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. Graphical Abstract Highlights Point of care (POC) test highly sensitive and specific against RT-PCR Time to result 2.6 h for POC versus 26.4 h for standard lab RT-PCR SARS-CoV-2 POC test reduces median time-to-bed placement by ∼6 h SARS-CoV-2 POC improves indices of hospital functioning and patient care Collier et al. report testing and implementation of an accurate SARS-CoV-2 point of care nucleic acid amplification test that leads to faster time to definitive bed placement from the ER, release of isolation rooms, avoidance of bed closures, and expedited discharges to care homes and access to hospital investigations and procedures.
【저자키워드】 COVID-19, SARS-CoV-2, infection control, POC, point of care, diagnostic test, nosocomial, 【초록키워드】 hospital, nasal, RT-PCR, discharge, nucleic acid, PCR testing, NAAT, implementation, nucleic acid amplification testing, Isolation, nucleic acid amplification test, nucleic acid amplification, swabbing, Admission, Care, POC test, leads, Patient care, 95% CI, RT-PCR testing, median time, avoidance, participant, Cohen’s κ correlation, isolation rooms, nosocomial spread, POC testing, rapid SARS-CoV-2 testing, positive, mitigate, lab, time, limit, IMPROVE, median, increase, faster, reduce, IQR, Point, the median, 【제목키워드】 Testing, validation, clinical, acid, Point,