TY - JOUR
T1 - The value of anal swab RT-PCR for COVID-19 diagnosis in adult Indonesian patients
AU - Abdullah, Murdani
AU - Sudrajat, Dedy Gunawanjati
AU - Muzellina, Virly Nanda
AU - Kurniawan, Juferdy
AU - Rizka, Aulia
AU - Pribadi, Rabbinu Rangga
AU - Idrus, Muhammad Firhat
AU - Yusra, Yusra
AU - Meilany, Sofy
AU - Surandy, Andry
AU - Shatri, Hamzah
AU - Rinaldi, Ikhwan
AU - Pitoyo, Ceva Wicaksono
AU - Renaldi, Kaka
AU - Utari, Amanda Pitarini
N1 - Funding Information:
1Gastroenterology, Pancreatobilliary, and Endoscopy Division, Internal Medicine Department, Rumah Sakit Umum Pusat Nasional Dr Cipto Mangunkusumo, Central Jakarta, Special Capital Region of Jakarta, Indonesia 2Indonesia Medical Education and Research Institute - Human Cancer Research Center, University of Indonesia Faculty of Medicine, Central Jakarta, Special Capital Region of Jakarta, Indonesia 3Hepatobilliary Division, Internal Medicine Department, Rumah Sakit Umum Pusat Nasional Dr Cipto Mangunkusumo, Central Jakarta, Special Capital Region of Jakarta, Indonesia 4Geriatric Division, Internal Medicine Department, Rumah Sakit Umum Pusat Nasional Dr Cipto Mangunkusumo, Central Jakarta, Special Capital Region of Jakarta, Indonesia 5Department of Clinical Pathology, Rumah Sakit Umum Pusat Nasional Dr Cipto Mangunkusumo, Central Jakarta, Special Capital Region Jakarta, Indonesia 6Research Center for Virology and Cancer Pathobiology, University of Indonesia Faculty of Medicine, Jakarta, Special Capital Region of Jakarta, Indonesia 7Psychosomatic and Palliative Care Division, Internal Medicine Department, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Rumah Sakit Umum Pusat Nasional Dr Cipto Mangunkusumo, Central Jakarta, Special Capital Region of Jakarta, Indonesia 8Hematology and Medical Oncology Division, Internal Medicine Department, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Rumah Sakit Umum Pusat Nasional Dr Cipto Mangunkusumo, Central Jakarta, Special Capital Region of Jakarta, Indonesia 9Respirology and Critical Care Division, Internal Medicine Department, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Rumah Sakit Umum Pusat Nasional Dr Cipto Mangunkusumo, Central Jakarta, Special Capital Region of Jakarta, Indonesia Acknowledgements This research/article’s publication is supported by Indonesian Ministry of Research, Technology and Higher Education through the Penelitian Terapan Unggulan Perguruan Tinggi (PTUPT) Program Contract NKB-288/ UN2.RST/HKP.05.00/2020. We express our gratitude to this research especially to Virology and Cancer Pathology Research Center, Faculty of Medicine, Universitas Indonesia for allowing the use of PCR amplification used kit from MiRXES Fortitude 2.1 Singapore, and Roche Light Cycler 480 Machine, Ajeng Apsari Utami and Frisky Ronald Tua as research assistants of Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia. The grant support is independent of the investigation process and write‐up.
Funding Information:
Competing interests MA reports grants from Indonesian Ministry of Research, Technology and Higher Education during the conduct of the study. DGS has nothing to disclose. VNM has nothing to disclose. JK has nothing to disclose. AR has nothing to disclose. APU has nothing to disclose. RRP has nothing to disclose. MFI has nothing to disclose. YY has nothing to disclose. SM has nothing to disclose. AS has nothing to disclose. HS has nothing to disclose. IR has nothing to disclose. CWP has nothing to disclose. KR has nothing to disclose.
Funding Information:
Funding This research/article’s publication is supported by Indonesian Ministry of Research, Technology, and Higher Education through the Penelitian Terapan Unggulan Perguruan Tinggi (PTUPT) Program Contract NKB-288/UN2.RST/ HKP.05.00/2020.
Funding Information:
This research/article?s publication is supported by Indonesian Ministry of Research, Technology and Higher Education through the Penelitian Terapan Unggulan Perguruan Tinggi (PTUPT) Program Contract NKB-288/UN2.RST/HKP.05.00/2020. We express our gratitude to this research especially to Virology and Cancer Pathology Research Center, Faculty of Medicine, Universitas Indonesia for allowing the use of PCR amplification used kit from MiRXES Fortitude 2.1 Singapore, and Roche Light Cycler 480 Machine, Ajeng Apsari Utami and Frisky Ronald Tua as research assistants of Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia. The grant support is independent of the investigation process and write?up. This research/article?s publication is supported by Indonesian Ministry of Research, Technology, and Higher Education through the Penelitian Terapan Unggulan Perguruan Tinggi (PTUPT) Program Contract NKB-288/UN2.RST/HKP.05.00/2020.
Publisher Copyright:
© 2020 American Society of Mechanical Engineers (ASME). All rights reserved.
PY - 2021/5/19
Y1 - 2021/5/19
N2 - Objective This study will test the performance of the anal swab PCR test when compared with the nasopharyngeal swab PCR test as a diagnostic tool for COVID-19. Design An observational descriptive study which included hospitalised suspected, or probable cases of hopitalised COVID-19 patients, conducted in Dr. Cipto Mangunkusumo National Hospital, Ciputra Hospital, Mitra Keluarga Depok Hospital and Mitra Keluarga Kelapa Gading Hospital, Indonesia. Epidemiological, clinical, laboratory and radiology data were obtained. Nasopharyngeal and anal swabs specimens were collected for SARS-CoV-2 RNA detection. Results We analysed 136 subjects as part of this study. The clinical spectrum of COVID-19 manifesation in this study was typical of hospitalised patients, with 25% classified as mild cases, 14.7% in severe condition and 12.5% of subjects classified as having acute respiratory distress syndrome. When compared with nasopharyngeal swab as the standard specimen for reverse transcription polymerase chain reaction (RT-PCR) detection of SARS-CoV-2 antigen, the sensitivity and specificity of the anal swab was 36.7% and 93.8%, respectively. The positive and negative predictive value were 97.8% and 16.5 %, respectively. The performance of the anal swab remained similar when only the subgroup of patients with gastrointestinal symptoms (n=92, 67.6%) was analysed (sensitivity 40% and specificity 91.7%). Out of all the subjects included in analysis, 67.6% had gastrointestinal symptoms. Similarly, 73.3% of patients in the anal swab-positive group had gastrointestinal symptoms. The two most common gastrointestinal symptoms in the subjects' population were nausea and anorexia. Conclusion Anal swab specimen has low sensitivity (36.7%) but high specificity (93.8%) for detecting SARS-CoV-2 antigen by RT-PCR. Only one additional positive result was found by anal swab among the nasopharyngeal swab-negative group. Anal swab may not be needed as an additional test at the beginning of a patient's diagnostic investigation and nasopharyngeal swab RT-PCR remains as the standard diagnostic test for COVID-19.
AB - Objective This study will test the performance of the anal swab PCR test when compared with the nasopharyngeal swab PCR test as a diagnostic tool for COVID-19. Design An observational descriptive study which included hospitalised suspected, or probable cases of hopitalised COVID-19 patients, conducted in Dr. Cipto Mangunkusumo National Hospital, Ciputra Hospital, Mitra Keluarga Depok Hospital and Mitra Keluarga Kelapa Gading Hospital, Indonesia. Epidemiological, clinical, laboratory and radiology data were obtained. Nasopharyngeal and anal swabs specimens were collected for SARS-CoV-2 RNA detection. Results We analysed 136 subjects as part of this study. The clinical spectrum of COVID-19 manifesation in this study was typical of hospitalised patients, with 25% classified as mild cases, 14.7% in severe condition and 12.5% of subjects classified as having acute respiratory distress syndrome. When compared with nasopharyngeal swab as the standard specimen for reverse transcription polymerase chain reaction (RT-PCR) detection of SARS-CoV-2 antigen, the sensitivity and specificity of the anal swab was 36.7% and 93.8%, respectively. The positive and negative predictive value were 97.8% and 16.5 %, respectively. The performance of the anal swab remained similar when only the subgroup of patients with gastrointestinal symptoms (n=92, 67.6%) was analysed (sensitivity 40% and specificity 91.7%). Out of all the subjects included in analysis, 67.6% had gastrointestinal symptoms. Similarly, 73.3% of patients in the anal swab-positive group had gastrointestinal symptoms. The two most common gastrointestinal symptoms in the subjects' population were nausea and anorexia. Conclusion Anal swab specimen has low sensitivity (36.7%) but high specificity (93.8%) for detecting SARS-CoV-2 antigen by RT-PCR. Only one additional positive result was found by anal swab among the nasopharyngeal swab-negative group. Anal swab may not be needed as an additional test at the beginning of a patient's diagnostic investigation and nasopharyngeal swab RT-PCR remains as the standard diagnostic test for COVID-19.
KW - anal
KW - COVID-19
KW - diagnostic virology
UR - http://www.scopus.com/inward/record.url?scp=85106611204&partnerID=8YFLogxK
U2 - 10.1136/bmjgast-2020-000590
DO - 10.1136/bmjgast-2020-000590
M3 - Article
AN - SCOPUS:85106611204
SN - 2054-4774
VL - 8
JO - BMJ Open Gastroenterology
JF - BMJ Open Gastroenterology
IS - 1
M1 - e000590
ER -
