Point-of-care COVID-19 testing in the emergency department: current status and future prospects

Abstract

This expert review outlines current and future point of care technologies for the diagnosis of the SARS-CoV 2 virus, which is responsible for causing coronavirus disease COVID-19 in the emergency department. COVID-19 first emerged in late 2019 and is responsible for a range of presentations from minor upper respiratory tract symptoms to severe pneumonia and multisystem organ failure. Among the technologies available include the gold standard of molecular point of care tests as well as antigen detection tests. We discuss point of care molecular tests including multiplex, targeted and single plex panels as well as various antigen testing methodologies in terms of availability and performance characteristics. In addition, we focus on current testing best practices and considerations for point of care testing in the emergency department based on a search of the literature available in PubMed to date and a review of FDA and CDC guidance. While there have been many advances in SARS-coV2 point of care testing, there remain challenges to implementation in the emergency department setting. A paradigm shift is needed to improve diagnosis and clinical outcomes.