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BMC Infect Dis . Universal SARS-CoV-2 RT-qPCR admission screening over 21 months in a German tertiary care hospital: detection of asymptomatic infe

tetano

Editor, Senior Moderator
BMC Infect Dis


. 2026 Jul 31;26(1):1415.
doi: 10.1186/s12879-026-14122-8.
Universal SARS-CoV-2 RT-qPCR admission screening over 21 months in a German tertiary care hospital: detection of asymptomatic infections

Isabella Eiter[SUP] 1 2 [/SUP], Till Gallasch[SUP] 2 [/SUP], Sören Krüger[SUP] 2 3 [/SUP], Michael Eisenmann[SUP] 2 4 [/SUP], Vera Rauschenberger[SUP] 2 [/SUP], Anna Höhn[SUP] 2 [/SUP], Sina Ebert[SUP] 2 [/SUP], Kerstin Knies[SUP] 5 [/SUP], Christiane Prifert[SUP] 5 6 [/SUP], Benedikt Weißbrich[SUP] 5 [/SUP], Lars Dölken[SUP] 5 7 [/SUP], Stefanie Kampmeier[SUP] 2 [/SUP], Isabell Wagenhäuser[SUP] 1 [/SUP], Manuel Krone[SUP] 8 9 [/SUP]


Affiliations
Abstract

Numerous nosocomial infections were observed in hospitals and other healthcare facilities during the COVID-19 pandemic, largely attributed to asymptomatic or pre-symptomatic carriers. SARS-CoV-2 screening data at admission of all hospitalised patients and accompanying persons of a tertiary-care hospital in Germany was included from 1 April 2020 to 31 December 2021. The first oropharyngeal swab of each newly admitted individual was tested for SARS-CoV-2 RNA using reverse transcription polymerase chain reaction (RT-qPCR). The overall testing costs and the costs per positively tested individual were analysed. Out of 111,271 screened individuals, 705 (0.6%) tested positive for SARS-CoV-2 by RT-qPCR. Among these, 236 cases (0.2%) had not been previously diagnosed and were identified through RT-qPCR admission screening. Of the newly detected cases,110 (0.1%) were asymptomatic without any known positive contact history. The specificity of RT-qPCR in screening use was 99.997% (95% CI 99.992-99.999%). The mean testing costs of identifying one SARS-CoV-2-positive individual through admission screening was €8,082.87. Long-term universal RT-qPCR admission screening detected a substantial number of otherwise unidentified SARS-CoV-2-positive individuals, proving its value as a infection control tool with an excellent specificity in screening use during the COVID-19 pandemic. This strategy represents an important lesson learned from the pandemic and may serve as a valuable infection control tool for future pandemics or seasonal pathogen surges.

Keywords: Admission screening; COVID-19; PCR; Pandemic preparedness; SARS-CoV-2.

 
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