Rapid COVID-19 Tests Key to Infection Control, Improved Patient Outcomes

By Megan Brooks

October 26, 2020

NEW YORK (Reuters Health) - Rapid, point-of-care testing (POCT) for suspected COVID-19 infection significantly reduces time to results and may improve infection control and patient outcomes, according to the first study to assess the real-world impact of rapid testing.

"POCT for COVID in hospitals is associated with a number of benefits including better use of infection control measures and patient flow and so should be rolled out to replace of laboratory PCR," lead author Dr. Tristan Clark of Southampton General Hospital, U.K., told Reuters Health by email.

"Now that there are effective therapies for COVID (these were not proven until after the trial) it will also allow earlier direct treatment which may in turn improve patient outcome," said Dr. Clark.

The study, published in The Lancet Respiratory Medicine, was conducted between mid-March and late April - the peak of the first COVID-19 wave in the U.K.

The study included 1,054 adults with COVID-19 symptoms presenting to the emergency department or other acute areas of Southampton General Hospital. Nose and throat swabs were taken from all patients; 499 patients were tested for SARS-CoV-2 using the QIA-stat-Dx Respiratory SARS-CoV-2 POCT platform from Qiagen and 555 were tested by laboratory PCR.

A total of 197 (39%) patients in POCT group and 155 (28%) in the control group tested positive for COVID-19.

The median wait time for results was 1.7 hours in the POCT group versus 21.3 hours with PCR testing in a centralized lab within the hospital (P<0.0001).

After testing, patients were transferred to a COVID-positive or COVID-negative wards. The median time to transfer was eight hours in the POCT group, compared with more than 28 hours in the PCR group, with 14% of the POCT group transferred directly to the correct ward (bypassing assessment areas) versus none of the control group.

The mean number of bed moves between admission and final ward arrival was significantly lower in the POCT group than in the control group (0.9 vs. 1.4).

In a statement, Dr. Clark said, "Our findings are the first to suggest the clinical benefits of molecular point-of-care COVID-19 testing in hospitals, demonstrating reduced delays, bed moves, and time in assessment areas, which all lead to better infection control. We believe that molecular POCTs should be urgently integrated into care pathways to reduce coronavirus transmission within hospitals to prevent the next wave of the pandemic overwhelming health services around the world."

He added in an email to Reuters Health, "POCT is not routine yet but is in the process of being rolled out across acute setting in the National Health Service (NHS). The major barrier to date has been the limited availability of test kits - which is slowly improving."

The study did not have commercial funding. None of the authors report ties to Qiagen.

SOURCE: https://bit.ly/31uFdeo Lancet Respiratory Medicine, online October 8, 2020.