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- Brendish NJ
- Poole S
- Naidu VV
- et al.
The reduction in response times in the point-of-care test group was impressive, especially considering that 6 months later over 10% of patients in UK hospitals still have to wait more than 24 hours for severe acute respiratory syndrome coronavirus 2 ( SARS-CoV -2) PCR test results.
Weekly statistics for NHS Test and Trace (England) and coronavirus (UK): 15 October to 21 October.
We agree that rapid diagnostics offer numerous benefits, but a substantial challenge remains in optimal implementation. In our hospital (Homerton University Hospital, London, UK) we had access to another rapid diagnostic PCR (Cepheid Xpert Xpress SARS-CoV-2; Cepheid, Sunnyvale, CA, USA) which likewise provides results within 1 hour . Compared to the study by Brendish and colleagues, where point-of-care testing was available to all patients upon admission to hospital, we used the physician-prompted rapid test, for example, to inform a specific cohort decision. of the patient or if there was substantial diagnostic uncertainty.
- Kucirka LM
- Lauer SA
- Laeyendecker O
- Boon D
- Lessler J
False negatives guide patient management based on clinical grounds. In the study by Brendish and colleagues, 13% of patients in each group were transferred to a definitive area (i.e., a designated COVID-19 negative or COVID-19 positive ward) with no results, or the clinical decision was made to ignore the test result. It is likely that all test results will need to be combined with additional parameters to estimate the true risk of infection.
- Brendish NJ
- Poole S
- Naidu VV
- et al.
Although more treatments are now available, the patients most likely to benefit from specific treatments for COVID-19 are those with a more severe disease, and therefore are likely to be treated empirically as well.
- Rao SN
- Manissero D
- Steele VR
- Couple J
,
- Pujadas E
- Chaudhry F
- McBride R
- et al.
because the rapid test could be used for early prognosis.
Finally, the cost-effectiveness of using rapid diagnostics such as these, which are substantially more expensive than laboratory batch-based PCR tests, must be weighed and is particularly relevant because the main benefits of such tests are improved flow. of the patient rather than nature.
We do not declare competing interests.
References
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Clinical Impact of the In-Hospital Suspected COVID-19 Point-of-Care Molecular Test (COV-19POC): A prospective, interventional, non-randomized, controlled study.
Lancet Respir Med. 2020; ()
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Weekly statistics for NHS Test and Trace (England) and coronavirus (UK): 15 October to 21 October.
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Change in False Negative Rate of SARS-CoV-2 Reverse Transcriptase Polymerase Chain Reaction Tests based on Time Elapsed since Exposure.
Ann Intern Med. 2020; 173: 262-267
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SARS-CoV-2 Viral Load Predicts COVID-19 Mortality.
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Article information
History of the publication
Published: 12 November 2020
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DOI: https://doi.org/10.1016/S2213-2600(20)30526-9
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© 2020 Elsevier Ltd. All rights reserved.
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