Impact of Pool Testing in Detection of Asymptomatic Patients With COVID-19

David L. Smalley, PhD; Patricia M. Cisarik, OD, PhD; James Grantham; William Cloud, MD; R. Brock Neil, PhD; Paul DePriest, MD

Disclosures

Lab Med. 2021;52(1):e15-e16. 

In This Article

Abstract and Introduction

Abstract

Objective: During the current pandemic, COVID-19 has been detected in patients using real-time reverse transcriptase-polymerase chain reaction (RT-PCR) that confirms the presence of SARS-CoV-2 RNA. The demand for increased testing, particularly for asymptomatic individuals required alternative approaches to single-patient RT-PCR testing, such as pooling.

Methods: This study explored the impact of dilution on the detectability of SARS-CoV-2 in asymptomatic patients using RT-PCR and demonstrated that pooling can be effective in low prevalence populations.

Results: The RT-PCR results for the 3:1, 5:1, and 7:1 aliquot samples showed little differences in CT values, confirming detection capability at these dilutions.

Conclusion: Based on the results of the present study, a pooled approach with up to 5:1 sample aliquots and using the current RT-PCR methodology likely will detect SARS CoV2 RNA among asymptomatic patients.

Introduction

During the current pandemic, COVID-19 has been detected in patients using real-time reverse transcriptase-polymerase chain reaction (RT-PCR) that confirms the presence of SARS-CoV-2 RNA. The escalation of COVID-19 infection numbers in the United States has created a commensurate demand for increased testing, particularly for asymptomatic individuals. Unfortunately, the availability of testing reagents for SARS-CoV-2 RT-PCR has lagged behind the demand; thus, alternative approaches to single-patient RT-PCR testing, such as pooling, are being explored.[1] Of concern for testing asymptomatic patients is whether viral shedding is strong enough for detection using a pooled approach. This study explored the impact of dilution on the detectability of SARS-CoV-2 in asymptomatic patients using RT-PCR.

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