Somerset and South Essex Coronavirus Antigen Testing (SOCRATES)

Evaluation of the PCL Rapid Point of Care Antigen Test for Severe Acute Respiratory Syndrome Coronavirus 2

This study is to evaluate the utility of the PCL Rapid Antigen Test for Coronavirus (COVID-19) in a real world clinical setting. The PCL test has completed laboratory validation and holds a European CE marking for in vitro diagnostic devices. These tests have been made available to South West Pathology Services as a donation in kind by iPP (Integrated Pathology Partnership). They have been widely used in South Korea. This study will test the practical delivery of the test in terms of time constraints and error rates. We will also compare the objective performance to the current standard diagnostic test for COVID-19 and against a proven serological antibody test when a suitable reference testing becomes available. We will recruit patients having a SARS CoV-2 PCR swab test and ask for consent to test them with the PCL antigen test in parallel. We aim to study 200 patients split across three sites; Musgrove Park Hospital, Basildon University Hospital and Southend University Hospital. The results will not be used to guide clinical decision making. Patients having a COVID PCR test will be asked to read the patient information sheet and asked if they would like to participate. The patients will be asked to have a second nasal/throat swab taken shortly after their swab for the PCR test. Written informed consent will be taken for whole blood or plasma left over from any routine clinical sample to be stored as anonymised samples for future testing once a reference test becomes available. We will report results of the onsite clinical diagnostic test and the PCL antigen test with the number of the kit used, and test date. Anonymised information about year of birth, gender and place of testing will be collected alongside date of onset, symptoms and immunodeficiency status or significant conditions.

Participants will be identified as they attend assessment areas or testing facilities hosted by the recruiting NHS centres. They will be screened by clinical staff and identified to the research team. Consent will be taken by a clinical staff member or research staff member with the aim of reducing the number of contacts with the patients and minimising the usage of personal protective equipment. The consent form gives the patient the opportunity to ask further questions. Only those that are able to consent for themselves will be recruited for this trial. We want to allow patients as long as possible to make a decision to participate but we feel it is important if possible that the swab samples are taken during the same patient contact (reducing PPE usage and minimising additional staff exposures). However there should not be undue delay to clinical testing therefore we propose if due to clinical urgency potential participants do not have sufficient time to consider the patient information sheet and discuss the trial prior to the PCR swab being taken they can have up to 24 hours to consider this information and participate if they wish to. Consent will be taken by a clinical staff member or research staff member reducing the number of contacts with the patients. They will then be assigned a trial number used to identify them during the trial. The consent form that will be photocopied and reprinted on clean paper, with the original staying with the patient. The clean copy will be stored in the patient's notes and the case record file. The current standard COVID PCR swab will be taken and a second swab taken immediately after for use in the rapid antigen test. As the swab process can be uncomfortable after the first swab is taken for the standard clinical test (PCR) the participant's consent will be confirmed again prior to taking the second swab required for the antigen test. After consent the research team will complete an anonymised data case record form from the notes and clinical management database. Participant's year of birth and date of onset of symptoms if symptomatic will be documented. From routine blood samples taken by phlebotomy or clinical staff consent will be sort to store a leftover sample. This will be processed and stored by research laboratory staff. This will be stored in an anonymised secure research freezer. In the laboratory their swab for the PCL COVID19 Ag rapid FIA will be run on the test platform. Following the test the swab will be destroyed as per local guidelines for contaminated items. This will performed by dedicated research laboratory scientists. Participant's results from this antigen test will not be used to make clinical decisions. We will not be able to feedback participants' individual results. Participants are expected to be in the study for total of 20 minutes total although this will be spread over their patient journey so they have sufficient time to read the information leaflet and ask questions.

Single arm trial design. Only patients undergoing standard clinical testing (SARS-CoV-2 PCR test) and consenting for additional testing with the PCL rapid antigen test will be included

The PCL COV05 - COVID 19 Ag Rapid FIA test has FSC and CE approvals for the qualitative detection of SARS-CoV-2 Antigens from human oropharyngeal swabs and deep sputum samples. The manufacturer is PCL Corporation Ltd 17F, 128 B-dong, Courthouse-ro, Songpa-gu, Seoul, South Korea.

Compare the sensitivity and specificity of the rapid antigen testing to current PCR test and any future developed reference test

Time from swab being taken to result being read by point of care analyser, manufacturer anticipates 10-15 minutes

Inclusion Criteria: Participant has clinical indication for a COVID diagnostic test and a clinical blood sample from which whole blood or plasma will be leftover for storage Exclusion Criteria: Inability to give written informed consent.

anonymised individual data would be available to be shared on request from other research teams/public health bodies but no formal plans in place at time of submission