Accuracy of anterior nasal swab rapid antigen tests compared with RT‐PCR for massive SARS‐CoV‐2 screening in low prevalence population

Abstract

The aim was to determine the accuracy of anterior nasal swab in rapid antigen (Ag) tests in a low SARS‐CoV‐2 prevalence and massive screened community. Individuals, aged 18 years or older, who self‐booked an appointment for real‐time reverse transcriptase‐polymerase chain reaction (RT‐PCR) test in March 2021 at a public test center in Copenhagen, Denmark were included. An oropharyngeal swab was collected for RT‐PCR testing, followed by a swab from the anterior parts of the nose examined by Ag test (SD Biosensor). Accuracy of the Ag test was calculated with RT‐PCR as reference. We included 7074 paired conclusive tests ( n = 3461, female: 50.7%). The median age was 48 years (IQR: 36–57 years). The prevalence was 0.9%, that is, 66 tests were positive on RT‐PCR. Thirty‐two had a paired positive Ag test. The sensitivity was 48.5% and the specificity was 100%. This study conducted in a low prevalence setting in a massive screening set‐up showed that the Ag test had a sensitivity of 48.5% and a specificity of 100%, that is, no false positive tests. The lower sensitivity is a challenge especially if Ag testing is not repeated frequently allowing this scalable test to be a robust supplement to RT‐PCR testing in an ambitious public SARS‐CoV‐2 screening.

Nasal swab is a good alternative sample for detecting SARS-CoV-2 with rapid antigen test: A meta-analysis

“…Among the 49 studies on nasal swabs containing 79,073 samples [ [2] , [3] , [4] , 6 , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] ], all of them were published between 2021 and 2022, and twenty-one studies were conducted in the USA [ 12 , 14 , 15 , 18 , 21 , 22 , [25] , [26] , [27] , [32] , [33] , [34] , [35] , 39 , 44 , 45 , [47] ...…”

Review—Role of Nanomaterials in Screenprinted Electrochemical Biosensors for Detection of Covid-19 and for Post-Covid Syndromes

“…Both the RT-PCR and Antigen test falls under the category of diagnostic tests while some clinicians also recognized the serology test for detection of Antibodies of past infection mostly inclined to asymptomatic patients, as the antibody test. 8,39 The diagnostic tests are used to detect the active virus infection used to identify the infected patient to isolate and quarantine them. A brief technical explanation of the present testing patterns is presented.…”

Diagnostik Klinis Infeksi SARS-CoV-2 dengan Metode Apusan

“…Pada tahap diagnosis dan identifikasi penyakit dan virus ini dilakukan beberapa jenis pemeriksaan mendasar hingga molekuler diantaranya rapid antigen, swab antigen dan swab PCR (Polymerase Chain Reaction) (Chu et al, 2022). Perbedaan pada jenis pemeriksaan ini terlihat pada cara pengambilan spesimen dan tata cara identifikasi virus di dalam muatan spesimen (Chu et al, 2022;Jakobsen et al, 2022).…”

“…Virus dan patogen lainnya dapat dideteksi dalam tinja, urin, atau darah (Ghasemi et al, 2022). Sampel dikumpulkan dari area yang mudah dijangkau (saluran hidung) karena virus cenderung mudah bereplikasi (Ghasemi et al, 2022;Glenn et al, 2022;Jakobsen et al, 2022).…”

“…Untuk SARS-CoV-2, bahan genom itu adalah RNA. Empat syarat umum pada pemeriksaan diagnostik COVID-19 yakni 1) Sensitivitas tes berupa proporsi hasil tes positif dari semua sampel yang benar-benar positif; 2) spesifisitas tes yakni proporsi hasil tes negatif dari semua sampel yang benarbenar negatif; 3) benar negatif yakni hasil tes negatif dari individu yang benar-benar tidak terinfeksi dan tidak ditemukan material genetik pada spesimen; dan 4) benar positif yakni hasil tes positif dari sampel yang benar-benar positif dari individu yang ditemukan adanya material genetik berupa RNA virus SARS-CoV-2 (Jakobsen et al, 2022). Perbedaan uji NAAT dan swab antigen menggunakan metode apusan disajikan pada tabel 2.…”