SARS-CoV-2 viral load dynamics and real-time RT-PCR cycle threshold interpretation in symptomatic non-hospitalised individuals in New Zealand: a multicentre cross sectional observational study
We conducted a multicentre cross sectional observational study of laboratory, public health and hospitalisation data for PCR-confirmed COVID-19 cases within the New Zealand Northern Region, between 12 February and 8 June 2020. The aim of this study was to describe population level SARS-CoV-2 upper r...
Gespeichert in:
| Veröffentlicht in: | Pathology 2021-06, Vol.53 (4), p.530-535 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 535 |
|---|---|
| container_issue | 4 |
| container_start_page | 530 |
| container_title | Pathology |
| container_volume | 53 |
| creator | Fox-Lewis, Andrew Fox-Lewis, Shivani Beaumont, Jenna Drinković, Dragana Harrower, Jay Howe, Kevin Jackson, Catherine Rahnama, Fahimeh Shilton, Blair Qiao, Helen Smith, Kevin K. Morpeth, Susan C. Taylor, Susan Blakiston, Matthew Roberts, Sally McAuliffe, Gary |
| description | We conducted a multicentre cross sectional observational study of laboratory, public health and hospitalisation data for PCR-confirmed COVID-19 cases within the New Zealand Northern Region, between 12 February and 8 June 2020. The aim of this study was to describe population level SARS-CoV-2 upper respiratory tract (URT) viral load dynamics by stratifying positivity rates and polymerase chain reaction (PCR) cycle threshold (Ct) values of URT samples from COVID-19 cases by days since symptom onset, and to explore utility of Ct values in determining length of time post-infection and thus potential infectivity.
Of 123,124 samples tested for SARS-CoV-2 by PCR, 579 samples (407 positive and 172 negative) from 368 symptomatic non-hospitalised individuals with PCR-confirmed infection were included. Sample positivity rate was 61.5% (8/13) for pre-symptomatic samples, rising to 93.2% (317/340) for samples collected during the purported symptomatic infectious period (days 0–10 post-symptom onset), and dropping to 36.3% (82/226) for post-infectious period samples (day 11 onwards). URT viral load peaked shortly after symptom onset, with median Ct values ranging 20.00–29.99 until 15 days post-symptom onset, and >30.00 after this time. Of samples with a Ct value of |
| doi_str_mv | 10.1016/j.pathol.2021.01.007 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7980174</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0031302521000854</els_id><sourcerecordid>2511894343</sourcerecordid><originalsourceid>FETCH-LOGICAL-c463t-509a282f87377faee9ed0222ebb8a55e61e9c4f6cacd3ed3742369ada2506e2c3</originalsourceid><addsrcrecordid>eNp9UU2LFDEQDaK4s6v_QCRHLxnz0Z8ehGXQVVhUZlcPXkImqXYydHfaJN3S_86fZnpnXPUiFIQir957VQ-hZ4yuGWXFy8N6UHHv2jWnnK1pKlo-QCuWFTkRtWAP0YpSwYigPD9D5yEcKKVZVVWP0ZkQlahqzlfo583l9oZs3BfC8WS9anHrlMFm7lVndcCqN9iDakm0HeDtLfm02WI96xZw3HsIyYDBto_gBw9RRev61OIwd0N0Xeo17l1P9i4MNqrWBljgxk7WjKoNC_YD_MBfk0SSeoUV7sY2TUEfPWDtXQg4gF54kze3C-AndepCHM38BD1qEhE8Pb0X6PPbN7ebd-T649X7zeU10VkhIslprXjFm6oUZdkogBoM5ZzDblepPIeCQa2zptBKGwFGlBkXRa2M4jktgGtxgV4feYdx14G5M6haOXjbKT9Lp6z896e3e_nNTbKsK8rKLBG8OBF4932EEGVng4Y27Q1uDJLnjFV1JjKRoNkRere_h-ZehlG5hC8P8hi-XMKXNBUt09jzvy3eD_1O-88OkA41WfAyaAu9BmN9urE0zv5f4Rc5DMjO</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2511894343</pqid></control><display><type>article</type><title>SARS-CoV-2 viral load dynamics and real-time RT-PCR cycle threshold interpretation in symptomatic non-hospitalised individuals in New Zealand: a multicentre cross sectional observational study</title><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Fox-Lewis, Andrew ; Fox-Lewis, Shivani ; Beaumont, Jenna ; Drinković, Dragana ; Harrower, Jay ; Howe, Kevin ; Jackson, Catherine ; Rahnama, Fahimeh ; Shilton, Blair ; Qiao, Helen ; Smith, Kevin K. ; Morpeth, Susan C. ; Taylor, Susan ; Blakiston, Matthew ; Roberts, Sally ; McAuliffe, Gary</creator><creatorcontrib>Fox-Lewis, Andrew ; Fox-Lewis, Shivani ; Beaumont, Jenna ; Drinković, Dragana ; Harrower, Jay ; Howe, Kevin ; Jackson, Catherine ; Rahnama, Fahimeh ; Shilton, Blair ; Qiao, Helen ; Smith, Kevin K. ; Morpeth, Susan C. ; Taylor, Susan ; Blakiston, Matthew ; Roberts, Sally ; McAuliffe, Gary</creatorcontrib><description>We conducted a multicentre cross sectional observational study of laboratory, public health and hospitalisation data for PCR-confirmed COVID-19 cases within the New Zealand Northern Region, between 12 February and 8 June 2020. The aim of this study was to describe population level SARS-CoV-2 upper respiratory tract (URT) viral load dynamics by stratifying positivity rates and polymerase chain reaction (PCR) cycle threshold (Ct) values of URT samples from COVID-19 cases by days since symptom onset, and to explore utility of Ct values in determining length of time post-infection and thus potential infectivity.
Of 123,124 samples tested for SARS-CoV-2 by PCR, 579 samples (407 positive and 172 negative) from 368 symptomatic non-hospitalised individuals with PCR-confirmed infection were included. Sample positivity rate was 61.5% (8/13) for pre-symptomatic samples, rising to 93.2% (317/340) for samples collected during the purported symptomatic infectious period (days 0–10 post-symptom onset), and dropping to 36.3% (82/226) for post-infectious period samples (day 11 onwards). URT viral load peaked shortly after symptom onset, with median Ct values ranging 20.00–29.99 until 15 days post-symptom onset, and >30.00 after this time. Of samples with a Ct value of <20.00, 96.1% were collected during the symptomatic infectious period. However, of samples with a Ct value ≥30.00 and ≥35.00, 46.9% and 18.5%, respectively, were also collected during the symptomatic infectious period.
The findings of this study indicate that at or soon after symptom onset represents the optimum time to test for SARS-CoV-2 in the URT, with median Ct values suggesting the useful testing window extends until around 15 days post-symptom onset. In asymptomatic individuals or those with unknown dates of symptom onset, Ct values <20.00 imply recent onset/potential infectivity, but Ct values ≥30.00 or ≥35.00 do not exclude recent onset/potential infectivity. Individual sample Ct values should not be used as an absolute marker of length of time post-infection or to exclude infectivity where date of symptom onset is unavailable.</description><identifier>ISSN: 0031-3025</identifier><identifier>EISSN: 1465-3931</identifier><identifier>DOI: 10.1016/j.pathol.2021.01.007</identifier><identifier>PMID: 33838922</identifier><language>eng</language><publisher>England: Elsevier B.V</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; COVID-19 ; COVID-19 - virology ; COVID-19 Testing ; Cross-Sectional Studies ; cycle threshold ; Female ; Humans ; Male ; Middle Aged ; New Zealand ; PCR ; Real-Time Polymerase Chain Reaction ; Reverse Transcriptase Polymerase Chain Reaction ; SARS-CoV-2 ; Viral Load ; Virology ; Young Adult</subject><ispartof>Pathology, 2021-06, Vol.53 (4), p.530-535</ispartof><rights>2021 Royal College of Pathologists of Australasia</rights><rights>Copyright © 2021 Royal College of Pathologists of Australasia. Published by Elsevier B.V. All rights reserved.</rights><rights>2021 Royal College of Pathologists of Australasia. Published by Elsevier B.V. All rights reserved. 2021 Royal College of Pathologists of Australasia</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c463t-509a282f87377faee9ed0222ebb8a55e61e9c4f6cacd3ed3742369ada2506e2c3</citedby><cites>FETCH-LOGICAL-c463t-509a282f87377faee9ed0222ebb8a55e61e9c4f6cacd3ed3742369ada2506e2c3</cites><orcidid>0000-0002-7590-5950</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33838922$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fox-Lewis, Andrew</creatorcontrib><creatorcontrib>Fox-Lewis, Shivani</creatorcontrib><creatorcontrib>Beaumont, Jenna</creatorcontrib><creatorcontrib>Drinković, Dragana</creatorcontrib><creatorcontrib>Harrower, Jay</creatorcontrib><creatorcontrib>Howe, Kevin</creatorcontrib><creatorcontrib>Jackson, Catherine</creatorcontrib><creatorcontrib>Rahnama, Fahimeh</creatorcontrib><creatorcontrib>Shilton, Blair</creatorcontrib><creatorcontrib>Qiao, Helen</creatorcontrib><creatorcontrib>Smith, Kevin K.</creatorcontrib><creatorcontrib>Morpeth, Susan C.</creatorcontrib><creatorcontrib>Taylor, Susan</creatorcontrib><creatorcontrib>Blakiston, Matthew</creatorcontrib><creatorcontrib>Roberts, Sally</creatorcontrib><creatorcontrib>McAuliffe, Gary</creatorcontrib><title>SARS-CoV-2 viral load dynamics and real-time RT-PCR cycle threshold interpretation in symptomatic non-hospitalised individuals in New Zealand: a multicentre cross sectional observational study</title><title>Pathology</title><addtitle>Pathology</addtitle><description>We conducted a multicentre cross sectional observational study of laboratory, public health and hospitalisation data for PCR-confirmed COVID-19 cases within the New Zealand Northern Region, between 12 February and 8 June 2020. The aim of this study was to describe population level SARS-CoV-2 upper respiratory tract (URT) viral load dynamics by stratifying positivity rates and polymerase chain reaction (PCR) cycle threshold (Ct) values of URT samples from COVID-19 cases by days since symptom onset, and to explore utility of Ct values in determining length of time post-infection and thus potential infectivity.
Of 123,124 samples tested for SARS-CoV-2 by PCR, 579 samples (407 positive and 172 negative) from 368 symptomatic non-hospitalised individuals with PCR-confirmed infection were included. Sample positivity rate was 61.5% (8/13) for pre-symptomatic samples, rising to 93.2% (317/340) for samples collected during the purported symptomatic infectious period (days 0–10 post-symptom onset), and dropping to 36.3% (82/226) for post-infectious period samples (day 11 onwards). URT viral load peaked shortly after symptom onset, with median Ct values ranging 20.00–29.99 until 15 days post-symptom onset, and >30.00 after this time. Of samples with a Ct value of <20.00, 96.1% were collected during the symptomatic infectious period. However, of samples with a Ct value ≥30.00 and ≥35.00, 46.9% and 18.5%, respectively, were also collected during the symptomatic infectious period.
The findings of this study indicate that at or soon after symptom onset represents the optimum time to test for SARS-CoV-2 in the URT, with median Ct values suggesting the useful testing window extends until around 15 days post-symptom onset. In asymptomatic individuals or those with unknown dates of symptom onset, Ct values <20.00 imply recent onset/potential infectivity, but Ct values ≥30.00 or ≥35.00 do not exclude recent onset/potential infectivity. Individual sample Ct values should not be used as an absolute marker of length of time post-infection or to exclude infectivity where date of symptom onset is unavailable.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>COVID-19</subject><subject>COVID-19 - virology</subject><subject>COVID-19 Testing</subject><subject>Cross-Sectional Studies</subject><subject>cycle threshold</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>New Zealand</subject><subject>PCR</subject><subject>Real-Time Polymerase Chain Reaction</subject><subject>Reverse Transcriptase Polymerase Chain Reaction</subject><subject>SARS-CoV-2</subject><subject>Viral Load</subject><subject>Virology</subject><subject>Young Adult</subject><issn>0031-3025</issn><issn>1465-3931</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UU2LFDEQDaK4s6v_QCRHLxnz0Z8ehGXQVVhUZlcPXkImqXYydHfaJN3S_86fZnpnXPUiFIQir957VQ-hZ4yuGWXFy8N6UHHv2jWnnK1pKlo-QCuWFTkRtWAP0YpSwYigPD9D5yEcKKVZVVWP0ZkQlahqzlfo583l9oZs3BfC8WS9anHrlMFm7lVndcCqN9iDakm0HeDtLfm02WI96xZw3HsIyYDBto_gBw9RRev61OIwd0N0Xeo17l1P9i4MNqrWBljgxk7WjKoNC_YD_MBfk0SSeoUV7sY2TUEfPWDtXQg4gF54kze3C-AndepCHM38BD1qEhE8Pb0X6PPbN7ebd-T649X7zeU10VkhIslprXjFm6oUZdkogBoM5ZzDblepPIeCQa2zptBKGwFGlBkXRa2M4jktgGtxgV4feYdx14G5M6haOXjbKT9Lp6z896e3e_nNTbKsK8rKLBG8OBF4932EEGVng4Y27Q1uDJLnjFV1JjKRoNkRere_h-ZehlG5hC8P8hi-XMKXNBUt09jzvy3eD_1O-88OkA41WfAyaAu9BmN9urE0zv5f4Rc5DMjO</recordid><startdate>20210601</startdate><enddate>20210601</enddate><creator>Fox-Lewis, Andrew</creator><creator>Fox-Lewis, Shivani</creator><creator>Beaumont, Jenna</creator><creator>Drinković, Dragana</creator><creator>Harrower, Jay</creator><creator>Howe, Kevin</creator><creator>Jackson, Catherine</creator><creator>Rahnama, Fahimeh</creator><creator>Shilton, Blair</creator><creator>Qiao, Helen</creator><creator>Smith, Kevin K.</creator><creator>Morpeth, Susan C.</creator><creator>Taylor, Susan</creator><creator>Blakiston, Matthew</creator><creator>Roberts, Sally</creator><creator>McAuliffe, Gary</creator><general>Elsevier B.V</general><general>Royal College of Pathologists of Australasia. Published by Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-7590-5950</orcidid></search><sort><creationdate>20210601</creationdate><title>SARS-CoV-2 viral load dynamics and real-time RT-PCR cycle threshold interpretation in symptomatic non-hospitalised individuals in New Zealand: a multicentre cross sectional observational study</title><author>Fox-Lewis, Andrew ; Fox-Lewis, Shivani ; Beaumont, Jenna ; Drinković, Dragana ; Harrower, Jay ; Howe, Kevin ; Jackson, Catherine ; Rahnama, Fahimeh ; Shilton, Blair ; Qiao, Helen ; Smith, Kevin K. ; Morpeth, Susan C. ; Taylor, Susan ; Blakiston, Matthew ; Roberts, Sally ; McAuliffe, Gary</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c463t-509a282f87377faee9ed0222ebb8a55e61e9c4f6cacd3ed3742369ada2506e2c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>COVID-19</topic><topic>COVID-19 - virology</topic><topic>COVID-19 Testing</topic><topic>Cross-Sectional Studies</topic><topic>cycle threshold</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>New Zealand</topic><topic>PCR</topic><topic>Real-Time Polymerase Chain Reaction</topic><topic>Reverse Transcriptase Polymerase Chain Reaction</topic><topic>SARS-CoV-2</topic><topic>Viral Load</topic><topic>Virology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fox-Lewis, Andrew</creatorcontrib><creatorcontrib>Fox-Lewis, Shivani</creatorcontrib><creatorcontrib>Beaumont, Jenna</creatorcontrib><creatorcontrib>Drinković, Dragana</creatorcontrib><creatorcontrib>Harrower, Jay</creatorcontrib><creatorcontrib>Howe, Kevin</creatorcontrib><creatorcontrib>Jackson, Catherine</creatorcontrib><creatorcontrib>Rahnama, Fahimeh</creatorcontrib><creatorcontrib>Shilton, Blair</creatorcontrib><creatorcontrib>Qiao, Helen</creatorcontrib><creatorcontrib>Smith, Kevin K.</creatorcontrib><creatorcontrib>Morpeth, Susan C.</creatorcontrib><creatorcontrib>Taylor, Susan</creatorcontrib><creatorcontrib>Blakiston, Matthew</creatorcontrib><creatorcontrib>Roberts, Sally</creatorcontrib><creatorcontrib>McAuliffe, Gary</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Pathology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fox-Lewis, Andrew</au><au>Fox-Lewis, Shivani</au><au>Beaumont, Jenna</au><au>Drinković, Dragana</au><au>Harrower, Jay</au><au>Howe, Kevin</au><au>Jackson, Catherine</au><au>Rahnama, Fahimeh</au><au>Shilton, Blair</au><au>Qiao, Helen</au><au>Smith, Kevin K.</au><au>Morpeth, Susan C.</au><au>Taylor, Susan</au><au>Blakiston, Matthew</au><au>Roberts, Sally</au><au>McAuliffe, Gary</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>SARS-CoV-2 viral load dynamics and real-time RT-PCR cycle threshold interpretation in symptomatic non-hospitalised individuals in New Zealand: a multicentre cross sectional observational study</atitle><jtitle>Pathology</jtitle><addtitle>Pathology</addtitle><date>2021-06-01</date><risdate>2021</risdate><volume>53</volume><issue>4</issue><spage>530</spage><epage>535</epage><pages>530-535</pages><issn>0031-3025</issn><eissn>1465-3931</eissn><abstract>We conducted a multicentre cross sectional observational study of laboratory, public health and hospitalisation data for PCR-confirmed COVID-19 cases within the New Zealand Northern Region, between 12 February and 8 June 2020. The aim of this study was to describe population level SARS-CoV-2 upper respiratory tract (URT) viral load dynamics by stratifying positivity rates and polymerase chain reaction (PCR) cycle threshold (Ct) values of URT samples from COVID-19 cases by days since symptom onset, and to explore utility of Ct values in determining length of time post-infection and thus potential infectivity.
Of 123,124 samples tested for SARS-CoV-2 by PCR, 579 samples (407 positive and 172 negative) from 368 symptomatic non-hospitalised individuals with PCR-confirmed infection were included. Sample positivity rate was 61.5% (8/13) for pre-symptomatic samples, rising to 93.2% (317/340) for samples collected during the purported symptomatic infectious period (days 0–10 post-symptom onset), and dropping to 36.3% (82/226) for post-infectious period samples (day 11 onwards). URT viral load peaked shortly after symptom onset, with median Ct values ranging 20.00–29.99 until 15 days post-symptom onset, and >30.00 after this time. Of samples with a Ct value of <20.00, 96.1% were collected during the symptomatic infectious period. However, of samples with a Ct value ≥30.00 and ≥35.00, 46.9% and 18.5%, respectively, were also collected during the symptomatic infectious period.
The findings of this study indicate that at or soon after symptom onset represents the optimum time to test for SARS-CoV-2 in the URT, with median Ct values suggesting the useful testing window extends until around 15 days post-symptom onset. In asymptomatic individuals or those with unknown dates of symptom onset, Ct values <20.00 imply recent onset/potential infectivity, but Ct values ≥30.00 or ≥35.00 do not exclude recent onset/potential infectivity. Individual sample Ct values should not be used as an absolute marker of length of time post-infection or to exclude infectivity where date of symptom onset is unavailable.</abstract><cop>England</cop><pub>Elsevier B.V</pub><pmid>33838922</pmid><doi>10.1016/j.pathol.2021.01.007</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-7590-5950</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0031-3025 |
| ispartof | Pathology, 2021-06, Vol.53 (4), p.530-535 |
| issn | 0031-3025 1465-3931 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7980174 |
| source | MEDLINE; Alma/SFX Local Collection |
| subjects | Adolescent Adult Aged Aged, 80 and over Child Child, Preschool COVID-19 COVID-19 - virology COVID-19 Testing Cross-Sectional Studies cycle threshold Female Humans Male Middle Aged New Zealand PCR Real-Time Polymerase Chain Reaction Reverse Transcriptase Polymerase Chain Reaction SARS-CoV-2 Viral Load Virology Young Adult |
| title | SARS-CoV-2 viral load dynamics and real-time RT-PCR cycle threshold interpretation in symptomatic non-hospitalised individuals in New Zealand: a multicentre cross sectional observational study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-14T11%3A55%3A31IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=SARS-CoV-2%20viral%20load%20dynamics%20and%20real-time%20RT-PCR%20cycle%20threshold%20interpretation%20in%20symptomatic%20non-hospitalised%20individuals%20in%20New%20Zealand:%20a%20multicentre%20cross%20sectional%20observational%20study&rft.jtitle=Pathology&rft.au=Fox-Lewis,%20Andrew&rft.date=2021-06-01&rft.volume=53&rft.issue=4&rft.spage=530&rft.epage=535&rft.pages=530-535&rft.issn=0031-3025&rft.eissn=1465-3931&rft_id=info:doi/10.1016/j.pathol.2021.01.007&rft_dat=%3Cproquest_pubme%3E2511894343%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2511894343&rft_id=info:pmid/33838922&rft_els_id=S0031302521000854&rfr_iscdi=true |