Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2021 Apr;159(4):1387-1390.
doi: 10.1016/j.chest.2020.10.017. Epub 2020 Oct 15.

Paired Nasopharyngeal and Deep Lung Testing for Severe Acute Respiratory Syndrome Coronavirus-2 Reveals a Viral Gradient in Critically Ill Patients: A Multicenter Study

Islam Hamed  1 , Nesreen Shaban  1 , Marwan Nassar  1 , Dilek Cayir  1 , Sam Love  1 , Martin D Curran  2 , Stephen Webb  3 , Huina Yang  3 , Katherine Watson  4 , Anthony Rostron  5 , Vilas Navapurkar  1 , Razeen Mahroof  1 , Andrew Conway Morris  6
Affiliations
Multicenter Study

Paired Nasopharyngeal and Deep Lung Testing for Severe Acute Respiratory Syndrome Coronavirus-2 Reveals a Viral Gradient in Critically Ill Patients: A Multicenter Study

Islam Hamed et al. Chest. 2021 Apr.
No abstract available

PubMed Disclaimer

Figures

Figure 1
Figure 1
Comparison of viral load of samples from nasopharynx (NP) and deep lung (endotracheal aspirate or BAL). A, Paired samples excluding samples in which NP (16) or deep lung (2) were below the limit of detection; color indicates time from symptom onset to test (red, <7 days; blue, 7-13 days; gray, >13 days); black line indicates median value. P value by Wilcoxon matched-pairs test. B, All samples from patients receiving noninvasive ventilation or oxygen at time of test. Blue line indicates median value. C, All samples from patients receiving invasive mechanical ventilation at time of test. Blue line indicates median value. D, All samples from patients receiving ECMO at time of test. Blue line indicates median value.
Figure 2
Figure 2
Relationship between duration of symptoms to testing and Ct value. A, Positive nasopharyngeal swab Ct values, R2 = 0, P = .89. B, Positive deep lung sample Ct values, R2 = 0.14, P = .0075. C, NP to deep lung Ct gradient (where both samples were positive), R2 = 0.2, P = .0089. Lines show regression line from simple linear regression with 95% CIs. Ct = cycle threshold.
See this image and copyright information in PMC

Comment in

  • Finding an Evidence-Based and Clinically Important Role for BAL in the Setting of Suspected SARS-Cov-2 Infection.
    Trisolini R, Bello G, Antonelli M. Trisolini R, et al. Chest. 2021 Apr;159(4):1680-1681. doi: 10.1016/j.chest.2020.11.037. Epub 2021 Apr 6. Chest. 2021. PMID: 34022001 Free PMC article. No abstract available.
  • Response.
    Hamed I, Shaban N, Nassar M, Cayir D, Love S, Navapurkar V, Mahroof R, Curran MD, Webb S, Yang H, Conway Morris A, Watson K, Rostron A. Hamed I, et al. Chest. 2021 Apr;159(4):1681-1682. doi: 10.1016/j.chest.2020.11.038. Epub 2021 Apr 6. Chest. 2021. PMID: 34022002 Free PMC article. No abstract available.

References

    1. Intensive Care National Audit and Research Network COVID-19 report. https://www.icnarc.org/DataServices/Attachments/Download/7bc41c30-efc2-e...
    1. Wang W., Xu Y., Gao R., et al. Detection of SARS-CoV-2 in different types of clinical specimens. JAMA. 2020;323(18):1843–1844. - PMC - PubMed
    1. Motley M.P., Bennett-Guerrero E., Fries B.C., Spitzer E.D. Review of viral testing (polymerase chain reaction) and antibody/serology testing for severe acute respiratory syndrome-coronavirus-2 for the intensivist. Crit Care Explor. 2020;2:e0154–e0158. - PMC - PubMed
    1. Gandhi M., Yokoe D.S., Havlir D.V. Asymptomatic transmission, the Achilles’ heel of current strategies to control Covid-19. N Engl J Med. 2020;382:2158–2160. - PMC - PubMed
    1. Wölfel R., Corman V.M., Guggemos W., et al. Virological assessment of hospitalized patients with COVID-2019. Nature. 2020;581(7809):465–469. - PubMed