PCR combined with serologic testing improves the yield and efficiency of SARS-CoV-2 infection hunting: A study in 40,689 consecutive overseas arrivals

Frontiers in Public Health

Public Health

Jian-Hui Zhu¹  Zhang Dai¹  Xian-Ming Liang¹  Yu Lin¹  Min-Jing Cai¹  Long-Can Jiang¹  Jing-Wen Zhang¹  Li-Li Fang² 

[1] Centre of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China;Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen, China;Department of Clinical Laboratory, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China;Xiamen Key Laboratory of Genetic Testing, School of Medicine, Xiamen University, Xiamen, China;

关键词: SARS-CoV-2;    serologic test;    PCR;    screening algorithm;    yield;    efficiency;   

DOI  :  10.3389/fpubh.2023.1077075

 received in 2022-10-22, accepted in 2023-01-17,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundThe global epidemiological situation of COVID-19 remains serious. The rapid hunting of SARS-CoV-2 infection is the key means for preventing transmission.MethodsA total of 40,689 consecutive overseas arrivals were screened for SARS-CoV-2 infection based on PCR and serologic testing. The yield and efficiency of different screening algorithms were evaluated.ResultAmong the 40,689 consecutive overseas arrivals, 56 (0.14%) subjects were confirmed to have SARS-CoV-2 infection. The asymptomatic rate was 76.8%. When the algorithm based on PCR alone was used, the identification yield of a single round of PCR (PCR1) was only 39.3% (95% CI: 26.1–52.5%). It took at least four rounds of PCR to achieve a yield of 92.9% (95% CI: 85.9–99.8%). Fortunately, an algorithm based on a single round of PCR combined with a single round of serologic testing (PCR1+ Ab1) greatly improved the screening yield to 98.2% (95% CI: 94.6–100.0%) and required 42,299 PCR and 40,689 serologic tests that cost 6,052,855 yuan. By achieving a similar yield, the cost of PCR1+ Ab1 was 39.2% of that of four rounds of PCR. For hunting one case in PCR1+ Ab1, 769 PCR and 740 serologic tests were required, costing 110,052 yuan, which was 63.0% of that of the PCR1 algorithm.ConclusionComparing an algorithm based on PCR alone, PCR combined with a serologic testing algorithm greatly improved the yield and efficiency of the identification of SARS-CoV-2 infection.

【 授权许可】

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Copyright © 2023 Fang, Zhu, Cai, Zhang, Jiang, Dai, Lin and Liang.