Comparison of the SARS-CoV-2 BD Veritor Nasal Antigen Test with Nasopharyngeal Reverse Transcription-PCR in Symptomatic Patients

Koga, Paula Célia Mariko; Maluf, Maira; Nunes, F.; Campos, Juliana Álvares Duarte Bonini; Gazarini, Lívia; Borghoff, Tatiane; Libanori, Glaís; Martino, Marinês Dalla Vale

doi:10.1128/spectrum.00190-22

Cited by 1 publication

(1 citation statement)

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“…We found a marked decline in RAT sensitivity when the test was administered ≥ 6 days from symptom onset, and this association was mainly mediated by higher Ct values suggestive of lower viral load. This was congruent with a Brazilian study which found that greatest sensitivity of the antigen test was observed when the test was performed within 5 days of symptom onset [ 23 ], suggestive that viral load markedly decreases 5 days after symptom onset.…”

Section: Discussionsupporting

confidence: 90%

Diagnostic performance of rapid antigen tests (RAT) for COVID-19 and factors associated with RAT-negative results among RT-PCR-positive individuals during Omicron BA.2, BA.5 and XBB.1 predominance

Tan,

Zeng,

Cui

et al. 2024

BMC Infect Dis

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Background While numerous studies have evaluated the real-world performance of rapid antigen tests (RATs), data on the effect of Omicron sublineages such as XBB and reinfections on RAT performance is limited. We assessed the performance of RATs and factors associated with RAT-negative results among individuals who tested SARS-CoV-2-positive by reverse transcription-polymerase chain reaction (RT-PCR). Methods We conducted a retrospective study among Singapore residents who underwent testing for SARS-CoV-2 with RAT (Acon Flowflex or SD Biosensor) and RT-PCR in the same clinical encounter between 9 May 2022 and 21 November 2022. RT-PCR served as a reference standard for RAT performance. Logistic regression was used to estimate the odds ratios (OR) of factors associated with negative RAT results among RT-PCR-positive cases. Results Of 8,620 clinical encounters analysed, 3,519 (40.8%) were SARS-CoV-2-positive on RT-PCR. Overall sensitivity and specificity of RAT was 84.6% (95% CI 83.3–85.7%) and 99.4% (95% CI 99.1–99.6%) respectively. Acon Flowflex consistently achieved higher sensitivity and specificity than SD Biosensor test kit. Among RT-PCR-positive cases, individuals who had a previous documented SARS-CoV-2 infection, coinfection with another respiratory pathogen or tested ≥ 6 days from symptom onset had higher odds of testing RAT-negative, but the associations were attenuated after adjustment for cycle threshold values (proxy for viral load). There was no significant difference in RAT performance between Omicron sublineages BA.2, BA.5 and XBB.1. Conclusion Diagnostic performance of RAT was not affected by changes in predominant circulating Omicron sublineages. However, reinfection cases may be under ascertained by RAT. In individuals with a previous SARS-CoV-2 infection episode or symptom onset ≥ 6 days prior to testing, a confirmatory RT-PCR may be considered if there is high clinical suspicion.

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Section: Discussionsupporting

confidence: 90%