How to design and implement a university-based COVID-19 testing programme? An evaluation of a novel RT-LAMP COVID-19 testing programme in a UK university.

BACKGROUND: Little is known about how asymptomatic testing as a method to control transmission of COVID-19 can be implemented, and the prevalence of asymptomatic infection within university populations. The objective of this study was to investigate how to effectively set-up and implement a COVID-19 testing programme using novel reverse transcriptase loop-mediated isothermal amplification (RT-LAMP) technology and to quantify the scale of asymptomatic infection on a university campus. METHODS: An observational study to describe the set-up and implementation of a novel COVID-19 testing programme on a UK university campus between September and December 2020. RT-LAMP testing was used to identify asymptomatic cases. RESULTS: A total of 1,673 tests were performed using RT-LAMP during the study period, of which 9 were positive for COVID-19, giving an overall positivity rate of 0.54%, equivalent to a rate in the tested population of 538 cases per 100,000 over the duration of testing. All positive tests were found to be positive on RT-PCR testing, giving a false positive rate of 0%. CONCLUSIONS: This study shows that it is possible to rapidly setup a universal university testing programme for COVID-19 in collaboration with local healthcare providers using RT-LAMP testing. Positive results were comparable to those in the local population, though with a different peak of infection. Further research to inform the design of the testing programme includes focus groups of those who underwent testing and further interrogation of the demographics of those opting to be tested to identify potential access problems or inequalities.

Design and implementation of a university-based COVID-19 testing programme: an observational study

Background Little is known about how asymptomatic testing as a method to control the transmission of COVID-19 can be successfully implemented, and the prevalence of asymptomatic infection within university populations. The aim of this study was to describe the methodology of implementing a novel asymptomatic mass testing programme, and to report the number of positive cases diagnosed during the study period. To our knowledge, this study is the first to report prevalence of asymptomatic COVID-19 infection within a UK university population using reverse transcriptase loop-mediated isothermal amplification (RT-LAMP) as a molecular diagnostic tool. Methods An observational study was undertaken to describe the set-up and implementation of a novel COVID-19 testing programme on a UK university campus between Sept 28 and Dec 18, 2020. Students and staff members volunteered for testing throughout the term. The programme used RT-LAMP testing to identify asymptomatic cases within the population. Any positive cases received RT-PCR testing to confirm the result using the current gold-standard testing methodology. Findings 1673 tests were done using RT-LAMP during the study period, of which nine were positive for COVID-19. This gave an overall positivity rate of 0·54%, equivalent to a rate in the tested population of 538 cases per 100 000 over the duration of testing. All positive tests were also found to be positive on RT-PCR testing, giving a false positive rate of 0%. Uptake was affected by changes to delivery of university teaching, leading to lower attendance on campus throughout the term. Interpretation This study shows that it is possible to rapidly set up a universal university testing programme for COVID-19 in collaboration with local health-care providers using RT-LAMP testing, with full concordance between RT-LAMP testing and RT-PCR testing on positive RT-LAMP results. Positive results were similar to those in the local population, although with a different weekly peak of infection. Funding None.

Cross-Reactive SARS-CoV-2 Neutralizing Antibodies From Deep Mining of Early Patient Responses.

Passive immunization using monoclonal antibodies will play a vital role in the fight against COVID-19. The recent emergence of viral variants with reduced sensitivity to some current antibodies and vaccines highlights the importance of broad cross-reactivity. This study describes deep-mining of the antibody repertoires of hospitalized COVID-19 patients using phage display technology and B cell receptor (BCR) repertoire sequencing to isolate neutralizing antibodies and gain insights into the early antibody response. This comprehensive discovery approach has yielded a panel of potent neutralizing antibodies which bind distinct viral epitopes including epitopes conserved in SARS-CoV-1. Structural determination of a non-ACE2 receptor blocking antibody reveals a previously undescribed binding epitope, which is unlikely to be affected by the mutations in any of the recently reported major viral variants including B.1.1.7 (from the UK), B.1.351 (from South Africa) and B.1.1.28 (from Brazil). Finally, by combining sequences of the RBD binding and neutralizing antibodies with the B cell receptor repertoire sequencing, we also describe a highly convergent early antibody response. Similar IgM-derived sequences occur within this study group and also within patient responses described by multiple independent studies published previously.