Point of Care Nucleic Acid Testing for SARS-CoV-2 in Hospitalized Patients: A Clinical Validation Trial and Implementation Study: A Clinical Validation Trial and Implementation Study

Dami A. Collier; Sonny M. Assennato; Ben Warne; Nyarie Sithole; Katherine Sharrocks; Allyson Ritchie; Pooja Ravji; Matthew Routledge; Dominic Sparkes; Jordan Skittrall; Anna Smielewska; Isobel Ramsey; Neha Goel; Martin Curran; David Enoch; Rhys Tassell; Michelle Lineham; Devan Vaghela; Clare Leong; Hoi Ping Mok; John Bradley; Kenneth G.C. Smith; Vivienne Mendoza; Nikos Demiris; Martin Besser; Gordon Dougan; Paul J. Lehner; Mark J. Siedner; Hongyi Zhang; Claire Waddington; Helen Lee; Ravindra K. Gupta; Stephen Baker; Ian Goodfellow; Paul Lyons; Nicholas J. Matheson; Mark Toshner; Michael P. Weekes; Nick Brown; Surendra Palmar; Daniel Chapman; Ashley Shaw; Vivien Mendoza; Sherly Jose; Areti Bermperi; Julie Ann Zerrudo; Evgenia Kourampa; Caroline Saunders; Ranalie de Jesus; Jason Domingo

doi:10.1016/j.xcrm.2020.100062

Point of Care Nucleic Acid Testing for SARS-CoV-2 in Hospitalized Patients: A Clinical Validation Trial and Implementation Study: A Clinical Validation Trial and Implementation Study

Dami A. Collier, Sonny M. Assennato, Ben Warne, Nyarie Sithole, Katherine Sharrocks, Allyson Ritchie, Pooja Ravji, Matthew Routledge, Dominic Sparkes, Jordan Skittrall, Anna Smielewska, Isobel Ramsey, Neha Goel, Martin Curran, David Enoch, Rhys Tassell, Michelle Lineham, Devan Vaghela, Clare Leong, Hoi Ping MokJohn Bradley, Kenneth G.C. Smith, Vivienne Mendoza, Nikos Demiris, Martin Besser, Gordon Dougan, Paul J. Lehner, Mark J. Siedner, Hongyi Zhang, Claire Waddington, Helen Lee, Ravindra K. Gupta, Stephen Baker, Ian Goodfellow, Paul Lyons, Nicholas J. Matheson, Mark Toshner, Michael P. Weekes, Nick Brown, Surendra Palmar, Daniel Chapman, Ashley Shaw, Vivien Mendoza, Sherly Jose, Areti Bermperi, Julie Ann Zerrudo, Evgenia Kourampa, Caroline Saunders, Ranalie de Jesus, Jason Domingo

Research output: Contribution to journal › Article › peer-review

39 Citations (Scopus)

Abstract

There is an urgent need for rapid SARS-CoV-2 testing in hospitals to limit nosocomial spread. We report an evaluation of point of care (POC) nucleic acid amplification testing (NAAT) in 149 participants with parallel combined nasal and throat swabbing for POC versus standard lab RT-PCR testing. Median time to result is 2.6 (IQR 2.3–4.8) versus 26.4 h (IQR 21.4–31.4, p < 0.001), with 32 (21.5%) positive and 117 (78.5%) negative. Cohen's κ correlation between tests is 0.96 (95% CI 0.91–1.00). When comparing nearly 1,000 tests pre- and post-implementation, the median time to definitive bed placement from admission is 23.4 (8.6-41.9) versus 17.1 h (9.0–28.8), p = 0.02. Mean length of stay on COVID-19 “holding” wards is 58.5 versus 29.9 h (p < 0.001). POC testing increases isolation room availability, avoids bed closures, allows discharge to care homes, and expedites access to hospital procedures. POC testing could mitigate the impact of COVID-19 on hospital systems.

Original language	English
Article number	100062
Journal	Cell Reports Medicine
Volume	1
Issue number	5
DOIs	https://doi.org/10.1016/j.xcrm.2020.100062
Publication status	Published - 25 Aug 2020
Externally published	Yes

Keywords

COVID-19
diagnostic test
infection control
nosocomial
POC
point of care
SARS-CoV-2

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10.1016/j.xcrm.2020.100062Licence: CC BY

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Collier, D. A., Assennato, S. M., Warne, B., Sithole, N., Sharrocks, K., Ritchie, A., Ravji, P., Routledge, M., Sparkes, D., Skittrall, J., Smielewska, A., Ramsey, I., Goel, N., Curran, M., Enoch, D., Tassell, R., Lineham, M., Vaghela, D., Leong, C., ... Domingo, J. (2020). Point of Care Nucleic Acid Testing for SARS-CoV-2 in Hospitalized Patients: A Clinical Validation Trial and Implementation Study: A Clinical Validation Trial and Implementation Study. Cell Reports Medicine, 1(5), Article 100062. https://doi.org/10.1016/j.xcrm.2020.100062

@article{c53c91cd8572481a90b0a2a5b6b817d0,

title = "Point of Care Nucleic Acid Testing for SARS-CoV-2 in Hospitalized Patients: A Clinical Validation Trial and Implementation Study: A Clinical Validation Trial and Implementation Study",

abstract = "There is an urgent need for rapid SARS-CoV-2 testing in hospitals to limit nosocomial spread. We report an evaluation of point of care (POC) nucleic acid amplification testing (NAAT) in 149 participants with parallel combined nasal and throat swabbing for POC versus standard lab RT-PCR testing. Median time to result is 2.6 (IQR 2.3–4.8) versus 26.4 h (IQR 21.4–31.4, p < 0.001), with 32 (21.5\%) positive and 117 (78.5\%) negative. Cohen's κ correlation between tests is 0.96 (95\% CI 0.91–1.00). When comparing nearly 1,000 tests pre- and post-implementation, the median time to definitive bed placement from admission is 23.4 (8.6-41.9) versus 17.1 h (9.0–28.8), p = 0.02. Mean length of stay on COVID-19 “holding” wards is 58.5 versus 29.9 h (p < 0.001). POC testing increases isolation room availability, avoids bed closures, allows discharge to care homes, and expedites access to hospital procedures. POC testing could mitigate the impact of COVID-19 on hospital systems.",

keywords = "COVID-19, diagnostic test, infection control, nosocomial, POC, point of care, SARS-CoV-2",

author = "Collier, \{Dami A.\} and Assennato, \{Sonny M.\} and Ben Warne and Nyarie Sithole and Katherine Sharrocks and Allyson Ritchie and Pooja Ravji and Matthew Routledge and Dominic Sparkes and Jordan Skittrall and Anna Smielewska and Isobel Ramsey and Neha Goel and Martin Curran and David Enoch and Rhys Tassell and Michelle Lineham and Devan Vaghela and Clare Leong and Mok, \{Hoi Ping\} and John Bradley and Smith, \{Kenneth G.C.\} and Vivienne Mendoza and Nikos Demiris and Martin Besser and Gordon Dougan and Lehner, \{Paul J.\} and Siedner, \{Mark J.\} and Hongyi Zhang and Claire Waddington and Helen Lee and Gupta, \{Ravindra K.\} and Stephen Baker and Ian Goodfellow and Paul Lyons and Matheson, \{Nicholas J.\} and Mark Toshner and Weekes, \{Michael P.\} and Nick Brown and Surendra Palmar and Daniel Chapman and Ashley Shaw and Vivien Mendoza and Sherly Jose and Areti Bermperi and Zerrudo, \{Julie Ann\} and Evgenia Kourampa and Caroline Saunders and \{de Jesus\}, Ranalie and Jason Domingo",

year = "2020",

month = aug,

day = "25",

doi = "10.1016/j.xcrm.2020.100062",

language = "English",

volume = "1",

journal = "Cell Reports Medicine",

issn = "2666-3791",

publisher = "Cell Press",

number = "5",

}

Collier, DA, Assennato, SM, Warne, B, Sithole, N, Sharrocks, K, Ritchie, A, Ravji, P, Routledge, M, Sparkes, D, Skittrall, J, Smielewska, A, Ramsey, I, Goel, N, Curran, M, Enoch, D, Tassell, R, Lineham, M, Vaghela, D, Leong, C, Mok, HP, Bradley, J, Smith, KGC, Mendoza, V, Demiris, N, Besser, M, Dougan, G, Lehner, PJ, Siedner, MJ, Zhang, H, Waddington, C, Lee, H, Gupta, RK, Baker, S, Goodfellow, I, Lyons, P, Matheson, NJ, Toshner, M, Weekes, MP, Brown, N, Palmar, S, Chapman, D, Shaw, A, Mendoza, V, Jose, S, Bermperi, A, Zerrudo, JA, Kourampa, E, Saunders, C, de Jesus, R & Domingo, J 2020, 'Point of Care Nucleic Acid Testing for SARS-CoV-2 in Hospitalized Patients: A Clinical Validation Trial and Implementation Study: A Clinical Validation Trial and Implementation Study', Cell Reports Medicine, vol. 1, no. 5, 100062. https://doi.org/10.1016/j.xcrm.2020.100062

Point of Care Nucleic Acid Testing for SARS-CoV-2 in Hospitalized Patients: A Clinical Validation Trial and Implementation Study: A Clinical Validation Trial and Implementation Study. / Collier, Dami A.; Assennato, Sonny M.; Warne, Ben et al.
In: Cell Reports Medicine, Vol. 1, No. 5, 100062, 25.08.2020.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Point of Care Nucleic Acid Testing for SARS-CoV-2 in Hospitalized Patients: A Clinical Validation Trial and Implementation Study: A Clinical Validation Trial and Implementation Study

AU - Collier, Dami A.

AU - Assennato, Sonny M.

AU - Warne, Ben

AU - Sithole, Nyarie

AU - Sharrocks, Katherine

AU - Ritchie, Allyson

AU - Ravji, Pooja

AU - Routledge, Matthew

AU - Sparkes, Dominic

AU - Skittrall, Jordan

AU - Smielewska, Anna

AU - Ramsey, Isobel

AU - Goel, Neha

AU - Curran, Martin

AU - Enoch, David

AU - Tassell, Rhys

AU - Lineham, Michelle

AU - Vaghela, Devan

AU - Leong, Clare

AU - Mok, Hoi Ping

AU - Bradley, John

AU - Smith, Kenneth G.C.

AU - Mendoza, Vivienne

AU - Demiris, Nikos

AU - Besser, Martin

AU - Dougan, Gordon

AU - Lehner, Paul J.

AU - Siedner, Mark J.

AU - Zhang, Hongyi

AU - Waddington, Claire

AU - Lee, Helen

AU - Gupta, Ravindra K.

AU - Baker, Stephen

AU - Goodfellow, Ian

AU - Lyons, Paul

AU - Matheson, Nicholas J.

AU - Toshner, Mark

AU - Weekes, Michael P.

AU - Brown, Nick

AU - Palmar, Surendra

AU - Chapman, Daniel

AU - Shaw, Ashley

AU - Mendoza, Vivien

AU - Jose, Sherly

AU - Bermperi, Areti

AU - Zerrudo, Julie Ann

AU - Kourampa, Evgenia

AU - Saunders, Caroline

AU - de Jesus, Ranalie

AU - Domingo, Jason

PY - 2020/8/25

Y1 - 2020/8/25

N2 - There is an urgent need for rapid SARS-CoV-2 testing in hospitals to limit nosocomial spread. We report an evaluation of point of care (POC) nucleic acid amplification testing (NAAT) in 149 participants with parallel combined nasal and throat swabbing for POC versus standard lab RT-PCR testing. Median time to result is 2.6 (IQR 2.3–4.8) versus 26.4 h (IQR 21.4–31.4, p < 0.001), with 32 (21.5%) positive and 117 (78.5%) negative. Cohen's κ correlation between tests is 0.96 (95% CI 0.91–1.00). When comparing nearly 1,000 tests pre- and post-implementation, the median time to definitive bed placement from admission is 23.4 (8.6-41.9) versus 17.1 h (9.0–28.8), p = 0.02. Mean length of stay on COVID-19 “holding” wards is 58.5 versus 29.9 h (p < 0.001). POC testing increases isolation room availability, avoids bed closures, allows discharge to care homes, and expedites access to hospital procedures. POC testing could mitigate the impact of COVID-19 on hospital systems.

AB - There is an urgent need for rapid SARS-CoV-2 testing in hospitals to limit nosocomial spread. We report an evaluation of point of care (POC) nucleic acid amplification testing (NAAT) in 149 participants with parallel combined nasal and throat swabbing for POC versus standard lab RT-PCR testing. Median time to result is 2.6 (IQR 2.3–4.8) versus 26.4 h (IQR 21.4–31.4, p < 0.001), with 32 (21.5%) positive and 117 (78.5%) negative. Cohen's κ correlation between tests is 0.96 (95% CI 0.91–1.00). When comparing nearly 1,000 tests pre- and post-implementation, the median time to definitive bed placement from admission is 23.4 (8.6-41.9) versus 17.1 h (9.0–28.8), p = 0.02. Mean length of stay on COVID-19 “holding” wards is 58.5 versus 29.9 h (p < 0.001). POC testing increases isolation room availability, avoids bed closures, allows discharge to care homes, and expedites access to hospital procedures. POC testing could mitigate the impact of COVID-19 on hospital systems.

KW - COVID-19

KW - diagnostic test

KW - infection control

KW - nosocomial

KW - POC

KW - point of care

KW - SARS-CoV-2

U2 - 10.1016/j.xcrm.2020.100062

DO - 10.1016/j.xcrm.2020.100062

M3 - Article

SN - 2666-3791

VL - 1

JO - Cell Reports Medicine

JF - Cell Reports Medicine

IS - 5

M1 - 100062

ER -

Point of Care Nucleic Acid Testing for SARS-CoV-2 in Hospitalized Patients: A Clinical Validation Trial and Implementation Study: A Clinical Validation Trial and Implementation Study

Abstract

Keywords

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