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Achenbach CJ, Caputo M, Hawkins C, Balmert LC, Qi C, Odorisio J, Dembele E, Jackson A, Abbas H, Frediani JK, Levy JM, Rebolledo PA, Kempker RR, Esper AM, Lam WA, Martin GS, Murphy RL. Clinical evaluation of the Diagnostic Analyzer for Selective Hybridization (DASH): A point-of-care PCR test for rapid detection of SARS-CoV-2 infection. PLoS One 2022; 17:e0270060. [PMID: 35709204 PMCID: PMC9202852 DOI: 10.1371/journal.pone.0270060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 06/02/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND An ideal test for COVID-19 would combine the sensitivity of laboratory-based PCR with the speed and ease of use of point-of-care (POC) or home-based rapid antigen testing. We evaluated clinical performance of the Diagnostic Analyzer for Selective Hybridization (DASH) SARS-CoV-2 POC rapid PCR test. METHODS We conducted a cross-sectional study of adults with and without symptoms of COVID-19 at four clinical sites where we collected two bilateral anterior nasal swabs and information on COVID-19 symptoms, vaccination, and exposure. One swab was tested with the DASH SARS-CoV-2 POC PCR and the second in a central laboratory using Cepheid Xpert Xpress SARS-CoV-2 PCR. We assessed test concordance and calculated sensitivity, specificity, negative and positive predictive values using Xpert as the "gold standard". RESULTS We enrolled 315 and analyzed 313 participants with median age 42 years; 65% were female, 62% symptomatic, 75% had received ≥2 doses of mRNA COVID-19 vaccine, and 16% currently SARS-CoV-2 positive. There were concordant results for 307 tests indicating an overall agreement for DASH of 0.98 [95% CI 0.96, 0.99] compared to Xpert. DASH performed at 0.96 [95% CI 0.86, 1.00] sensitivity and 0.98 [95% CI 0.96, 1.00] specificity, with a positive predictive value of 0.85 [95% CI 0.73, 0.96] and negative predictive value of 0.996 [95% CI 0.99, 1.00]. The six discordant tests between DASH and Xpert all had high Ct values (>30) on the respective positive assay. DASH and Xpert Ct values were highly correlated (R = 0.89 [95% CI 0.81, 0.94]). CONCLUSIONS DASH POC SARS-CoV-2 PCR was accurate, easy to use, and provided fast results (approximately 15 minutes) in real-life clinical settings with an overall performance similar to an EUA-approved laboratory-based PCR.
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Affiliation(s)
- Chad J. Achenbach
- Havey Institute for Global Health, Feinberg School of Medicine, Northwestern University, Evanston, IL, United States of America
- Department of Medicine, Division of Infectious Diseases, Feinberg School of Medicine, Northwestern University, Evanston, IL, United States of America
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Evanston, IL, United States of America
| | - Matthew Caputo
- Havey Institute for Global Health, Feinberg School of Medicine, Northwestern University, Evanston, IL, United States of America
| | - Claudia Hawkins
- Havey Institute for Global Health, Feinberg School of Medicine, Northwestern University, Evanston, IL, United States of America
- Department of Medicine, Division of Infectious Diseases, Feinberg School of Medicine, Northwestern University, Evanston, IL, United States of America
| | - Lauren C. Balmert
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Evanston, IL, United States of America
| | - Chao Qi
- Department of Pathology, Northwestern University, Evanston, IL, United States of America
| | - Joseph Odorisio
- Havey Institute for Global Health, Feinberg School of Medicine, Northwestern University, Evanston, IL, United States of America
| | - Etienne Dembele
- Havey Institute for Global Health, Feinberg School of Medicine, Northwestern University, Evanston, IL, United States of America
| | - Alema Jackson
- Access Community Health Network, Chicago, IL, United States of America
| | - Hiba Abbas
- Access Community Health Network, Chicago, IL, United States of America
| | - Jennifer K. Frediani
- Atlanta Center for Microsystems Engineered Point-of-Care Technologies, Atlanta, GA, United States of America
- Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, GA, United States of America
| | - Joshua M. Levy
- Atlanta Center for Microsystems Engineered Point-of-Care Technologies, Atlanta, GA, United States of America
- Emory University Department of Otolaryngology, Atlanta, GA, United States of America
| | - Paulina A. Rebolledo
- Atlanta Center for Microsystems Engineered Point-of-Care Technologies, Atlanta, GA, United States of America
- Emory University Division of Infectious Diseases, Atlanta, GA, United States of America
| | - Russell R. Kempker
- Atlanta Center for Microsystems Engineered Point-of-Care Technologies, Atlanta, GA, United States of America
- Emory University Division of Infectious Diseases, Atlanta, GA, United States of America
| | - Annette M. Esper
- Atlanta Center for Microsystems Engineered Point-of-Care Technologies, Atlanta, GA, United States of America
- Emory University Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Atlanta, GA, United States of America
| | - Wilbur A. Lam
- Atlanta Center for Microsystems Engineered Point-of-Care Technologies, Atlanta, GA, United States of America
- Emory University Department of Pediatrics, Atlanta, GA, United States of America
| | - Greg S. Martin
- Atlanta Center for Microsystems Engineered Point-of-Care Technologies, Atlanta, GA, United States of America
- Emory University Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Atlanta, GA, United States of America
| | - Robert L. Murphy
- Havey Institute for Global Health, Feinberg School of Medicine, Northwestern University, Evanston, IL, United States of America
- Department of Medicine, Division of Infectious Diseases, Feinberg School of Medicine, Northwestern University, Evanston, IL, United States of America
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Achenbach CJ, Caputo M, Hawkins C, Balmert LC, Qi C, Odorisio J, Dembele E, Jackson A, Abbas H, Frediani JK, Levy JM, Rebolledo PA, Kempker RR, Esper AM, Lam WA, Martin GS, Murphy RL. Clinical evaluation of the Diagnostic Analyzer for Selective Hybridization (DASH): a point-of-care PCR test for rapid detection of SARS-CoV-2 infection. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.01.24.22269785. [PMID: 35118476 PMCID: PMC8811909 DOI: 10.1101/2022.01.24.22269785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
BACKGROUND Rapid and accurate testing for SARS-CoV-2 is an essential tool in the medical and public health response to the COVID-19 pandemic. An ideal test for COVID-19 would combine the sensitivity of laboratory-based PCR combined with the speed and ease of use of point-of-care (POC) or home-based rapid antigen testing. METHODS To evaluate the performance of the Diagnostic Analyzer for Selective Hybridization (DASH) SARS-CoV-2 POC PCR (sample insertion to result time of 16 minutes), we conducted a cross-sectional study of adults with and without symptoms of COVID-19 at four clinical sites. We collected two bilateral anterior nasal swabs from each participant and information on COVID-19 symptoms, vaccination, and exposure. One swab was tested with the DASH SARS-CoV-2 POC PCR and the second in a central laboratory using Cepheid Xpert Xpress SARS-CoV-2 PCR. We assessed test concordance and calculated sensitivity, specificity, negative and positive predictive values using Xpert as the "gold standard." RESULTS We enrolled 315 and analyzed 313 participants with median age 42 years; 65% were female, 62% symptomatic, 75% had received ≥2 doses of mRNA COVID-19 vaccine, and 16% currently COVID-19 positive. There were concordant results for 307 tests indicating an overall agreement for DASH of 0.98 [95% CI 0.96, 0.99] compared to Xpert. DASH performed at 0.96 [95% CI 0.86, 1.00] sensitivity and 0.98 [95% CI 0.96, 1.00] specificity, with a positive predictive value of 0.85 [95% CI 0.73, 0.96] and negative predictive value of 0.996 [95% CI 0.99, 1.00]. The six discordant tests between DASH and Xpert all had high Ct values (>30) on the respective positive assay. DASH and Xpert Ct values were highly correlated (R=0.89 [95% CI 0.81, 0.94]). CONCLUSIONS DASH POC SARS-CoV-2 PCR was accurate, easy to use, and provided fast results in real-life clinical settings with an overall performance similar to an EUA-approved laboratory-based PCR. Its compact design and ease of use are optimal for a variety of healthcare, and potentially community settings, including areas with lack of access to central laboratory-based PCR testing. SUMMARY DASH is an accurate, easy to use, and fast point-of-care test with applications for diagnosis and screening of SARS-CoV-2 infection.
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Affiliation(s)
- Chad J Achenbach
- Havey Institute for Global Health, Feinberg School of Medicine, Northwestern University
- Department of Medicine, Division of Infectious Diseases, Feinberg School of Medicine, Northwestern University
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University
| | - Matthew Caputo
- Havey Institute for Global Health, Feinberg School of Medicine, Northwestern University
| | - Claudia Hawkins
- Havey Institute for Global Health, Feinberg School of Medicine, Northwestern University
- Department of Medicine, Division of Infectious Diseases, Feinberg School of Medicine, Northwestern University
| | - Lauren C Balmert
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University
| | - Chao Qi
- Department of Pathology, Northwestern University
| | - Joseph Odorisio
- Havey Institute for Global Health, Feinberg School of Medicine, Northwestern University
| | - Etienne Dembele
- Havey Institute for Global Health, Feinberg School of Medicine, Northwestern University
| | | | | | - Jennifer K Frediani
- Atlanta Center for Microsystems Engineered Point-of-Care Technologies
- Emory University Nell Hodgson Woodruff School of Nursing
| | - Joshua M Levy
- Atlanta Center for Microsystems Engineered Point-of-Care Technologies
- Emory University Department of Otolaryngology
| | - Paulina A Rebolledo
- Atlanta Center for Microsystems Engineered Point-of-Care Technologies
- Emory University Division of Infectious Diseases
| | - Russell R Kempker
- Atlanta Center for Microsystems Engineered Point-of-Care Technologies
- Emory University Division of Infectious Diseases
| | - Annette M Esper
- Atlanta Center for Microsystems Engineered Point-of-Care Technologies
- Emory University Division of Pulmonary, Allergy, Critical Care and Sleep Medicine
| | - Wilbur A Lam
- Atlanta Center for Microsystems Engineered Point-of-Care Technologies
- Emory University Department of Pediatrics
| | - Greg S Martin
- Atlanta Center for Microsystems Engineered Point-of-Care Technologies
- Emory University Division of Pulmonary, Allergy, Critical Care and Sleep Medicine
| | - Robert L Murphy
- Havey Institute for Global Health, Feinberg School of Medicine, Northwestern University
- Department of Medicine, Division of Infectious Diseases, Feinberg School of Medicine, Northwestern University
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