Point of care molecular and antigen detection tests for COVID-19: current status and future prospects

ABSTRACT

Introduction

Detection of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) has been critical to support and management of the COVID-19 pandemic. Point of care testing (POCT) for SARS-CoV-2 has been a widely used tool for detection of SARS-CoV-2.

Areas covered

POCT nucleic acid amplification tests (NAATs) and rapid antigen tests (RATs) have been the most readily used POCT for SARS-CoV-2. Here, current knowledge on the utility of POCT NAATs and RATs for SARS-CoV-2 are reviewed and discussed alongside aspects of quality assurance factors that must be considered for successful and safe implementation of POCT.

Expert opinion

Use cases for implementation of POCT must be evidence based, regardless of the test used. A quality assurance framework must be in place to ensure accuracy and safety of POCT.

KEYWORDS:

• SARS-CoV-2
• POCT
• rapid antigen test
• COVID-19
• laboratory oversight
• quality assurance

Article highlights

• A quality assurance framework must be in place when POCT are implemented to ensure safety and accuracy.

• POCT NAAT and RAT are most sensitive in symptomatic individuals early in the course of disease.

• Speed, portability, and user-friendly design make rapid NAAT and RAT amenable to testing outside traditional laboratory environments and by non-laboratory trained individuals.

• POCT NAAT and RAT have shown utility in Emergency Department settings, providing fast result turnaround time, reducing wait times and patient isolation periods.

• POCT for COVID-19 have been helpful in determining eligibility for therapeutics, especially in situations where laboratory RT-PCR is not readily available.

• POCT NAAT and RAT must be closely monitored for changes in performance as new SARS-CoV-2 variants emerge.

Declaration of interests

Julie Shaw has sat on advisory boards for Abbott POCT. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewers disclosure

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was not funded.