Detection of SARS-CoV-2 through pool testing for COVID-19: an integrative review

Costa, Murilo Soares; Guimarães, Nathália Sernizon; Andrade, André Barbosa de; Vaz-Tostes, Luiza Passini; Oliveira, Rhuan Braga; Simões, Madara da Silva; Gelape, Gabriel de Oliveira; Alves, Cláudia Regina Lindgren; Machado, Elaine Leandro; Fonseca, Flávio Guimarães da; Teixeira, Santuza Maria Ribeiro; Sato, Hugo Itaru; Takahashi, Ricardo H. C.; Tupinambás, Unaí

doi:10.1590/0037-8682-0276-2021

Cited by 5 publications

(6 citation statements)

References 42 publications

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“…For this purpose, the use of POC‐based real‐time RT‐PCR tests in addition to the conventional‐type platform may provide rapid, sensitive, and specific SARS‐CoV‐2 detection, 23 and the pooled‐specimen screening strategy is an effective way to increase testing capacity and save substantial resources, making laboratory diagnosis sustainable. 24 …”

Section: Discussionmentioning

confidence: 99%

“…For this purpose, the use of POC-based real-time RT-PCR tests in addition to the conventional-type platform may provide rapid, sensitive, and specific SARS-CoV-2 detection, 23 and the pooled-specimen screening strategy is an effective way to increase testing capacity and save substantial resources, making laboratory diagnosis sustainable. 24 In this study, we comprehensively evaluated the performance of one dual-target conventional and two POC real-time RT-PCR tests for the detection of SARS-CoV-2 from nasopharyngeal or oropharyngeal specimens in either a separate or a 5-specimen pooling manner. Xpert Xpress and cobas Liat are two of the rapid real-time…”

Section: Discussionmentioning

confidence: 99%

“…Early identification of these hidden individuals before they can further transmit SARS‐CoV‐2 to other susceptible people can have a very large positive impact on the development of surge epidemics. For this purpose, the use of POC‐based real‐time RT‐PCR tests in addition to the conventional‐type platform may provide rapid, sensitive, and specific SARS‐CoV‐2 detection, 23 and the pooled‐specimen screening strategy is an effective way to increase testing capacity and save substantial resources, making laboratory diagnosis sustainable 24 …”

Section: Discussionmentioning

confidence: 99%

“…85 to 938 copies/mL (Ct values of[23][24][25][26][27][28][29][30][31][32][33][34][35] could also be correctly identified by Xpert Xpress, although the tested sample number was only 5 29. In this study, 5-specimen pooling showed an increase in the Ct value of 1.7-2.0 in conventional real-time RT-PCR, 2.5-2.8 in Xpert Xpress and 1.8 in cobas Liat.…”

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confidence: 99%

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Evaluation of conventional and point‐of‐care real‐time RT‐PCR tests for the detection of SARS‐CoV‐2 through a pooled testing strategy

Liu

2022

Clinical Laboratory Analysis

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Background The rapid identification and isolation of individuals infected with SARS‐CoV‐2 are fundamental countermeasures for the efficient control of the COVID‐19 pandemic, which has affected millions of people around the world. Real‐time RT‐PCR is one of the most commonly applied reference methods for virus detection, and the use of pooled testing has been proposed as an effective way to increase the throughput of routine diagnostic tests. However, the clinical applicability of different types of real‐time RT‐PCR tests in a given group size remains inconclusive due to inconsistent regional disease prevalence and test demands. Methods In this study, the performance of one dual‐target conventional and two point‐of‐care real‐time RT‐PCR tests in a 5‐specimen pooled testing strategy for the detection of SARS‐COV‐2 was evaluated. Results We demonstrated the proof of concept that all of these real‐time RT‐PCR tests could feasibly detect SARS‐CoV‐2 from nasopharyngeal and oropharyngeal specimens that contain viral RNA loads in the range of 3.48 × 10 5 to 3.42 × 10 2 copies/ml through pooled testing in a group size of 5 with overall positive percent agreement (pooling vs. individual testing) ranging from 100% to 93.75%. Furthermore, the two POC real‐time RT‐PCR tests exhibited comparable sensitivity to that of the dual‐target conventional one when clinical specimens were tested individually. Conclusion Our findings support the feasibility of using real‐time RT‐PCR tests developed as a variety of platforms in routine laboratory detection of suspected COVID‐19 cases through a pooled testing strategy that is beneficial to increasing the daily diagnostic capacity.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Evaluation of conventional and point‐of‐care real‐time RT‐PCR tests for the detection of SARS‐CoV‐2 through a pooled testing strategy

Liu

2022

Clinical Laboratory Analysis

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“…Pool testing is a method of grouping several samples to be analyzed in a single reaction test. Practical experience shows that countries that carried out massive testing campaigns were the most effective in controlling the pandemic [13]. Therefore, pool testing has become an appealing method that has been explored by many laboratories using RT-qPCR [13][14][15][16][17][18][19][20][21][22][23][24].…”

Section: Introductionmentioning

confidence: 99%

Practical considerations to establish a validated platform for pooled detection of SARS-CoV-2 by droplet digital PCR

et al. 2022

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Detection of SARS-CoV-2 has created an enormous workload for laboratories worldwide resulting in a restriction at the time of massive testing. Pool testing is a strategy that reduces time and costs. However, beyond the detection of infectious diseases in blood banks, this approach is rarely implemented in routine laboratories. Therefore, what was learned from the SARS-CoV-2 pool testing should represent an opportunity to increase diagnostic capabilities. The present work, carried out in the context of a diagnostic laboratory of a public hospital during the COVID-19 pandemic, represents a contribution to this end. The main limitation of pool testing is the risk of false negatives that could have been identified by individual tests. These limitations are the dilution of samples with a low virus load during pooling and that the integrity of the sample may be affected by the quality of the sample collection. Fortunately, both limitations coincide with the main strengths of droplet digital PCR (ddPCR). ddPCR is a third-generation PCR that splits the amplification into thousands of droplets that work in parallel, increasing sensitivity and resistance to inhibitors. Therefore, ddPCR is particularly useful for pool testing. Here we show how to factor between test sensitivity and savings in test time and resources. We have identified and optimized critical parameters for pool testing. The present study, which analyzed 1000 nasopharyngeal samples, showed that the pool testing could detect even a single positive sample with a CT value of up to 30 in pools of 34 samples. This test was performed using three different standard extraction methods, the simplest being heating only, which resulted in substantial savings of extraction reagents in addition to PCR reagents. Moreover, we show that pooling can be extended to use saliva, which is less invasive and allows self-collection, reducing the risk for health personnel.

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Evaluation of pooling strategy of SARS-CoV-2 RT-PCR in limited resources setting in Egypt at low prevalence

2023

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Sample pooling testing for SARS-COV-2 can be an effective tool in COVID-19 screening when resources are limited, yet it is important to assess the performance before implementation as pooling has its limitations. Our objective was to assess the efficacy of pooling samples for coronavirus 2019 (COVID-19) compared to an individual analysis by using commercial platforms for nucleic acid testing. A total of 2200 nasopharyngeal swabs for SARS-COV-2 were tested individually and in pools of 4, 8, and 10. The cycle threshold (Ct) values of the positive pooled samples were compared to their corresponding individual positive samples. In pool size 10 samples, an estimated increase of 3-Ct was obtained, which led to false negative results in low viral load positive samples. Pooling SARS COV-2 samples is an effective strategy of screening to increase laboratories’ capacity and reduce costs without affecting diagnostic performance. A pool size of 8 is recommended.

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Detection of SARS-CoV-2 through pool testing for COVID-19: an integrative review

Cited by 5 publications

References 42 publications

Evaluation of conventional and point‐of‐care real‐time RT‐PCR tests for the detection of SARS‐CoV‐2 through a pooled testing strategy

Evaluation of conventional and point‐of‐care real‐time RT‐PCR tests for the detection of SARS‐CoV‐2 through a pooled testing strategy

Practical considerations to establish a validated platform for pooled detection of SARS-CoV-2 by droplet digital PCR

Evaluation of pooling strategy of SARS-CoV-2 RT-PCR in limited resources setting in Egypt at low prevalence

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