Evaluation of a Rapid Antigen Test for the Diagnosis of SARS-CoV-2 during the COVID-19 Pandemic

Cheng, Chen Chuan; Liu, Chia-Chen; Chiu, Ting-Fang; Chen, Saint Shiou-Sheng

doi:10.1177/00469580221105354

Cited by 3 publications

(1 citation statement)

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“…Personal risk assessments during Omicron-dominant months likely influenced testing patterns, as at-home antigen testing became more available and popular. Negative results from these less sensitive antigen tests could skew SOI assignments (25, 26), especially for children that were difficult to sample, asymptomatic, or had low viral loads. Nevertheless, the risk the Omicron VOC posed to children and their adult caretakers is strongly reflected in these data.…”

Section: Discussionmentioning

confidence: 99%

The impact of SARS-CoV-2 variants on the likelihood of children identified as sources of infection in the NIH workforce: a cohort study

van Loben Sels,

Bailin,

Bell

et al. 2023

Preprint

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BackgroundChildren (<18 years old) were not initially considered significant sources of infection (SOIs) for SARS-CoV-2. Risk mitigation strategies were thus prioritized for adults, and vaccination was inaccessible for children until mid-2021. Emergence of novel variants led to significant increases in COVID-19 cases in both children and adults. Whether these emergence events and increased vulnerability of unvaccinated children had a synergistic effect resulting in increased caseloads in adults requires further exploration.MethodsA retrospective cohort study was conducted among 3,545 workers diagnosed with COVID-19. Case details were compiled during contact investigations. Variants of concern were identified following sequencing of biological samples collected through employer-based testing programs. Logistic regression was performed to compare the odds of having a child SOI based on the dominant variant in the workforce.ResultsOne-fourth (24.5%) of the cohort reported having a child in-residence; 11.2% identified a child as their SOI. In Alpha-dominant months, the odds of having a child SOI were 0.3, and the child SOI was likely older (5-17 years old). The odds of having a child SOI increased to 1.3 and 2.2 in Delta- and Omicron-dominant months, respectively. The odds of having younger child SOIs (<5 years old) were significantly higher in Omicron-dominant months.ConclusionsChildren were highly likely to acquire the virus and posed a significant risk of transmission to their adult caretakers during Delta- and Omicron-dominant months. Without proper mitigation strategies in both the home and the workplace, child-associated transmission can threaten operations in the forms of staff shortages.What is already known on this topicIncreases in transmission trends related to SARs-CoV-2 Variants of Concern have been documented in the literature at the population level and in workplaces.What this study addsThis study looks more closely at the role that children played in transmission to adult workers, and therefore their potential to seed transmission outside of the home. This interface of transmission has been neglected in the literature but is key for future policy development.How this study might affect research, practice, or policyTransmission of SARS-CoV-2 from children to their caretakers may cause significantly increased odds of infection in a worker population. This may have second order effects for staffing, particularly in workgroups with employees of childbearing age. Employers should consider this in the design of their policies for continuity of operations, telework, and leave.

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Section: Discussionmentioning

confidence: 99%

The impact of SARS-CoV-2 variants on the likelihood of children identified as sources of infection in the NIH workforce: a cohort study

van Loben Sels,

Bailin,

Bell

et al. 2023

Preprint

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Comparison of diagnostic accuracy of rapid antigen tests for COVID-19 compared to the viral genetic test in adults: a systematic review and meta-analysis

Hirabayashi,

Mercado,

Hull

et al. 2024

JBI Evidence Synthesis

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Objective: The objective of this review is to determine the diagnostic accuracy of the currently available and upcoming point-of-care rapid antigen tests (RATs) used in primary care settings relative to the viral genetic real-time reverse transcriptase polymerase chain reaction (RT-PCR) test as a reference for diagnosing COVID-19/SARS-CoV-2 in adults. Introduction: Accurate COVID-19 point-of-care diagnostic tests are required for real-time identification of SARS-CoV-2 infection in individuals. Real-time RT-PCR is the accepted gold standard for diagnostic testing, requiring technical expertise and expensive equipment that are unavailable in most primary care locations. RATs are immunoassays that detect the presence of a specific viral protein, which implies a current infection with SARS-CoV-2. RATs are qualitative or semi-quantitative diagnostics that lack thresholds that provide a result within a short time frame, typically within the hour following sample collection. In this systematic review, we synthesized the current evidence regarding the accuracy of RATs for detecting SARS-CoV-2 compared with RT-PCR. Inclusion criteria: Studies that included nonpregnant adults (18 years or older) with suspected SARS-CoV-2 infection, regardless of symptomology or disease severity, were included. The index test was any available SARS-CoV-2 point-of-care RAT. The reference test was any commercially distributed RT-PCR–based test that detects the RNA genome of SARS-CoV-2 and has been validated by an independent third party. Custom or in-house RT-PCR tests were also considered, with appropriate validation documentation. The diagnosis of interest was COVID-19 disease and SARS-CoV-2 infection. This review considered cross-sectional and cohort studies that examined the diagnostic accuracy of COVID-19/SARS-CoV-2 infection where the participants had both index and reference tests performed. Methods: The keywords and index terms contained in relevant articles were used to develop a full search strategy for PubMed and adapted for Embase, Scopus, Qinsight, and the WHO COVID-19 databases . Studies published from November 2019 to July 12, 2022, were included, as SARS-CoV-2 emerged in late 2019 and is the cause of a continuing pandemic. Studies that met the inclusion criteria were critically appraised using QUADAS-2. Using a customized tool, data were extracted from included studies and were verified prior to analysis. The pooled sensitivity, specificity, positive predictive, and negative predictive values were calculated and presented with 95% CIs. When heterogeneity was observed, outlier analysis was conducted, and the results were generated by removing outliers. Results: Meta-analysis was performed on 91 studies of 581 full-text articles retrieved that provided true-positive, true-negative, false-positive, and false-negative values. RATs can identify individuals who have COVID-19 with high reliability (positive predictive value 97.7%; negative predictive value 95.2%) when considering overall performance. However, the lower level of sensitivity (67.1%) suggests that negative test results likely need to be retested through an additional method. Conclusions: Most reported RAT brands had only a few studies comparing their performance with RT-PCR. Overall, a positive RAT result is an excellent predictor of a positive diagnosis of COVID-19. We recommend that Roche’s SARS-CoV-2 Rapid Antigen Test and Abbott’s BinaxNOW tests be used in primary care settings, with the understanding that negative results need to be confirmed through RT-PCR. We recommend adherence to the STARD guidelines when reporting on diagnostic data. Review registration: PROSPERO CRD42020224250

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Covid-19 A Comprehensive Review of Signs, Symptoms, Diagnosis, and Treatment Strategies

Mr. Kachare Vishal,

Prof. Waghmare S. U.,

Poonam B. Kodage

2024

IJARSCT

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The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has significantly impacted global health. This review aims to provide a comprehensive overview of the signs, symptoms, diagnosis, and treatment modalities of COVID-19. The clinical presentation of COVID-19 varies widely, ranging from asymptomatic or mild symptoms to severe respiratory distress and multiorgan failure. Common symptoms include fever, cough, fatigue, and dyspnea, with less frequent symptoms such as anosmia, ageusia, and gastrointestinal symptoms. Diagnosis primarily relies on reverse transcription-polymerase chain reaction (RT-PCR) testing of respiratory specimens. However, imaging modalities such as chest X-ray and Antibody Test Antigen test in diagnosis, especially in cases with atypical presentations. Treatment strategies include supportive care, antiviral therapy, and, in severe cases, and other intensive care measures. The development and distribution of vaccines have been pivotal in controlling the spread of the virus. Despite significant progress in understanding and managing COVID-19, ongoing research is crucial to refine diagnostic strategies, develop effective therapies, and improve patient outcomes. Antiviral drugs, such as remdesivir, poxolovid, molonupiravir, have been widely used to inhibit viral replication and reduce the severity and duration of symptoms. Immunomodulators, including tocilizumab have been used to target specific pathways involved in the hyperinflammatory response seen in severe COVID-19. Monoclonal antibodies, such as casirivimab/imdevimab and sotrovimab, have been employed for passive immunization to neutralize the virus and reduce the risk of severe disease progression

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Evaluation of a Rapid Antigen Test for the Diagnosis of SARS-CoV-2 during the COVID-19 Pandemic

Cited by 3 publications

References 10 publications

The impact of SARS-CoV-2 variants on the likelihood of children identified as sources of infection in the NIH workforce: a cohort study

The impact of SARS-CoV-2 variants on the likelihood of children identified as sources of infection in the NIH workforce: a cohort study

Comparison of diagnostic accuracy of rapid antigen tests for COVID-19 compared to the viral genetic test in adults: a systematic review and meta-analysis

Covid-19 A Comprehensive Review of Signs, Symptoms, Diagnosis, and Treatment Strategies

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