Adequacy of Serial Self-performed SARS-CoV-2 Rapid Antigen Detection Testing for Longitudinal Mass Screening in the Workplace

Papenburg, Jesse; Campbell, Jonathon R.; Caya, Chelsea; Dion, Cynthia; Corsini, Rachel; Cheng, Matthew P.; Menzies, Dick; Yansouni, Cédric P.

doi:10.1001/jamanetworkopen.2022.10559

Cited by 21 publications

(22 citation statements)

References 15 publications

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“…Of the 22 studies reviewed, 9 [ 11 , 12 , 13 , 14 , 18 , 25 , 35 , 37 , 39 ] used self-taken rapid antigen tests approved by the WHO for professional use [ 31 ], which are the STANDARD-Q COVID-19 Ag Test, Panbio COVID-19 Ag Rapid Test, LumiraDx SARS-CoV-2 Ag Test, Abbott Panbio COVID-19 Ag Rapid Test and SARS-CoV-2 Antigen Rapid Test (Flowflex).…”

Section: Resultsmentioning

confidence: 99%

“…Regarding the technique, the study of Tonen-Woleyc et al, 2021, revealed that the majority of participants (94.4%) understood the sample collection instructions [ 20 ], and in another study (Jing et al, 2022) 255 of 264 (96.6%) participants were able to perform the test successfully [ 42 ]. As a result, in many of these studies, the sensitivity and specificity were found to be the same between healthcare providers and non-healthcare providers [ 11 , 17 , 18 , 21 , 23 , 37 ]. Indeed, Savage et al, 2022, revealed that the sensitivity of self-taken rapid antigen tests was higher (90.5%) compared with professional-taken tests (78.3%) [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

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The Diagnostic Accuracy of SARS-CoV-2 Nasal Rapid Antigen Self-Test: A Systematic Review and Meta-Analysis

Karlafti

Tsavdaris

Kotzakioulafi

et al. 2023

Life

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Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of coronavirus disease 2019 (COVID-19), a disease that quickly spread into a pandemic. As such, management of the COVID-19 pandemic is deemed necessary, and it can be achieved by using reliable diagnostic tests for SARS-CoV-2. The gold standard for the diagnosis of SARS-CoV-2 is a molecular detection test using the reverse transcription polymerase chain reaction technique (rt-PCR), which is characterized by various disadvantages in contrast with the self-taken nasal rapid antigen tests that produce results faster, have lower costs and do not require specialized personnel. Therefore, the usefulness of self-taken rapid antigen tests is indisputable in disease management, facilitating both the health system and the examinees. Our systematic review aims to access the diagnostic accuracy of the self-taken nasal rapid antigen tests. Methods: This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool was used to assess the risk of bias in the included studies. All the studies included in this systematic review were found after searching the two databases, Scopus and PubΜed. All but original articles were excluded from this systematic review, while all the studies concerning self-taken rapid antigen tests with a nasal sample and using rt-PCR as a reference test were included. Meta-analysis results and plots were obtained using RevMan software and the MetaDTA website. Results: All 22 studies included in this meta-analysis demonstrated a specificity of self-taken rapid antigen tests greater than 98%, which exceeds the minimum required yield for the diagnosis of SARS-CoV-2, according to the WHO. Notwithstanding, the sensitivity varies (from 40% to 98.7%), which makes them in some cases unsuitable for the diagnosis of positive cases. In the majority of the studies, the minimum required performance set by the WHO was achieved, which is 80% compared with rt-PCR tests. The pooled sensitivity of self-taken nasal rapid antigen tests was calculated as 91.1% and the pooled specificity was 99.5%. Conclusions: In conclusion, self-taken nasal rapid antigen tests have many advantages over rt-PCR tests, such as those related to the rapid reading of the results and their low cost. They also have considerable specificity and some self-taken rapid antigen test kits also have remarkable sensitivity. Consequently, self-taken rapid antigen tests have a wide range of utility but are not able to completely replace rt-PCR tests.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Diagnostic Accuracy of SARS-CoV-2 Nasal Rapid Antigen Self-Test: A Systematic Review and Meta-Analysis

Karlafti

Tsavdaris

Kotzakioulafi

et al. 2023

Life

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“…In addition, CDC recently recommended continuation of wearing masks around others in public places until two consecutive negative RAT results ( 27 ). Taken together, RAT may detect replication-competent SARS-CoV-2 virus, and accuracy of this test can be improved by increasing the frequency or providing adequate guidance for procedure and interpretation ( 13 , 28 ). Our data on the daily RAT results provide important insights into the contingency or crisis plan during the pandemic.…”

Section: Discussionmentioning

confidence: 99%

Daily, self-test rapid antigen test to assess SARS-CoV-2 viability in de-isolation of patients with COVID-19

et al. 2022

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BackgroundIsolation of COVID-19 patients is a crucial infection control measure to prevent further SARS-CoV-2 transmission, but determining an appropriate timing to end the COVID-19 isolation is a challenging. We evaluated the performance of the self-test rapid antigen test (RAT) as a potential proxy to terminate the isolation of COVID-19 patients.Materials and methodsSymptomatic COVID-19 patients were enrolled who were admitted to a regional community treatment center (CTC) in Seoul (South Korea). Self-test RAT and the collection of saliva samples were performed by the patients, on a daily basis, until patient discharge. Cell culture and subgenomic RNA detection were performed on saliva samples.ResultsA total of 138 pairs of saliva samples and corresponding RAT results were collected from 34 COVID-19 patients. Positivity of RAT and cell culture was 27% (37/138) and 12% (16/138), respectively. Of the 16 culture-positive saliva samples, seven (43.8%) corresponding RAT results were positive. Using cell culture as the reference standard, the overall percent agreement, percent positive agreement, and percent negative agreement of RAT were 71% (95% CI, 63–78), 26% (95% CI, 12–42), and 82% (95% CI, 76–87), respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of the RAT for predicting culture results were 44% (95% CI, 20–70), 75% (95% CI, 66–82), 18% (95% CI, 8–34), and 91% (95% CI, 84–96), respectively.ConclusionAbout half of the patients who were SARS-CoV-2 positive based upon cell culture results gave negative RAT results. However, the remaining positive culture cases were detected by RAT, and RAT showed relatively high negative predictive value for viable viral shedding.

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“…In a subsequent prospective study, we found that essential workers could perform self-testing adequately using manufacturer-included instructions, but that the interpretation of test results was significantly improved after modified instructions that emphasized key processes were implemented. 60 The cost of the tests themselves is about $5, 61 but other costs associated with testing are uncertain, and the need for RT-PCR confirmation will vary by epidemiologic setting and government policy.…”

Section: Discussionmentioning

confidence: 99%

Systematic on-site testing for SARS-CoV-2 infection among asymptomatic essential workers in Montréal, Canada: a prospective observational and cost-assessment study

Campbell¹,

Dion²,

Uppal³

et al. 2022

cmajo

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Background: Essential workers are at increased risk for SARS-CoV-2 infection. We aimed to estimate the yield, acceptability and cost of systematic workplace-based testing of asymptomatic essential workers for SARS-CoV-2 infection. Methods: From Jan. 27 to Mar. 12, 2021, we prospectively recruited non–health care essential businesses in Montréal, Canada, through email or telephone contact. Two trained mobile teams, each composed of 2 non–health care professionals, visited businesses. Consenting asymptomatic employees provided saline gargle samples under supervision. Samples were analyzed by means of reverse transcription polymerase chain reaction (RT-PCR). At businesses with outbreaks (≥ 2 participants with a positive result), we retested all participants with a negative result on initial testing. Our primary outcomes were yield (proportion of test results that were positive), acceptability (proportion of participants estimated to be present at the business who agreed to participate) and costs (including training, sample collection and analysis, and communicating results). Our secondary outcome was identification of factors associated with a positive test result on multivariable logistic regression. Results: Of the 366 businesses contacted, 69 (18.8%) agreed to participate. Nineteen businesses (28%) were manufacturers or suppliers, 12 (17%) were in auto sales or repair, and 11 (16%) were in childcare; the corresponding number of employees was 1225, 242 and 113. The median number of participants per business was 13 (interquartile range [IQR] 8–22). Of an estimated 2348 employees on site, 2128 (90.6%) participated (808 [38.0%] female, median age 48 [IQR 37–57] yr). Of the 2626 tests performed, 53 (2.0%) gave a positive result. Self-reported nonwhite ethnicity (adjusted odds ratio [OR] 3.7, 95% confidence interval [CI] 1.4–9.9) and a negative SARS-CoV-2 test result before the study (adjusted OR 0.4, 95% CI 0.2–0.8) were associated with a positive test result. Five businesses were experiencing an outbreak; at these businesses, 40/917 participants (4.4%) had a positive result on the initial test. We repeated testing for employees with initially negative results at 3 of these businesses over 2–3 weeks: 8/350 participants (2.3%) had a positive result on the second test, and none had a positive result on the third and fourth tests; no employer reported new positive results after our final visit (up to Mar. 26, 2021). At the remaining 64 businesses, 1211 participants were tested once, of whom 5 (0.4%) had a positive result. The per-person RT-PCR cost was $34, and all other costs, $8.67. Interpretation: On-site saline gargle sampling of essential workers for SARS-CoV-2 testing was acceptable and of modest cost, and appears most useful in the context of outbreaks. This sampling strategy should be evaluated further as a component of efforts to prevent SARS-CoV-2 transmission. Preprint: medRxiv —...

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Adequacy of Serial Self-performed SARS-CoV-2 Rapid Antigen Detection Testing for Longitudinal Mass Screening in the Workplace

Cited by 21 publications

References 15 publications

The Diagnostic Accuracy of SARS-CoV-2 Nasal Rapid Antigen Self-Test: A Systematic Review and Meta-Analysis

The Diagnostic Accuracy of SARS-CoV-2 Nasal Rapid Antigen Self-Test: A Systematic Review and Meta-Analysis

Daily, self-test rapid antigen test to assess SARS-CoV-2 viability in de-isolation of patients with COVID-19

Systematic on-site testing for SARS-CoV-2 infection among asymptomatic essential workers in Montréal, Canada: a prospective observational and cost-assessment study

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