Effects of Different SARS-CoV-2 Testing Strategies in the Emergency Department on Length of Stay and Clinical Outcomes: A Randomised Controlled Trial

The turn-around-time (TAT) of diagnostic and screening measures such as testing for SARS-CoV-2 can affect a patient’s length of stay (LOS) in the hospital as well as the emergency department (ED). This, in turn, can affect clinical outcomes. Therefore, a reliable and time-efficient SARS-CoV-2 testin...

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Bibliographic Details
Published in:The Canadian journal of infectious diseases & medical microbiology 2024-02, Vol.2024, p.9571236-12
Main Authors: Boldt, Kira Louisa, Bolanaki, Myrto, Holert, Fabian, Fischer-Rosinský, Antje, Slagman, Anna, Möckel, Martin
Format: Article
Language:English
Subjects:
Admission and discharge
Antigens
Clinical outcomes
Clinical trials
COVID-19
Emergency medical care
Emergency medical services
Emergency service
Evaluation
Hospitals
Informed consent
Laboratories
Length of stay
Nosocomial infections
Pandemics
Patients
Polymerase chain reaction
Reverse transcription
Severe acute respiratory syndrome coronavirus 2
Viral infections
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Summary:The turn-around-time (TAT) of diagnostic and screening measures such as testing for SARS-CoV-2 can affect a patient’s length of stay (LOS) in the hospital as well as the emergency department (ED). This, in turn, can affect clinical outcomes. Therefore, a reliable and time-efficient SARS-CoV-2 testing strategy is necessary, especially in the ED. In this randomised controlled trial, n = 598 ED patients presenting to one of three university hospital EDs in Berlin, Germany, and needing hospitalisation were randomly assigned to two intervention groups and one control group. Accordingly, different SARS-CoV-2 testing strategies were implemented: rapid antigen and point-of-care (POC) reverse transcription polymerase chain reaction (rtPCR) testing with the Roche cobas® Liat® (LIAT) (group one n = 198), POC rtPCR testing with the LIAT (group two n = 197), and central laboratory rtPCR testing (group three, control group n = 203). The median LOS in the hospital as an inpatient across the groups was 7 days. Patients’ LOS in the ED of more than seven hours did not differ significantly, and furthermore, no significant differences were observed regarding clinical outcomes such as intensive care unit stay or death. The rapid and POC test strategies had a significantly (p
ISSN:1712-9532
1918-1493
DOI:10.1155/2024/9571236