Abstract
To minimize sample dilution effect on SARS-CoV-2 pool testing, we assessed analytical and diagnostic performance of a new methodology, namely swab pooling. In this method, swabs are pooled at the time of collection, as opposed to pooling of equal volumes from individually collected samples. Paired analysis of pooled and individual samples from 613 patients revealed 94 positive individuals. Having individual testing as reference, no false-positives or false-negatives were observed for swab pooling. In additional 18,922 patients screened with swab pooling (1,344 pools), mean Cq differences between individual and pool samples ranged from 0.1 (Cr.I. -0.98 to 1.17) to 2.09 (Cr.I. 1.24 to 2.94). Overall, 19,535 asymptomatic patients were screened using 4,400 RT-qPCR assays. This corresponds to an increase of 4.4 times in laboratory capacity and a reduction of 77% in required tests. Therefore, swab pooling represents a major alternative for reliable and large-scale screening of SARS-CoV-2 in low prevalence populations.
Highlights
The COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has dramatically impacted public health worldwide in the year of 2020 [1, 2]
The dilution factor is equal to the number of individual samples within a pool, yielding expected mean cycle quantification (Cq) differences of at least 3.32 Cq and as high as 7.37 Cq depending on the number of pooled samples and the amplification efficiency
Pool testing has gained importance to fight the COVID-19 pandemic, as challenges involving cost and logistics are at the core of shared struggles to promote large-scale screenings worldwide [10]
Summary
The COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has dramatically impacted public health worldwide in the year of 2020 [1, 2]. Rapid identification and isolation of infected individuals is essential, but this can be challenging given the infectious potential of both asymptomatic and presymptomatic cases [3, 4]. In this scenario, massive population SARS-CoV-2 testing is an urgent need to allow the isolation of infected individuals and, the pandemic control. Swab pooling for SARS-CoV-2 screening the form of salaries for authors [APC, GNFC, AFR, DRB, DCB, LEY and LFVO], and helped in the sample collection process, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section
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