤7 days, Group B of patients who presented with signs and symptoms >7 days and group C comprised of asymptomatic patients. The Chi-square test was done to test the statistical significance of association of symptomatic patients with outcome of the antigen test.

Results: Of the total 16,258 samples tested, the maximum number of positive cases were found in the age group 30-39 years followed by 20-29 years. The least number of positive cases were found in extreme age group, i.e., six cases in >90 years and no case was found in below 9 years. No significant impact was found on the positivity rates on the basis of gender. The percentage positivity as detected by rapid antigen was 2.1% and maximum patients were found in the group having symptoms ≤7 days (p<0.05).

Conclusion: Rapid Antigen Detection Test (RADT) for SARS-CoV-2 is a simple, portable, fast and easy to perform test. It could be easily used in rural areas as it does not require special laboratory setup. It could be used for mass testing and helped as a good epidemiological tool. However, few symptomatic cases which could not be detected by rapid testing had to be cross checked with Real Time-Reverse Transcriptase Polymerase Chain Reaction (RT-PCR). Thus, when used in conjunction with molecular methods, the sensitivity of the test increased.

Keywords

Epidemiological, Point of care, Rapid antigen detection test

The hurricane of COVID-19 outbreak has affected the mankind in the past two years causing immense damage in all spheres of life. Ever since it started in March 2020, there have been constant efforts to devise a fast, sensitive and specific test for its detection which can also be used in rural and peripheral areas easily and reach out to the outreach. The timely detection of the virus is very important as the prompt isolation of the patients curtails the further dissemination of the virus. The high transmission rates and limited testing capacity has been a hindrance in managing the pandemic (1).

Besides, the conventional gold standard techniques are time taking and there is an increased risk of cross contamination, pipetting errors, etc. There has been a race to develop nucleic acid assays, hybridisation microarray assays and amplicon based metagenomics sequencing (2). The need of the hour has been to develop rapid, inexpensive testing methods which can be deployed without using special equipments or infrastructure. The Lateral Flow Detection (LFD) tests have given promising results and are cost-effective (3). The other rapid tests like the Quidel’s Antigen test besides testing for the SARS-CoV-2 also checks for the Influenza virus antigens and got an Emergency Use Authorisation (EUA) from the Food and Drug Administration (FDA) (4). The Nucleic Acid Amplification Test (NAAT) and RT-PCR assays available for COVID-19 detection are automated and molecular based methods but take more time in comparison to rapid testing. The rapid tests have also served as good diagnostic tools for surveillance (5). Other studies from different parts of India have shown that RADT has proved to be a good epidemiological tool in detection of COVID-19 (6). The Indian Council of Medical Research (ICMR) certified the studies on RADT which accounted for close to 50% testing of COVID-19 (7),(8),(9). This is the first study from Northern India (Firozabad, Uttar Pradesh) which was conducted to discuss the utility of the rapid testing for COVID-19 in a tertiary care hospital in different age groups, gender and associating it with symptoms.

Material and Methods

This retrospective study was conducted in Department of Microbiology, Autonomous State Medical College and SNM Hospital, Firozabad, Uttar Pradesh, India. A total of 16,258 samples were collected from April 2020 to August 2021 (thereafter the data was analysed from September 2021 to December 2021) from the Firozabad district and all the neighbouring areas.

Inclusion criteria: RAT was done on the samples taken from the patients who presented with ILI and SARI like symptoms as and when they reported and also from patients seeking hospitalisation, from contacts (asymptomatic direct or high risk contacts) and travellers (domestic and International). The data of symptoms and clinical history/travel history was collected from hospital records or patient summary reports.

Exclusion criteria: The samples from places with low prevalence of infection (orange and green containment zones of neighbouring areas of Firozabad, UP for e.g., Etah, Kasganj, etc.,) (10) were excluded to avoid false positive results.

The details of age and gender were recorded along with signs and symptoms. The cases were divided into three groups viz., group A patients who presented with symptoms ≤7 days, group B patients who presented with signs and symptoms >7 days (11) and group C comprised of asymptomatic patients (who had been in direct contact with symptomatic patients and high risk contacts with co-morbid conditions like diabetes, heart ailments, etc., and people coming from red containment zone) and those who were seeking to travel within the country (domestic) or outside the country (International) when lockdown was suspended.

The Standard Q COVID-19 antigen kit manufactured by SD Biosensor was used, which comprises of a rapid immunochromatographic assay, for the qualitative detection of specific antigens to SARS-CoV-2. The sample was collected from the surface of the posterior nasopharynx of the patient with the help of a sterile swab by trained staff following proper precautions and processed as per the manufacturers’ instructions without any delay. The swab was then inserted in the extraction buffer, stirred and removed following which the nozzle cap was pressed tightly on the tube. Three drops of the extracted specimen was put on the cassette well and the result was read within 15-30 minutes.

Principle

The test is based on immunochromatographic assay which comprises of a nitrocellulose membrane precoated with mouse monoclonal antichicken IgY antibody on the control line region and mouse monoclonal anti SARS-CoV-2 antibody (conjugated with colour particles used as antigen detectors) on the test line region. The sample containing SARS-CoV-2 antigen interacted with monoclonal anti SARS-CoV-2 antibody making an antigen-antibody colour particle complex which migrated via capillary action on the membrane until the test line where it was captured by the mouse monoclonal anti SARS-CoV-2 antibody. The intensity of the coloured line depend upon the amount of antigen present in the specimen. The control line always appeared which indicated that the test procedure was performed properly.

Interpretation of the result- The specimens which showed coloured line in both the test and control were considered positive, the ones which showed line only in the control and not in the test well were considered negative and those which showed coloured line in test well but not in the control were considered invalid and were repeated.

Statistical Analysis

All the variables have been presented in the form of frequencies and percentages and these percentages have been calculated from the total number of antigen tests done which were 16,258, besides being depicted in suitable diagrammatical representation for the bird-eye-view. Thereafter, the Chi-square test was done to test the statistical significance of association of symptomatic patients with outcome of the antigen test. All the analysis was performed using R software version 3.6.2 and MS Excel 2007. A p-value <0.05 was considered to be statistically significant.

Results

A total of 16,258 samples were included and analysed. The maximum testing for the COVID-19 Rapid antigen was done in males of age group 20-29 years (Table/Fig 1). The maximum occurrence of the infection was in the age group 30-39 years followed by 20-29 years and the least positivity was found in the higher age groups above 90 years followed by age group below 9 years. The people seeking to travel in the age group 30-39 years showed 23 (0.1%) positivity (Table/Fig 2). The patients in different categories for Coronavirus antigen testing showed maximum positivity 102 (0.6%) in the group of contacts of positive cases (Table/Fig 3).

The percentage positivity as detected by Rapid antigen was 2.1% out of a total number of 16,258 samples tested. There was no effect of positivity on the basis of gender (p>0.05) (Table/Fig 1). There were six samples that gave invalid results and were repeated. Patients that presented with symptoms less than a week showed maximum 142 (0.9%) antigen positivity (Table/Fig 4).

Discussion

COVID-19 pandemic has hit the population of all age groups irrespective of gender. In this study, a preponderance of the infection in the age groups of 30-39 years (p-value <0.05) followed by 20-29 years age was observed. This was due to more locomotion of these age groups owing to job and travel. Bello-Chavolla OY et al., in their study also had similar findings (11). In their study Bello-Chavolla OY et al., found higher mortality (29.5%) and severity of infection in older Mexican adults due to COVID-19 infection (12). In the present study, testing was done more in males compared to females, which could be attributed to more movement of males than females in search of livelihood especially from rural to urban areas. However, there was no significant impact on the positivity rates on the basis of gender (p>0.05). The SARS-CoV-2 binds to the host cells on the Angiotensin-Converting Enzyme 2 (ACE2) receptors on different human tissues (13),(14),(15). In one of the pioneer studies done by Li MY et al., they did not find any significant difference in ACE2 expression levels in males and females or younger and older age groups indicating that the virus may infect the different genders and age groups equally (16).

In the present study, the percentage positivity was 2.1% out of a total of 16,258 samples. Other studies also showed positivity rates between 1-8% (1),(17), whereas, some showed a slightly higher (more than 10%) prevalence of the infection (18),(19). The positivity 0.9% was found more in patients who presented with signs and symptoms for ≤7 days (p<0.05). Harmon A et al., also observed the maximum sensitivity of rapid tests done between days 0 to day 3 of the onset of symptoms in the patients (1). The results of this study were in concordance with other studies in which maximum number of infected persons were detected with the help of rapid tests in the first week of symptom onset (11),(20),(21). This was due to higher viral load and concentrations in the first week of infection (22). Researchers have concluded that within the first week of symptoms onset the results of rapid tests were better than RT-PCR and correlated with the presence of SARS-CoV-2 virus which could be cultured (19). The efficacy of the test reflects in it detecting 0.4% positive cases among asymptomatic individuals in this study. Previous data conclude that asymptomatic people account for approximately 40-45% of infection and pose a threat of spreading the virus over an extended period of even more than 14 days (23). Others also showed that asymptomatic residents had the potential of spreading the SARS-CoV-2 infection thus, indicating additional prevention measures (24).

The performance of Standard Q COVID-19 Rapid test was evaluated by using it on Quantitative Reverse Transcription PCR (RT-qPCR) and viral culture positive samples and it could not only detect samples with high Ribonucleic Acid (RNA) loads reliably but the negative results corresponded to non cultivable samples in Vero E6 cells (17). However, there have been studies that have questioned the sensitivity of the Lateral Flow antigen Testing (LFT) (25),(26),(27). The testing of COVID-19 has largely depended on PCR which is a reliable and powerful testing method having the potential of detecting the virus even in very minute quantities. Since the viral RNA fragments can be found in the patients even after the clearing of the infectious virus, PCR can detect these not only in infected but also in individuals who have been recently infected (28). It can also detect the viral RNA in asymptomatic individuals (29). However, when mass spread of the SARS-CoV-2 needs to be curtailed then it is more important to have a test which would detect the presence of the virus in the patient on the present day rather than from an earlier infection (30). This will be helpful in prompt isolation of the patients which is required to stop the further spread of the disease.

Bello-Chavolla OY et al., in their study also concluded that RAT could be used for a large scale testing of SARS-CoV-2 but keeping a check on the false negatives (11). False negatives could be a result of testing patients too early after the infection (31). This is of great epidemiological significance as an unknown person harbouring the virus may act as a vector thus spreading it to many people. The increase in false negatives can also be attributed to local outbreaks (32). Kweon OJ et al., concluded that RAT should be done in conjunction with other molecular tests in order not to miss any positive cases (33). ICMR in its advisory had also recommended the use of RADT in combination of RT-PCR test especially in cases of suspected individuals who gave a negative result in RADT (34). Besides, the ICMR in its advisory stated to use RADT as the first test of choice (35). The 0.1% people who were seeking to travel could be detected by the test, which was by and large the most beneficial outcome of the testing as they were immediately isolated which helped to curb the spread of infection not only locally but also across the boundaries. Besides, the detection of positive contacts of patients was a major help and the test helped in contact tracing also. The RAT has been an effective testing method for Coronavirus in low resource settings (36),(37) and has been used as point of care test giving results in a short time period even in outside central laboratory testing facilities.

Limitation(s)

In some suspected cases with negative RADT, the test results had to be cross checked with RT-PCR. Getting a proper clinical history in some cases was difficult due to the fear and stigma of the disease among the patients, their attendants and also the healthcare professionals. The worst experience was to witness the elderly (who could not explain their condition properly) being abandoned by their own kin. This caused a hindrance in taking proper history in such cases.

Conclusion

Thus, RADT for SARS-CoV-2 is a simple, fast, cheap, easy to perform point of care test which does not require special laboratory setups. Since it is not much expertise dependant, it can be used in rural areas and at home following proper precautions and disposal instructions. Being portable it enabled mass testing and helped as a good epidemiological tool. In the study RADT was found to be a sensitive test.

Acknowledgement

The authors are thankful to Dr. Sangeeta Aneja (Principal, Autonomous State Medical College, Firozabad, Uttar Pradesh, India) for her heartfelt support and guidance. The authors are thankful to the entire technical team who worked dedicatedly and tirelessly in this hour of pandemic.

References

1.
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DOI and Others

DOI: 10.7860/JCDR/2022/55224.16224

Date of Submission: Jan 25, 2022
Date of Peer Review: Feb 16, 2022
Date of Acceptance: Mar 05, 2022
Date of Publishing: Apr 01, 2022

AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? NA
• Was informed consent obtained from the subjects involved in the study? NA
• For any images presented appropriate consent has been obtained from the subjects. NA

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Jan 30, 2022
• Manual Googling: Feb 16, 2022
• iThenticate Software: Mar 04, 2022 (6%)

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