Asymptomatic Testing of Hospital Admissions for SARS-CoV-2: Is it OK to Stop?

Brust, Karen; Kobayashi, Takaaki; Diekema, Daniel J.

doi:10.1093/cid/ciad423

Cited by 5 publications

(2 citation statements)

References 18 publications

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“…Most of the studies were retrospective observational analyses. Brust et al [63] could not find any prospective evaluations involving control units or hospitals.…”

Section: Sars-cov-2 Testing In Asymptomatic Patientsmentioning

confidence: 98%

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Non-Pharmacological Strategies and Interventions for Effective COVID-19 Control: A Narrative Review

Aho Glele,

de Rougemont

2023

JCM

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The COVID-19 pandemic had a devastating impact on the world, causing widespread illness and death. Focusing on prevention strategies to limit the spread of the disease remains essential. Despite the advent of vaccines, maintaining a vigilant approach to prevention remains paramount. We reviewed effective strategies to prevent COVID-19 transmission, including various prevention measures and interventions and both established practices and unresolved issues that have been addressed in meta-analyses, literature reviews, or in the health care context. Standard precautions are the cornerstone of infection control, with hand hygiene and mask use as key components. The use of surgical masks is recommended to prevent droplet transmission, while eye protection is recommended in combination with masks. In terms of room occupancy, ventilation is critical in reducing the risk of transmission in poorly ventilated environments. Chemical disinfection of indoor air with Triethylene glycol-based products can provide safe additional protection. Since viral RNA detection on surfaces does not necessarily indicate infectivity, the risk of transmission by surface contact remains low if surfaces are properly maintained and hand hygiene is practiced regularly. Thus, prevention of SARS-CoV-2 transmission requires a multifaceted approach, including reducing particle emissions from infected persons by wearing masks, eliminating aerosols by ventilation and air treatment, ensuring physical separation, and protecting exposed persons with masks and eye protection.

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“…Most of the studies were retrospective observational analyses. Brust et al [63] could not find any prospective evaluations involving control units or hospitals.…”

Section: Sars-cov-2 Testing In Asymptomatic Patientsmentioning

confidence: 98%

“…In their Viewpoint article, Brust et al [63] state that no increase in hospital-acquired COVID-19 has been documented since the discontinuation of admission testing. This statement is based on an analysis of the few published experiences with cessation of testing for SARS-CoV-2 in asymptomatic patients.…”

Section: Sars-cov-2 Testing In Asymptomatic Patientsmentioning

confidence: 99%

Non-Pharmacological Strategies and Interventions for Effective COVID-19 Control: A Narrative Review

Aho Glele,

de Rougemont

2023

JCM

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Acceptance of SARS-CoV-2 Surveillance Testing Among Patients Receiving Dialysis

Montez-Rath,

Varkila,

et al. 2024

JAMA Netw Open

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ImportanceIntegrating routine SARS-CoV-2 testing in dialysis facilities may benefit patients receiving dialysis by mitigating risks of serious illness and reducing transmission. Patient acceptance of nonmandatory testing is unknown.ObjectiveTo evaluate the acceptance of 2 SARS-CoV-2 testing strategies among patients in hemodialysis facilities nationwide.Design, Setting, and ParticipantsThis nationwide cluster (dialysis facility–level) randomized trial investigated the acceptance of SARS-CoV-2 testing among patients receiving maintenance hemodialysis at facilities located in 22 states.InterventionAnterior nares real-time reverse transcriptase-polymerase chain reaction tests offered once every 2 weeks (static testing facilities) vs offered once a week, once every 2 weeks, or once a month depending on county COVID-19 infection prevalence (dynamic testing facilities). Facilities were randomized by county, and tests were offered for 3 months between February 4 and July 24, 2023.Main Outcomes and MeasuresThe primary outcome was test acceptance. Secondary outcomes included the proportion of patients who accepted at least 1 test.ResultsIn total, 62 hemodialysis facilities were randomized and 57 participated. Among 2389 participating patients, the median age was 64 (IQR, 54-74) years, 1341 (56%) were male, 138 (6%) were categorized as American Indian, 60 (3%) Asian, 885 (37%) Black, 75 (3%) Native Hawaiian or Pacific Islander, 338 (14%) Hispanic, and 876 (37%) White; and 1603 (67%) had diabetes. A median of 6 (IQR, 6-6) tests were offered per patient in the static arm and 4 (3-6) tests in the dynamic arm. Test acceptance was low: 8% of offered tests were accepted in each of the test arms. Among 503 patients who accepted at least 1 test, the median percentage of offered tests that were accepted was 16% (IQR, 17%-42%) using the static testing strategy and 50% (IQR, 33%-75%) using the dynamic testing strategy (P &lt; .001). Older patients (odds ratio [OR], 1.08 [95% CI, 1.01-1.16] per 5-year age increment), patients with (vs without) diabetes (OR, 1.59 [95% CI, 1.18-2.16]), and women compared with men (OR, 1.30 [95% CI, 0.98-1.73]) were more likely to accept multiple tests. Patients designated in the electronic health record as Hispanic were more likely than patients designated as White (OR, 1.78 [95% CI, 1.15-2.76]) to accept at least 1 test, whereas patients living in zip codes electing Republican representatives to Congress were less likely than patients living in zip codes electing Democratic representatives (OR, 0.34 [95% CI, 0.17-0.69]) to accept multiple tests.Conclusions and RelevanceIn this cluster randomized trial evaluating 2 SARS-CoV-2 testing strategies in dialysis facilities, test acceptance was low, and a dynamic testing strategy anchored to COVID-19 infection prevalence did not outperform a static testing strategy of every 2 weeks.Trial RegistrationClinicalTrials.gov Identifier: NCT05225298

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