Role of admission rapid antigen testing (RATs) for COVID-19 on patients transferred from acute hospitals to a post-acute rehabilitation setting.

Background: Rapid antigen tests (RATs) are suitable for point-of -care testing, require no laboratory time and give immediate results. However, are RATs useful for detecting asymptomatic COVID-19 infection when compared with polymerase chain reaction (PCR) testing in healthcare settings?

Aim: The aim of this study was to implement a reliable testing system utilising RATs to promptly detect COVID-19 infection in predominantly asymptomatic patients transferred from acute hospitals to a post-acute rehabilitation unit (PARU).

Methods: RAT testing was carried out on all new admissions without a history of confirmed Covid-19 infection within three months of admission. PCR testing was carried out on all patients with a positive RAT for confirmation purposes. The cycle threshold (Ct) values of COVID-19 detected results on PCR testing were examined to determine the utility of the RATs.

Results: A total of 1,403 patients were transferred to the PARU from January to December 2023. The results of the study revealed an 85% accuracy of RATs with a 15% rate of false negative results at the time of admission. All patients that had a positive RAT at the time of admission also had a positive PCR test.

Conclusion: This testing algorithm resulted in early detection and prompt isolation of positive cases reducing the likely spread of COVID-19 infection, hospital outbreaks and bed/ward closures.