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

Bae, Seongman; Park, Heedo; Kim, Ji Yeun; Park, Sunghee; Lim, So Yun; Bae, Joon‐Yong; Kim, Jeonghun; Jung, Jiwon; Kim, Min Jae; Chong, Yong Pil; Lee, Sang‐Oh; Choi, Sang‐Ho; Kim, Yang Soo; Park, Man‐Seong; Kim, Sung-Han

doi:10.3389/fmed.2022.922431

Cited by 3 publications

(2 citation statements)

References 38 publications

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“…Test positivity (new infections detected). Across twenty studies, new infections detected by COVIDST varied from 0.02% to 27% [22,25,27,28,31,[36][37][38][39][40][41][42][43][44][45][46][47][48]. In two other studies, test positivity varied from 12% to 83.3% during the delta wave and 41.7% to 87.2% during the omicron wave [29,49].…”

Section: Synthesized Results For Secondary Outcomesmentioning

confidence: 99%

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Self-tests for COVID-19: What is the evidence? A living systematic review and meta-analysis (2020–2023)

Anand,

Vialard,

Esmail

et al. 2024

PLOS Glob Public Health

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COVID-19 self-testing strategy (COVIDST) can rapidly identify symptomatic and asymptomatic SARS-CoV-2-infected individuals and their contacts, potentially reducing transmission. In this living systematic review, we evaluated the evidence for real-world COVIDST performance. Two independent reviewers searched six databases (PubMed, Embase, Web of Science, World Health Organization database, Cochrane COVID-19 registry, Europe PMC) for the period April 1st, 2020, to January 18th, 2023. Data on studies evaluating COVIDST against laboratory-based conventional testing and reported on diagnostic accuracy, feasibility, acceptability, impact, and qualitative outcomes were abstracted. Bivariate random effects meta-analyses of COVIDST accuracy were performed (n = 14). Subgroup analyses (by sampling site, symptomatic/asymptomatic infection, supervised/unsupervised strategy, with/without digital supports) were conducted. Data from 70 included studies, conducted across 25 countries with a median sample size of 817 (range: 28–784,707) were pooled. Specificity and DOR was high overall, irrespective of subgroups (98.37–99.71%). Highest sensitivities were reported for: a) symptomatic individuals (73.91%, 95%CI: 68.41–78.75%; n = 9), b) mid-turbinate nasal samples (77.79%, 95%CI: 56.03–90.59%; n = 14), c) supervised strategy (86.67%, 95%CI: 59.64–96.62%; n = 13), and d) use of digital interventions (70.15%, 95%CI: 50.18–84.63%; n = 14). Lower sensitivity was attributed to absence of symptoms, errors in test conduct and absence of supervision or a digital support. We found no difference in COVIDST sensitivity between delta and omicron pre-dominant period. Digital supports increased confidence in COVIDST reporting and interpretation (n = 16). Overall acceptability was 91.0–98.7% (n = 2) with lower acceptability reported for daily self-testing (39.5–51.1%). Overall feasibility was 69.0–100.0% (n = 5) with lower feasibility (35.9–64.6%) for serial self-testing. COVIDST decreased closures in school, workplace, and social events (n = 4). COVIDST is an effective rapid screening strategy for home-, workplace- or school-based screening, for symptomatic persons, and for preventing transmission during outbreaks. These data will guide COVIDST policy. Our review demonstrates that COVIDST has paved the way for self-testing in pandemics worldwide.

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Section: Synthesized Results For Secondary Outcomesmentioning

confidence: 99%

“…Conversely, a community-based study reported sensitivity of 23% within 0–1 days and 66.67% within 2–4 days of symptom onset [ 23 ]. Finally, another study reported a sensitivity of 73% when self-test was conducted within 0–5 days of symptom onset as compared to 22% when conducted after 5 days [ 27 ].…”

Section: Resultsmentioning

confidence: 99%

Self-tests for COVID-19: What is the evidence? A living systematic review and meta-analysis (2020–2023)

Anand,

Vialard,

Esmail

et al. 2024

PLOS Glob Public Health

View full text Add to dashboard Cite

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Self-tests for COVID-19: what is the evidence? A living systematic review and meta-analysis (2020-2023)

Anand,

Vialard,

Esmail

et al. 2023

Preprint

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COVID-19 self-testing strategy (COVIDST) can rapidly identify symptomatic and asymptomatic SARS-CoV-2-infected individuals and their contacts, potentially reducing transmission. In this living systematic review, we evaluated the evidence for real-world COVIDST performance. Two independent reviewers searched six databases (PubMed, Embase, Web of Science, World Health Organization database, Cochrane COVID-19 registry, Europe PMC) for the period April 1st, 2020, to January 18th, 2023. Data on studies evaluating COVIDST against laboratory-based conventional testing and reported on diagnostic accuracy, feasibility, acceptability, impact, and qualitative outcomes were abstracted. Bivariate random effects meta-analyses of COVIDST accuracy were performed (n=14). Subgroup analyses (by sampling site, symptomatic/asymptomatic infection, supervised/unsupervised strategy, with/without digital supports) were conducted. Data from 70 included studies, conducted across 25 countries with a median sample size of 817 (range: 28-784,707) were pooled. Specificity was high overall, irrespective of subgroups (98.37-99.71%). Highest sensitivities were reported for: a) symptomatic individuals (73.91%, 95%CI: 68.41-78.75%; n=9), b) mid-turbinate nasal samples (77.79%, 95%CI: 56.03-90.59%; n=14), c) supervised strategy (86.67%, 95%CI: 59.64-96.62%; n=13), and d) presence of digital interventions (70.15%, 95%CI: 50.18-84.63%; n=14). Sensitivity was lower in asymptomatic populations (40.18%, 95% CI: 21.52-62.20%; n=4), due to errors in test conduct and absence of supervision or a digital support. We found no difference in COVIDST sensitivity between delta and omicron pre-dominant period. Digital supports increased confidence in COVIDST reporting and interpretation (n=16). Overall acceptability was 91.0-98.7% (n=2) with lower acceptability reported for daily self-testing (39.5-51.1%). Feasibility was 69.0-100.0% (n=5) with lower feasibility (35.9-64.6%) for serial self-testing. COVIDST decreased closures in school, workplace, and social events (n=4). COVIDST is an effective rapid screening strategy for home-, workplace- or school-based screening, for symptomatic persons, and for preventing transmission during outbreaks. This data is useful for updating COVIDST policy. Our review demonstrates that COVIDST has paved the way for the introduction of self-tests, worldwide.

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Viral Shedding Kinetics in Patients with COVID-19

Kim

2023

Korean J healthc assoc Infect Control Prev

Self Cite

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The epidemiologic data revealed that most COVID-19 transmission occurred through contact within 3 to 5 days or less from the symptom onset. However, epidemiologic data are prone to recall and misclassification bias; therefore, laboratory data, including viable viral shedding kinetics, can complement these epidemiologic observations and provide important insight in terms of isolation policy and treatment duration of antiviral therapy. The studies revealed that asymptomatic patients with Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) infection had a similar viral load to symptomatic patients during the early course of the disease but exhibited a more rapid decrease in viral load with the loss of infectivity. Furthermore, symptomatic patients with COVID-19 had high infectivity and high symptom scores during the early course of the disease and gradually lost infectivity and symptom severity. In addition, the studies on the effect of COVID-19 vaccination on viral load kinetics showed that fully vaccinated individuals had a shorter duration of viable viral shedding and a lower secondary attack rate than partially vaccinated or unvaccinated individuals. Furthermore, the more recent variants, such as Omicron had a shorter viable viral shedding time (median 3-5 days from the symptom onset) than the precedent variants, such as Delta (median 8.5 days from the symptom onset). Furthermore, immunocompromised patients with COVID-19 tended to shed viable viruses for a prolonged period of up to a median of 4 weeks from the symptom onset.

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

Cited by 3 publications

References 38 publications

Self-tests for COVID-19: What is the evidence? A living systematic review and meta-analysis (2020–2023)

Self-tests for COVID-19: What is the evidence? A living systematic review and meta-analysis (2020–2023)

Self-tests for COVID-19: what is the evidence? A living systematic review and meta-analysis (2020-2023)

Viral Shedding Kinetics in Patients with COVID-19

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