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Discussion about how to use Inheres in (in relation to Direct site) for 1. SARS-CoV-2 tests and 2. in general.

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  1. 871557008 | Detection of ribonucleic acid of Severe acute respiratory syndrome coronavirus 2 in oropharyngeal swab (observable entity) | now has 704319004 |Inheres in (attribute)| = 31389004 |Oropharyngeal structure (body structure)|, which might not represent the meaning of the concept. The location of specimen taking is selected because of its representativeness of the patient as a whole but the infection is not limited to the oropharyngeal structure.

    While evidence is limited, there are indications that SARS-CoV-2 infects multiple types of tissue in multiple locations: https://www.nature.com/articles/s41421-021-00249-2

    Current (2021-07-31) defintion is:

    === 363787002 |Observable entity (observable entity)| :
      { 246093002 |Component (attribute)| = 1240411000000107 |Ribonucleic acid of Severe acute respiratory syndrome coronavirus 2 (substance)| }
      { 370130000 |Property (attribute)| = 705057003 |Presence (property) (qualifier value)| }
      { 704319004 |Inheres in (attribute)| = 31389004 |Oropharyngeal structure (body structure)| }
      { 704327008 |Direct site (attribute)| = 461911000124106 |Swab specimen from oropharynx (specimen)| }

    Alternative values for Inheres in could be e.g. 278826002 | Body internal region (body structure) | (as used in 276885007 | Core body temperature (observable entity) |) if the test is done to determine the presence of the virus in the patient rather than the presence of the virus in oropharynx.

  2. There are examples where the sample is not representative for the patient as a whole, e.g. presence of bacteria in the blood stream vs. on the skin surface have distinct clinical implications. Thus, a generic value of Inheres in (like 278826002 | Body internal region (body structure) |) would be applicable in select cases. Still, for microbiology studies, presence of bacteria in e.g. an arterial specimen would be representative for the blood stream as a whole.

  3. For comparison:

    NPU59105 Secr(Nasoph)—Severe acute respiratory syndrome coronavirus 2(RNA); arb.c.(proc.) = ?

    LOINC: 94759-8 SARS-CoV-2 (COVID-19) RNA [Presence] in Nasopharynx by NAA with probe detection (system = Nph)