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Real-world evaluation of COVID-19 lateral flow device (LFD) mass-testing in healthcare workers at a London hospital; a prospective cohort analysis
- Source :
- The Journal of Infection
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Objectives Real-world evaluation of the performance of the Innova lateral flow immunoassay antigen device (LFD) for regular COVID-19 testing of hospital workers. Methods This prospective cohort analysis took place at a London NHS Trust. 5076 secondary care healthcare staff participated in LFD testing from 18 November 2020 to21 January 2021. Staff members submitted results and symptoms via an online portal twice weekly. Individuals with positive LFD results were invited for confirmatory SARS CoV-2 PCR testing. The positive predictive value (PPV) of the LFD was measured. Secondary outcome measures included time from LFD result to PCR test and staff symptom profiles. Results 284/5076 individuals reported a valid positive LFD result, and a paired PCR result was obtained in 259/284 (91.2%). 244 were PCR positive yielding a PPV of 94.21% (244/259, 95% CI 90.73% to 96.43%). 204/259 (78.8%) staff members had the PCR within 36 hours of the LFD test. Symptom profiles were confirmed for 132/244 staff members (54.1%) with positive PCR results (true positives) and 13/15 (86.6%) with negative PCR results (false positives). 91/132 true positives (68.9%) were symptomatic at the time of LFD testing: 65/91 (71.4%) had symptoms meeting the PHE case definition of COVID-19, whilst 26/91 (28.6%) had atypical symptoms. 18/41 (43.9%) staff members who were asymptomatic at the time of positive LFD developed symptoms in the subsequent four days. 9/13 (76.9%) false positives were asymptomatic, 1/13 (7.7%) had atypical symptoms and 3/13 (23.1%) had symptoms matching the PHE case definition. Conclusions The PPV of the Innova LFD is high when used amongst hospital staff during periods of high prevalence of COVID-19, yet we find frequent use by symptomatic staff rather than as a purely asymptomatic screening tool. LFD testing does allow earlier isolation of infected workers and facilitates detection of individuals whose symptoms do not qualify for PCR testing.
- Subjects :
- Microbiology (medical)
medicine.medical_specialty
Coronavirus disease 2019 (COVID-19)
Health Personnel
Lateral flow assay
Microbiology
Asymptomatic
Cohort Studies
COVID-19 Testing
Internal medicine
London
Health care
False positive paradox
medicine
Lateral flow tests
Humans
Prospective Studies
Prospective cohort study
Letter to the Editor
Diagnostics
High prevalence
SARS-CoV-2
business.industry
COVID-19
food and beverages
1103 Clinical Sciences
Inova
Hospitals
Infectious Diseases
Point-of-care
medicine.symptom
business
Cohort study
Lateral flow immunoassay
Subjects
Details
- ISSN :
- 01634453
- Volume :
- 83
- Database :
- OpenAIRE
- Journal :
- Journal of Infection
- Accession number :
- edsair.doi.dedup.....b78effd4d554ff7f7b46b9fa8a4aa8f0