Back to Search Start Over

The value of anal swab RT-PCR for COVID-19 diagnosis in adult Indonesian patients

Authors :
Murdani Abdullah
Dedy Gunawanjati Sudrajat
Virly Nanda Muzellina
Juferdy Kurniawan
Aulia Rizka
Amanda Pitarini Utari
Rabbinu Rangga Pribadi
Muhammad Firhat Idrus
Sofy Meilany
Andry Surandy
Hamzah Shatri
Ikhwan Rinaldi
Ceva Wicaksono Pitoyo
Kaka Renaldi
Source :
BMJ Open Gastroenterology, Vol 8, Iss 1 (2021)
Publication Year :
2021
Publisher :
BMJ Publishing Group, 2021.

Abstract

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.

Details

Language :
English
ISSN :
20200005 and 20544774
Volume :
8
Issue :
1
Database :
Directory of Open Access Journals
Journal :
BMJ Open Gastroenterology
Publication Type :
Academic Journal
Accession number :
edsdoj.6008a09c17cf4276bc2fa2bf9093cc96
Document Type :
article
Full Text :
https://doi.org/10.1136/bmjgast-2020-000590