Exploring Workplace Testing with Real-Time Polymerase Chain Reaction SARS-CoV-2 Testing

Abstract

Background: Molecular tests (i.e. RT-PCR) and antigen tests are currently used to detect SARS-CoV-2. RT-PCR tests are generally considered to be the gold standard for clinical diagnosis of SARS-CoV-2 due to their accuracy and reliability, but can take longer to return results than antigen tests. Objective: Examine if a point-of-care (POC) testing for SARS-CoV-2 infection would provide a flexible resource to help achieve workplace safety during this pandemic. Design: We compared the test results and time to test results between a POC RT-PCR test and a send-out PCR test for workplace screening in a workplace screening program implemented as part of the National Basketball Association (NBA) summer program in Orlando, Florida in the summer of 2020. Participants: We collected 978 samples from NBA support personnel at Disney World during the 2020 NBA Summer League subject to the NBA Universal Screening program. Main Measures: SARS-CoV-2 infection status as tested by the POC RT-PCR test and laboratory-based RT-PCR testing. Results: POC testing shorted the time to results to 110 minutes (SD 37 minutes) in the POC setting from the 754 minutes (SD 207 minutes) (p=0.00) for send-out tests. The specificity of Abstract POC RT-PCR single POC testing was 98.7% compared with send-out RT-PCR testing and was confirmed at 99.8% in a validation analysis. The sensitivity of the POC testing was 100% compared with send-out RT-PCR, although in a validation analysis, sensitivity appeared as 0% because only the 12 positive or indeterminate samples on the first analysis were retested and the majority were false-positives that were correctly ruled out. Conclusions: POC testing for SARS-CoV-2 with RT-PCR technology is possible at a greatly reduced time compared with send-out PCR testing.