Rapid bedside testing is faster than standard COVID-19 centralized PCR testing

Point-of-care tests when COVID-19 is suspected may reduce time to results and improve infection control. This suggests that these tests may have clinical advantages over the widely used laboratory PCR method.

In an intervention study that followed the SARS-CoV-2 test on admission to a UK hospital, waiting for results was closer to the patient’s bedside point-of-care test (POCT) compared to 21.3 hours using standard processes. It took only 1.7 hours when using. Overview of PCR tests in a centralized lab in a hospital.

This study was the first to assess the actual effects of POCT and Lancet Respiratory Medicine journal. It took place between March 20th and April 29th, 2020 (the first wave peak of COVID-19 in the UK).

A study of 1054 patients in the United Kingdom using the QIA-stat-Dx POCT platform found that testing suspicious COVID-19 at the Point of Care helped healthcare providers better manage case surges. It suggests that it may help reduce the spread of infection in hospitals.

During the first wave of Coronavirus Pandemic health care systems around the world have relied on PCR testing of patient samples in centralized hospital laboratories. This is a time-consuming and resource-intensive approach. Delayed results mean that patients take longer to be admitted to the correct COVID / non-COVID ward. As a result, patients wait in a mixed evaluation room and are more likely to be infected between positive and negative patients.

In recent months, many molecular POCT testing platforms have been developed, promising rapid results from testing in areas where patients are being examined, such as A & E. Swab samples take up very little physical space and are placed in test cartridges that can be operated by medical staff. This is different from the standard lab PCR test, where samples are sent to a central lab and processed by professional staff. Although data support the speed and accuracy of POCT kits, there is still a lack of insight into hospital care and its impact on infection.

To tackle COVID-19, it is important to reduce diagnosis time because patients can be isolated quickly and treatment can be started immediately. In addition, rapid case identification allows patients to avoid evaluation areas, reducing the need for bed decontamination and reducing staff exposure.

As the hospital prepares for the second wave of the pandemic, a quick examination of suspected COVID-19 cases will be the key to containing and preventing the hospital from being overwhelmed.

“Our findings first suggest the clinical benefits of the Molecular Point of Care COVID-19 test in hospitals, showing delays, bed movements, and time savings in the evaluation area, all better infections. It leads to management, “says Dr. Tristan William Clark, lead author of Southampton General Hospital, UK. “We believe there is an urgent need to integrate molecular POCT into care pathways to reduce coronavirus infections in hospitals and prevent the next wave of pandemic overwhelming medical services around the world.”

Non-randomized trials were conducted in the Acute Medical Unit and Emergency Department of Southampton General Hospital and included adults with COVID-19 symptoms.

Nose and throat swabs were taken from all patients and tested for SARS-CoV-2 virus infection. Approximately half of patients (499/1054) use a kit called the QIAstat-Dx Respiratory SARS-CoV-2 panel to detect SARS-CoV-2 and other respiratory organs at a dedicated hub for acute medical units. Tested using POCT. Viruses including influenza. They were also tested using standard laboratory PCR tests. The remaining control patients (555/1054) were tested using only standard PCR tests.

Of the 500 patients in the POCT group, 197 (39%) were found to be PCR-positive for SARS-CoV-2, whereas Control group..

The authors compared the time it took to receive results for the two tests. A secondary analysis, a planned outcome indicator that is less important than the primary outcome indicator but is still interested in assessing the effectiveness of interventions, examined infection control and diagnostic accuracy.

The median time to POCT results was 1.7 hours compared to 21.3 hours, and the difference remained large even after considering factors such as disease severity, age, and gender.

After the test, the patient was transferred to the final COVID positive or negative ward. This took 8 hours in the POCT group, 28.8 hours in the control group, 13.7% in the POCT group was transferred directly to the correct ward (bypassing the evaluation area), and 0% in the control group. The average number of bed movements from admission to arrival in the final ward was lower in the POCT group at 0.9 than in the control group at 1.4.

These improvements were seen without compromising diagnostic accuracy. The diagnostic accuracy of the 469 POCT tests was evaluated, with 99.4% sensitivity (176/177 participants) and 98.6% specificity (288/292 participants), surpassing central lab PCR (85.9%). I will. [152/177] Sensitivity and 98.9% [289/292] Specificity).

The findings provide evidence that SARS-CoV-2 POCT is feasible in the context of proper infection control and staff training. This study may inform patient diagnosis and containment decisions as the pandemic continues.

Most COVID-positive patients were enrolled in additional COVID-19 clinical trials conducted during the first wave (63% in the POCT group and 67% in the control group). Patients in the POCT group were enrolled in the clinical trial two days earlier than those in the PCR group, with a median waiting period of 1 to 3 days.

“Recruiting patients in clinical trials remains an international priority throughout this pandemic and is essential to accelerate the search for effective treatments,” says Dr. Clark. “This is especially true when researchers are investigating the potential of antiviral drugs. Antiviral drugs should be given in the early stages of the disease for maximum benefit.”

The authors found that the POCT group had more serious illnesses due to limitations in the study, especially the inability to randomize groups due to staffing, and differences in baseline measurements of many factors. It warns you that it is showing.They further warn that POCT should always be performed under proper conditions. Infection control Due to guidelines and trained staff, the findings may not extend to non-hospital environments.

Dr. Luke Moore of the Chelsea and Westminster Hospital NHS Foundation Trust (UK), who was not involved in the study, said in a linked comment: CoV-2 turnaround time leads to faster patient placement in the appropriate care area, reduced bed movement, and faster time to enroll in other COVID-19 clinical trials. These are all important benefits … Independent, positive, controlled, on-site assessment of respiratory virus diagnosis such as by Blendish et al. Is essential and will be added from this pandemic and beyond Point of Care platform. Further clear analysis of implementation and impact needs to be further promoted in order to best understand and utilize value. ”