Pooled Testing Strategies for SARS-CoV-2 diagnosis: A comprehensive review

Diagn Microbiol Infect Dis. 2021 Oct;101(2):115432. doi: 10.1016/j.diagmicrobio.2021.115432. Epub 2021 May 17.

Abstract

SARS-CoV-2 has surged across the globe causing the ongoing COVID-19 pandemic. Systematic testing to facilitate index case isolation and contact tracing is needed for efficient containment of viral spread. The major bottleneck in leveraging testing capacity has been the lack of diagnostic resources. Pooled testing is a potential approach that could reduce cost and usage of test kits. This method involves pooling individual samples and testing them 'en bloc'. Only if the pool tests positive, retesting of individual samples is performed. Upon reviewing recent articles on this strategy employed in various SARS-CoV-2 testing scenarios, we found substantial diversity emphasizing the requirement of a common protocol. In this article, we review various theoretically simulated and clinically validated pooled testing models and propose practical guidelines on applying this strategy for large scale screening. If implemented properly, the proposed approach could contribute to proper utilization of testing resources and flattening of infection curve.

Keywords: COVID-19; Diagnosis; Pooled testing; RT-PCR; SARS-CoV-2; Sensitivity.

Publication types

  • Review

MeSH terms

  • COVID-19 / diagnosis
  • COVID-19 / epidemiology
  • COVID-19 Nucleic Acid Testing
  • Humans
  • Mass Screening
  • Reproducibility of Results
  • SARS-CoV-2 / genetics
  • SARS-CoV-2 / isolation & purification*
  • Sensitivity and Specificity
  • Specimen Handling*