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Large-Scale SARS-CoV-2 Testing Utilizing Saliva and Transposition Sample Pooling
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Boosting test-efficiency by pooled testing for SARS-CoV-2-Formula for optimal pool size.

Rudolf Hanel1,2, Stefan Thurner1,2,3,4

  • 1Section for Science of Complex Systems, Medical University of Vienna, Vienna, Austria.

Plos One
|November 4, 2020
PubMed
Summary
This summary is machine-generated.

Pooling SARS-CoV-2 samples can significantly increase testing capacity during shortages. This study provides a formula to determine optimal pool sizes, maximizing efficiency and minimizing missed infections based on prevalence and PCR test accuracy.

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Area of Science:

  • Epidemiology
  • Infectious Diseases
  • Public Health

Background:

  • Healthcare systems face SARS-CoV-2 test shortages during pandemics.
  • Sample pooling offers a strategy to amplify testing capacity, especially at low infection prevalence.

Purpose of the Study:

  • To develop a formula for optimal pooled testing group sizes.
  • To estimate efficiency gains and the upper bound of missed infections in pooled SARS-CoV-2 testing.
  • To analyze the impact of population infection levels and PCR test characteristics on pooling effectiveness.

Main Methods:

  • Mathematical modeling to derive formulas for optimal pool size, efficiency gain, and missed infection rates.
  • Analysis as a function of population infection levels and false negative/positive rates of PCR tests.
  • Evaluation of the effect of using 1 to 5 replicates for pooled tests.

Main Results:

  • Optimal pool size decreases as infection prevalence increases (e.g., 34 at 0.1%, 11 at 1%, 4 at 10%).
  • Efficiency gains are substantial at low prevalence (e.g., 15x at 0.1% infection), diminishing significantly at higher prevalence.
  • Pooling provides no benefit at infection levels of 30% or higher.

Conclusions:

  • Sample pooling is an effective strategy to enhance SARS-CoV-2 testing capacity when infection rates are low.
  • The optimal pooling strategy is dynamic and depends heavily on the current prevalence of the virus in the population.
  • Careful consideration of test characteristics and replication is necessary to balance efficiency with the risk of missing infections.