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. 2021 Nov;27(11):2887-2891.
doi: 10.3201/eid2711.211135. Epub 2021 Aug 23.

Correlation of SARS-CoV-2 Subgenomic RNA with Antigen Detection in Nasal Midturbinate Swab Specimens

Katherine Immergluck, Mark D Gonzalez, Jennifer K Frediani, Joshua M Levy, Janet Figueroa, Anna Wood, Beverly B Rogers, Jared O'Neal, Roger Elias-Marcellin, Allie Suessmith, Julie Sullivan, Raymond F Schinazi, Ahmed Babiker, Anne Piantadosi, Miriam B Vos, Greg S Martin, Wilbur A Lam, Jesse J Waggoner

Correlation of SARS-CoV-2 Subgenomic RNA with Antigen Detection in Nasal Midturbinate Swab Specimens

Katherine Immergluck et al. Emerg Infect Dis. 2021 Nov.

Abstract

Among symptomatic outpatients, subgenomic RNA of severe acute respiratory syndrome coronavirus 2 in nasal midturbinate swab specimens was concordant with antigen detection but remained detectable in 13 (82.1%) of 16 nasopharyngeal swab specimens from antigen-negative persons. Subgenomic RNA in midturbinate swab specimens might be useful for routine diagnostics to identify active virus replication.

Keywords: COVID-19; RNA; SARS-CoV-2; antigen detection; coronavirus; coronavirus disease; nasal midturbinate; nasopharyngeal; nucleocapsid; respiratory infections; severe acute respiratory syndrome coronavirus 2; subgenomic RNA; swab specimens; viruses; zoonoses.

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Figures

Figure 1
Figure 1
Correlation of sgRNA levels with total SARS-CoV-2 RNA in samples from study participants in Atlanta, Georgia, USA. A) N2 Ct values for samples in which sgRNA was detectable (gray dots) or not detectable (red dots). Horizontal bars indicate means, and error bars indicate SDs. B) sgRNA Ct values versus corresponding Ct values for the N2 target. Results of simple linear regression (black line) and error bars (dotted lines) are shown. Line of identity (gray line) is shown for reference. Ct, cycle threshold; N2, nucleocapsid 2; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; sgRNA, subgenomic RNA.
Figure 2
Figure 2
Concordance of SARS-CoV-2 sgRNA with nucleocapsid antigen detection in MT swab specimens, but not NP swab specimens, from study participants in Atlanta, Georgia, USA. sgRNA remains detectable in NP swab specimens for persons who showed negative results for nucleocapsid antigen. Symbols represent MT (blue) and NP (purple) swab specimens for persons with (filled circles) and without (open circles) detectable sgRNA. Horizontal bars indicate means, and error bars indicate SDs. Ct, cycle threshold; MT, nasal midturbinate; NP, nasopharyngeal; N2, nucleocapsid 2; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; sgRNA, subgenomic RNA.
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