ABSTRACT
Introduction: With the rapid spreading of the coronavirus (COVID-19) pandemic and the limited capacities of realtime reverse transcriptase-PCR (RT-PCR) at the laboratory level, there is an emerging need for rapid, point-of-care (POC), molecular testing in the Emergency Department (ED). Aims and objectives: To compare the diagnostic performance of ID NOW COVID-19 assay (Abbott, Chicago, Il, USA) performed by ED doctors with a gold standard reference RT-PCR test (GeneXpert assay developed by Cepheid). Method(s): Paired nasopharyngeal swabs were collected from consecutive adult patients suspected of having COVID-19 in the ED of a tertiary hospital in Athens (Greece);the first swab was directly used for the ID NOW COVID-19 assay in POC by an emergency physician and the second was analyzed with reference RT-PCR by a central laboratory technician. Cohen's kappa was run to determine if there was sufficient agreement between the two diagnostic methods. Result(s): Seventy one consecutive patients (36 female, mean age 64.6) were enrolled in the present study from 15th January to 21th February, 2022. The two tests agreed on 20 positive and 50 negative results. On the contrary, ID NOW COVID-19 assay was found positive in one patient with a negative reference RT-PCR test. There was very good agreement between the two diagnostic methods [kappa = 0.966 (95% CI, 0.900 to 1.032), p < 0.0001]. Conclusion(s): Comparison of a POC and a standard laboratory RT-PCR test in an ED patient population yielded high positive (95%) and negative percent agreement (100%). ID NOW COVID-19 assay seems to be a highly reliable POC test for early screening and triage of suspected COVID-19 patients.