AUTHOR=Lancelot Moira , Fibben Kirby , Sullivan Julie , O’Sick William , McLendon Kaleb , Wu Huixia , Rao Anuradha , Bassit Leda C. , Greenleaf Morgan , Miller Pamela , Krull Wolfgang , Tyburski Erika , Roback John D. , Lam Wilbur A. , Damhorst Gregory L. TITLE=Effect of swab pooling on the Accula point-of-care RT-PCR for SARS-CoV-2 detection JOURNAL=Frontiers in Microbiology VOLUME=14 YEAR=2023 URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2023.1219214 DOI=10.3389/fmicb.2023.1219214 ISSN=1664-302X ABSTRACT=Introduction

Swab pooling may allow for more efficient use of point-of-care assays for SARS-CoV-2 detection in settings where widespread testing is warranted, but the effects of pooling on assay performance are not well described.

Methods

We tested the Thermo-Fisher Accula rapid point-of-care RT-PCR platform with contrived pooled nasal swab specimens.

Results

We observed a higher limit of detection of 3,750 copies/swab in pooled specimens compared to 2,250 copies/swab in individual specimens. Assay performance appeared worse in a specimen with visible nasal mucous and debris, although performance was improved when using a standard laboratory mechanical pipette compared to the transfer pipette included in the assay kit.

Conclusion

Clinicians and public health officials overseeing mass testing efforts must understand limitations and benefits of swab or sample pooling, including reduced assay performance from pooled specimens. We conclude that the Accula RT-PCR platform remains an attractive candidate assay for pooling strategies owing to the superior analytical sensitivity compared to most home use and point-of-care tests despite the inhibitory effects of pooled specimens we characterized.