Pooling of Samples for SARS-CoV-2 Detection Using a Rapid Antigen Test

Area of Science:

• Infectious Diseases
• Diagnostic Technologies
• Public Health Surveillance

Background:

• Reverse-transcription polymerase chain reaction (RT-PCR) is a common but costly COVID-19 diagnostic method.
• Pooled testing with RT-PCR has improved efficiency, but its application to antigen testing remains unevaluated.
• Current SARS-CoV-2 surveillance methods face limitations in cost and resource intensity.

Purpose of the Study:

• To evaluate the feasibility of pooled sample testing for SARS-CoV-2 antigen detection.
• To develop and validate a pooling strategy for antigen tests to enhance surveillance capabilities.
• To assess the potential of this method for low-resource settings and mass screening.

Main Methods:

• A proof-of-concept laboratory study was designed to test pooled nasal swab specimens.
• Multiple individual nasal swab samples (up to 20) were combined into single pools.
• The pooled samples were then tested using antigen detection assays to identify SARS-CoV-2 presence.

Main Results:

• Pooling up to 20 nasal swab specimens per pool demonstrated effective SARS-CoV-2 detection.
• The pooling strategy remained sensitive even when a pool contained only a single positive sample.
• This method showed potential for expanding surveillance capacity with antigen tests.

Conclusions:

• Pooled antigen testing offers a cost-effective and efficient approach to SARS-CoV-2 surveillance.
• This strategy can significantly broaden the reach of diagnostic testing in schools, workplaces, and low-to-middle income countries.
• Further implementation of pooled antigen testing can improve global public health response to pandemics.