Evaluating the efficiency of specimen pooling for PCR-based detection of COVID-19 |
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Authors: | Supaporn Wacharapluesadee Thongchai Kaewpom Weenassarin Ampoot Siriporn Ghai Worrawat Khamhang Kanthita Worachotsueptrakun Phanni Wanthong Chatchai Nopvichai Thirawat Supharatpariyakorn Opass Putcharoen Leilani Paitoonpong Gompol Suwanpimolkul Watsamon Jantarabenjakul Pasin Hemachudha Artit Krichphiphat Rome Buathong Tanarak Plipat Thiravat Hemachudha |
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Affiliation: | 1. Thai Red Cross Emerging Infectious Diseases Health Science Centre, World Health Organization Collaborating Centre for Research and Training on Viral Zoonoses, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand;2. Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, 3. Thai Red Cross Emerging Infectious Diseases Clinical Centre, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand;4. Department of Pediatrics, Faculty of Medicine, 5. Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand |
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Abstract: | In the age of a pandemic, such as the ongoing one caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the world faces a limited supply of tests, personal protective equipment, and factories and supply chains are struggling to meet the growing demands. This study aimed to evaluate the efficacy of specimen pooling for testing of SARS-CoV-2 virus, to determine whether costs and resource savings could be achieved without impacting the sensitivity of the testing. Ten previously tested nasopharyngeal and throat swab specimens by real-time polymerase chain reaction (PCR), were pooled for testing, containing either one or two known positive specimens of varying viral concentrations. Specimen pooling did not affect the sensitivity of detecting SARS-CoV-2 when the PCR cycle threshold (Ct) of original specimen was lower than 35. In specimens with low viral load (Ct > 35), 2 of 15 pools (13.3%) were false negative. Pooling specimens to test for Coronavirus Disease 2019 infection in low prevalence (≤1%) areas or in low risk populations can dramatically decrease the resource burden on laboratory operations by up to 80%. This paves the way for large-scale population screening, allowing for assured policy decisions by governmental bodies to ease lockdown restrictions in areas with a low incidence of infection, or with lower-risk populations. |
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Keywords: | cost efficiency COVID-19 PCR real-time PCR SARS-CoV-2 specimen pooling |
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