Rational use of SARS-CoV-2 polymerase chain reaction tests within institutions caring for the vulnerable
File(s)
Author(s)
Yates, T
Cooke, G
MacPherson, P
Type
Journal Article
Abstract
Institutions such as hospitals and nursing or long-stay residential homes accommodate individuals at considerable risk of mortality should they acquire SARS-CoV-2 infection. In these settings, polymerase chain reaction tests play a central role in infection prevention and control. Here, we argue that both false negative and false positive tests are possible and that careful consideration of the prior probability of infection and of test characteristics are needed to prevent harm. We outline evidence suggesting that regular systematic testing of asymptomatic and pre-symptomatic individuals could play an important role in reducing transmission of SARS-CoV-2 within institutions. We discuss how such a programme might be organised, arguing that frequent testing and rapid reporting of results are particularly important. We highlight studies demonstrating that polymerase chain reaction testing of pooled samples can be undertaken with acceptable loss of sensitivity, and advocate such an approach where test capacity is limited. We provide an approach to calculating the most efficient pool size. Given the current limitations of tests for SARS-CoV-2 infection, physical distancing and meticulous infection prevention and control will remain essential in institutions caring for vulnerable people.
Date Issued
2020-07-02
Date Acceptance
2020-06-24
ISSN
2046-1402
Publisher
F1000 Research Ltd
Start Page
1
End Page
13
Journal / Book Title
F1000Research
Volume
9
Issue
671
Copyright Statement
© 2020 Yates TA et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Sponsor
National Institute for Health Research
National Institute for Health Research
Identifier
https://f1000research.com/articles/9-671/v1
Grant Number
ACF-2018-21-007
RP-2016-07-012
Subjects
COVID-19
Clinical Diagnostics
Epidemiology
Infection Prevention and Control
SARS Coronavirus 2
Betacoronavirus
COVID-19
COVID-19 Testing
Clinical Laboratory Techniques
Coronavirus Infections
False Negative Reactions
False Positive Reactions
Hospitals
Humans
Nursing Homes
Pandemics
Pneumonia, Viral
Polymerase Chain Reaction
SARS-CoV-2
Humans
Pneumonia, Viral
Coronavirus Infections
False Negative Reactions
False Positive Reactions
Clinical Laboratory Techniques
Polymerase Chain Reaction
Hospitals
Nursing Homes
Pandemics
Betacoronavirus
COVID-19
SARS-CoV-2
COVID-19 Testing
0601 Biochemistry and Cell Biology
1103 Clinical Sciences
1112 Oncology and Carcinogenesis
Publication Status
Published
Date Publish Online
2020-07-02