Hospital laboratory experience with SARS-CoV-2 (COVID-19) molecular assay sample pooling method in New York City.

The ongoing SARS-CoV-2 (COVID-19) pandemic has been a huge challenge for healthcare systems worldwide. Laboratories have been confronted with rapidly increasing testing demands that exceed testing capacity. Regions with a low SARS-CoV-2 molecular assay positivity rate are looking for ways to increase testing capacity and prevent a second wave while returning to ‘normal’ life. One aspect of this process is to reopen non-COVID-19 related medical services that were shut down due to SARS-CoV-2 transmission risk. Sample pooling method has been used for mass testing of several infectious diseases for decades and is currently proposed as a new strategy to increase COVID-19 testing capacity in low-risk regions.1–5 New York State Department of Health (NYSDOH) requires patients to be tested for COVID-19 using a molecular assay for detection of SARS-CoV-2 RNA before medical procedures. While the number of medical procedures were rapidly increasing at our hospital, the supply of SARS-CoV-2 molecular assay reagents has been insufficient and inconsistent. To meet the need of testing before medical procedures in a timely manner and prevent possible delays in patient care, Lenox Hill Hospital laboratory implemented the sample pooling method for patient testing. We, herein, report our 6-week experience with pool testing for COVID-19. In the beginning of July 2020, we validated the pooling testing method for COVID-19 using the Cepheid Xpert Xpress SARS-2 CoV-2 (EUA) cartridges on GeneXpert System (Cepheid, Sunnyvale, California, USA) by using the recent guidelines published by the Food and Drug Administration and NYSDOH.6 7 The SARS-CoV-2 positivity rate at Lenox Hill Hospital of Northwell Health was <3% over the last month with the majority of the days being 0%–1%. Briefly, a sample pool was created by combining 200 µL of Universal Transport Medium from each patient …