Cell Reports Medicine (Aug 2020)
Point of Care Nucleic Acid Testing for SARS-CoV-2 in Hospitalized Patients: 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 S. Waddington,
- Helen Lee,
- Ravindra K. Gupta,
- Stephen Baker,
- John Bradley,
- Gordon Dougan,
- Ian Goodfellow,
- Ravindra K. Gupta,
- Paul J. Lehner,
- Paul Lyons,
- Nicholas J. Matheson,
- Kenneth G.C. Smith,
- Mark Toshner,
- Michael P. Weekes,
- Nick Brown,
- Martin Curran,
- Surendra Palmar,
- Hongyi Zhang,
- David Enoch,
- Daniel Chapman,
- Ashley Shaw,
- Vivien Mendoza,
- Sherly Jose,
- Areti Bermperi,
- Julie Ann Zerrudo,
- Evgenia Kourampa,
- Caroline Saunders,
- Ranalie de Jesus,
- Jason Domingo,
- Ciro Pasquale,
- Bensi Vergese,
- Phoebe Vargas,
- Marivic Fabiculana,
- Marlyn Perales,
- Richard Skells,
- Lee Mynott,
- Elizabeth Blake,
- Amy Bates,
- Anne-laure Vallier,
- Alexandra Williams,
- David Phillips,
- Edmund Chiu,
- Alex Overhill,
- Nicola Ramenante,
- Jamal Sipple,
- Steven Frost,
- Helena Knock,
- Richard Hardy,
- Emily Foster,
- Fiona Davidson,
- Viona Rundell,
- Purity Bundi,
- Richmond Abeseabe,
- Sarah Clark,
- Isabel Vicente
Affiliations
- Dami A. Collier
- Division of Infection and Immunity, University College London, London WC1E 6BT, UK; Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID), Cambridge CB2 0AW, UK
- Sonny M. Assennato
- Diagnostics for the Real World EU, Chesterford Research Park, Saffron Walden CB10 1XL, UK
- Ben Warne
- Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID), Cambridge CB2 0AW, UK; Department of Infectious Diseases, Cambridge University NHS Hospitals Foundation Trust, Cambridge CB2 0QQ, UK; Department of Medicine, University of Cambridge, Cambridge CB2 0AW, UK
- Nyarie Sithole
- Department of Infectious Diseases, Cambridge University NHS Hospitals Foundation Trust, Cambridge CB2 0QQ, UK
- Katherine Sharrocks
- Department of Infectious Diseases, Cambridge University NHS Hospitals Foundation Trust, Cambridge CB2 0QQ, UK
- Allyson Ritchie
- Diagnostics for the Real World EU, Chesterford Research Park, Saffron Walden CB10 1XL, UK
- Pooja Ravji
- Department of Infectious Diseases, Cambridge University NHS Hospitals Foundation Trust, Cambridge CB2 0QQ, UK
- Matthew Routledge
- Department of Infectious Diseases, Cambridge University NHS Hospitals Foundation Trust, Cambridge CB2 0QQ, UK
- Dominic Sparkes
- Department of Infectious Diseases, Cambridge University NHS Hospitals Foundation Trust, Cambridge CB2 0QQ, UK
- Jordan Skittrall
- Department of Infectious Diseases, Cambridge University NHS Hospitals Foundation Trust, Cambridge CB2 0QQ, UK
- Anna Smielewska
- Department of Infectious Diseases, Cambridge University NHS Hospitals Foundation Trust, Cambridge CB2 0QQ, UK
- Isobel Ramsey
- Department of Infectious Diseases, Cambridge University NHS Hospitals Foundation Trust, Cambridge CB2 0QQ, UK
- Neha Goel
- Diagnostics for the Real World EU, Chesterford Research Park, Saffron Walden CB10 1XL, UK
- Martin Curran
- Clinical Microbiology & Public Health Laboratory, Public Health England, Cambridge CB2 0QQ, UK
- David Enoch
- Clinical Microbiology & Public Health Laboratory, Public Health England, Cambridge CB2 0QQ, UK
- Rhys Tassell
- POC Testing, Department of Pathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
- Michelle Lineham
- POC Testing, Department of Pathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
- Devan Vaghela
- Department of Infectious Diseases, Cambridge University NHS Hospitals Foundation Trust, Cambridge CB2 0QQ, UK
- Clare Leong
- Department of Infectious Diseases, Cambridge University NHS Hospitals Foundation Trust, Cambridge CB2 0QQ, UK
- Hoi Ping Mok
- Department of Infectious Diseases, Cambridge University NHS Hospitals Foundation Trust, Cambridge CB2 0QQ, UK
- John Bradley
- Department of Medicine, University of Cambridge, Cambridge CB2 0AW, UK; National Institutes for Health Research (NIHR) Cambridge Biomedical Research Centre, Cambridge CB2 0QQ, UK
- Kenneth G.C. Smith
- Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID), Cambridge CB2 0AW, UK; Department of Medicine, University of Cambridge, Cambridge CB2 0AW, UK
- Vivienne Mendoza
- NIHR Cambridge Clinical Research Facility, Cambridge CB2 0QQ, UK
- Nikos Demiris
- Department of Statistics, Athens University of Economics and Business, 28is Oktovriou 76, 104 34 Athens, Greece
- Martin Besser
- Department of Haematology, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
- Gordon Dougan
- Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID), Cambridge CB2 0AW, UK; Department of Medicine, University of Cambridge, Cambridge CB2 0AW, UK
- Paul J. Lehner
- Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID), Cambridge CB2 0AW, UK; Department of Medicine, University of Cambridge, Cambridge CB2 0AW, UK
- Mark J. Siedner
- Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
- Hongyi Zhang
- Clinical Microbiology & Public Health Laboratory, Public Health England, Cambridge CB2 0QQ, UK
- Claire S. Waddington
- Department of Infectious Diseases, Cambridge University NHS Hospitals Foundation Trust, Cambridge CB2 0QQ, UK; Department of Medicine, University of Cambridge, Cambridge CB2 0AW, UK
- Helen Lee
- Diagnostics for the Real World EU, Chesterford Research Park, Saffron Walden CB10 1XL, UK
- Ravindra K. Gupta
- Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID), Cambridge CB2 0AW, UK; Department of Infectious Diseases, Cambridge University NHS Hospitals Foundation Trust, Cambridge CB2 0QQ, UK; Department of Medicine, University of Cambridge, Cambridge CB2 0AW, UK; Africa Health Research Institute, Durban 4001, South Africa; Corresponding author
- Stephen Baker
- John Bradley
- Gordon Dougan
- Ian Goodfellow
- Ravindra K. Gupta
- Paul J. Lehner
- Paul Lyons
- Nicholas J. Matheson
- Kenneth G.C. Smith
- Mark Toshner
- Michael P. Weekes
- Nick Brown
- Martin Curran
- Surendra Palmar
- Hongyi Zhang
- David Enoch
- Daniel Chapman
- Ashley Shaw
- Vivien Mendoza
- Sherly Jose
- Areti Bermperi
- Julie Ann Zerrudo
- Evgenia Kourampa
- Caroline Saunders
- Ranalie de Jesus
- Jason Domingo
- Ciro Pasquale
- Bensi Vergese
- Phoebe Vargas
- Marivic Fabiculana
- Marlyn Perales
- Richard Skells
- Lee Mynott
- Elizabeth Blake
- Amy Bates
- Anne-laure Vallier
- Alexandra Williams
- David Phillips
- Edmund Chiu
- Alex Overhill
- Nicola Ramenante
- Jamal Sipple
- Steven Frost
- Helena Knock
- Richard Hardy
- Emily Foster
- Fiona Davidson
- Viona Rundell
- Purity Bundi
- Richmond Abeseabe
- Sarah Clark
- Isabel Vicente
- Journal volume & issue
-
Vol. 1,
no. 5
p. 100062
Abstract
Summary: 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.
