Rapid coronavirus test speeds up access to urgent care and will free up beds ahead of winter

The first analysis of a new point-of-care ânucleic acid testâ for SARS-CoV-2 in a UK hospital setting shows these machines dramatically reduce time spent on COVID-19 âholdingâ wards â allowing patients to be treated or discharged far quicker than with current lab testing set-ups.
The rapid diagnostic capability of SAMBA II devices â an average of 2.6 hours compared with 26.4 hours for standard lab tests â led to an increased availability of âisolation roomsâ needed for infected patients, as well as fewer hospital bay closures.
University of Cambridge researchers behind the new study, currently a pre-print and awaiting peer-review, say that the time and hospital capacity spared by these devices will be âcritical as we move towards autumn and winterâ.
The SAMBA II machine was developed by a University spinout company, Diagnostics in the Real World, and deployed for trials in Addenbrookeâs Hospital, part of Cambridge University Hospitals NHS Foundation Trust (CUH).
âThe backlog of routine operations and screenings as a result of the pandemic is a huge issue, and must be resolved ahead of winter, when the NHS will face even more pressure from other infections like norovirus and influenza,â said study lead author Professor Ravi Gupta.
âRapidly testing admissions for SARS-CoV-2 at the point of care is essential for reducing COVID-19 transmission in hospitals, speeding up access to urgent care and allowing safe discharge to care homes. It could make all the difference in a few monthsâ time.â
âUse of point-of-care testing would speed up the identification of patients for COVID-19 clinical trials, and receiving an experimental treatment a day earlier could make a clinical difference.â
âHospitals across the UK, as well as care homes and prisons, could benefit from SAMBA II devices,â said Gupta, from the Cambridge Institute of Therapeutic Immunology & Infectious Diseases (CITIID). âGiven the technological capital of the UK we should not be falling so short on rapid point-of-care testing.â
Standard tests are sent for analysis in central laboratories, where backlogs can see delays of two days or more. SAMBA machines can produce a diagnosis in as little as 90 minutes.
Dr Helen Lee, CEO of Diagnostics in the Real World, developed the SAMBA II technology while at Cambridgeâs Department of Haematology. The chemistry behind the machines has been used for on-the-spot HIV diagnostics across Africa.
The devices search for tiny traces of virus genetic code, and are extremely sensitive in the detection of active infections. Once nose and throat swabs have been loaded into a SAMBA machine, the process is fully automated, making them easy to use.
The initial âCOVIDxâ clinical study led by Gupta at Addenbrookeâs with 149 participants found SAMBA II had 96.9% sensitivity (accurate identification of positive cases) and 99.1% specificity (accurate identification of negative cases) compared to the standard lab test. It was also around 24 hours faster.
The success of the COVIDx study saw the hospital switch nearly all of its SARS-CoV-2 testing from the standard lab âRT-PCRâ tests over to the use of SAMBA II during May: an opportunity for a âreal-worldâ comparison and its effect on hospital functioning.
Gupta and colleagues compared data from the electronic patient records of all those who had in-hospital tests done in the ten days before and then after the switch to SAMBA devices at CUH.
The researchers found that the average length of time patients had to spend on a COVID019 âholdingâ ward before they could be discharged or progress with treatment almost halved: dropping from 58.5 hours to just 30 hours.
They also saw a fall in use of the single-occupancy âisolationâ rooms in which COVID-19 patients are ideally treated â from 30.8% to 21.2% after SAMBAâs introduction, as patients with symptoms were shown to be COVID-19 negative.
In fact, the researchers say the testing devices prevented 11 ward closures in the ten days after implementation. âKeeping surgical bays open means fewer cancelled operations, speeding up access to life-saving clinical intervention,â said Gupta.
The majority of those tested using SAMBA II during the first ten days of hospital-wide use were admissions to the Emergency Department (ED). The remainder included pre-op screenings (11%) and discharges to nursing homes (10%).
Some 96% of the SAMBA testing on pre-operative patients increased speed of âsurgical interventionâ, including kidney and liver transplants. The tests also allowed earlier discharge to nursing homes or into supported living in 79% of those cases, with the remainder delayed by âsystematic issuesâ not tests themselves.
Dr Dami Collier, who coordinated and analysed COVIDx, said: âOur research demonstrates that point-of-care testing with SAMBA II machines is not only reliable, accurate and much faster, but that the diagnostic speed leads to significant real-world improvements for patient care and safety.â
CUH Medical Director, Dr Ashley Shaw, said: âPoint of care testing has been hugely beneficial in enabling our clinical teams to make well-informed and timely decisions, keeping patients and staff as safe as possible throughout this difficult period.â
This work was supported by Wellcome, the Addenbrookeâs Charitable Trust, and the National Institute of Health Research (NIHR) Cambridge Biomedical Research Centre.
Image: Research nurses from the NIHR Clinical Research Facility processing patient samples using SAMBA machines at Addenbrookeâs Hospital in Cambridge, UK. Credit: Cambridge University Hospitals
Source: University of Cambridge