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The following is a summary of “Can self-testing be enhanced to hasten safe return of healthcare workers in pandemics? Random order, open label trial using two manufacturers’ SARS-CoV-2 lateral flow devices concurrently and nested viral culture study,” published in the November 2024 issue of Infectious Disease by Zhang et al.
The COVID-19 pandemic necessitated balancing patient safety against staff shortages, exacerbated by the Omicron variant, which led to critical worker absences worldwide.
Researchers conducted a retrospective study to evaluate the combined efficacy of 2 lateral flow tests (LFT) Omicron detection and the viral shedding potential of healthcare workers with infection after a 5-day isolation period and examined the virus culture 5–7 days after a positive test.
They enrolled fully vaccinated Liverpool (UK) University Hospital staff in a randomized, open-label trial (February-May 2022) to assess the combined efficacy of Innova and Orient Gene LFTs for SARS-CoV-2 detection and user acceptability. Participants self-administered daily LFTs in randomized order for 10 days, completing a user-experience questionnaire. A subset provided swabs for viral culture on days 5-7 post-symptom onset or positive test, with positivity defined by cytopathic effect or N gene detection.
The results showed that 226 individuals reported 1,466 LFT pairs, with 8.7% disagreement. Orient Gene tests were more likely to be favorable than Innova (OR: 2.1, 1.1-4.1; P=0.03). Innova agreement was lower if swabbed second (OR: 2.7, 1.3-5.2; P=0.005). Orient Gene-positive, Innova-negative pairs increased over time (OR: 1.2, 1.1-1.3; P<0.001). Most participants found dual swabbing easy (90.7%) and non-disruptive (57.1%), gave more preference (65.6%), and felt more confident with dual test results. Viral cultures on days 5-7 were positive in 19.4% (6/31) and indeterminate in 35.5% (11/31) of LFT-positive participants, suggesting ongoing infectivity.
Investigators concluded that dual-brand LFTs improved SARS-CoV-2 detection and were well-tolerated, but early return-to-work policies post-Omicron infection were inadequate, highlighting the need for flexible self-testing strategies in future pandemics.
Source: bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-024-10155-z
