SARS-CoV-2 screening in patients in need of urgent inpatient treatment in the Emergency Department (ED) by digitally integrated point-of-care PCR: a clinical cohort study

Abstract

Patients in need of urgent inpatient treatment were recruited prospectively. A rapid point of care polymerase chain reaction test (POC-PCR; Liat®) for SARS-CoV2 was conducted in the Emergency Department (ED) and a second PCR-test from the same swab was ordered in the central laboratory (PCR). POC-PCR analyzers were digitally integrated in the laboratory information system. Overall, 160 ED patients were included. A valid POC-PCR-test result was available in 96.3% (n = 154) of patients. N = 16 patients tested positive for Severe Acute Respiratory Syndrome-Corona Virus 2 (10.0%). The POC PCR test results were available within 102 minutes (median, interquartile range: 56-211), which was significantly earlier compared to the central laboratory PCR (811 minutes; interquartile range: 533-1289, P < 0.001). The diagnostic accuracy of the POC-PCR test was 100%. The implementation and digital laboratory information system integration was successfully done. Staff satisfaction with the POC process was high. The POC-PCR testing in the ED is feasible and shows a very high diagnostic performance. Trial registration: DRKS00019207.

Keywords: Critical interventions; Digital integration; Emergency Department; POC PCR; SARS-CoV-2.

Fig. 1

Process of the digitally integrated SARS-CoV-2 POC. ED = Emergency Department; POC = point-of-care.

Fig. 2

Patient flow diagram. For this implementation and feasibility study, n = 200 tests were available. CL = central laboratory; ED = Emergency Department; PCR = polymerase chain reaction; POC = point-of-care.