Laboratory testing for the diagnosis of COVID-19

Lai, Christopher K C; Lam, Wai Yip

doi:10.1016/j.bbrc.2020.10.069

Cited by 108 publications

(131 citation statements)

References 76 publications

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“…Rapid antigen tests (RAT) represent a good option for mass testing and for rapidly capturing individuals that are potentially more infectious, especially in decentralized settings, or in those scenarios where molecular testing is not feasible or easily accessible. In fact, despite their lower sensitivity, they are able to identify current infections during the most contagious phase and are faster, simpler-to-use, and less expensive than NAAT [ 7 , 8 ]. Overall, these tests can ultimately help to relieve the pressure on healthcare systems and support public health strategies to control virus spread.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 Rapid Antigen Test as Screening Strategy at Points of Entry: Experience in Lazio Region, Central Italy, August–October 2020

et al. 2021

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COVID-19 pandemic is a dramatic health, social and economic global challenge. There is urgent need to maximize testing capacity. Rapid Antigen Tests (RAT) represent good candidates for point-of-care and mass surveillance testing to rapidly identify SARS-CoV-2-infected people, counterbalancing lower sensitivity vs. gold standard molecular tests with fast results and possible recurrent testing. We describe the results obtained with the testing algorithm implemented at points of entry (airports and ports) in the Lazio Region (Italy), using the STANDARD F COVID-19 Antigen Fluorescence ImmunoAssay (FIA), followed by molecular confirmation of FIA-positive samples. From mid-August to mid-October 2020, 73,643 RAT were reported to the Regional Surveillance Information System for travelers at points of entry in Lazio Region. Of these, 1176 (1.6%) were FIA-positive, and the proportion of RT-PCR-confirmed samples was 40.5%. Our data show that the probability of confirmation was directly dependent from the semi-quantitative FIA results. In addition, the molecularly confirmed samples were those with high levels of virus and that were actually harboring infectious virus. These results support public health strategies based on early mass screening campaigns by RAT in settings where molecular testing is not feasible or easily accessible, such as points of entry. This approach would contribute to promptly controlling viral spread through travel, which is now of particular concern due to the spread of SARS-CoV-2 variants.

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Section: Introductionmentioning

confidence: 99%

COVID-19 Rapid Antigen Test as Screening Strategy at Points of Entry: Experience in Lazio Region, Central Italy, August–October 2020

et al. 2021

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“…Antigen rapid tests (Ag RDT) can represent a good option for mass testing and for rapidly capturing individuals potentially more infectious, especially in decentralized settings, or in those scenarios where molecular testing is not feasible or easily accessible. In fact, despite the lower sensitivity, they are able to identify current infections during the most contagious phase and are faster, simpler-to-use, and less expensive than NAAT [7][8]. Overall, these tests may ultimately help to relieve the pressure on healthcare systems.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 Antigen Rapid Test as Screening Strategy at the Points-of-Entry: Experience in Lazio Region, Central Italy, August-October 2020

Colavita

Vairo

Meschi

et al. 2020

Preprint

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COVID-19 pandemic is becoming one of the most dramatic health, social and economic global challenges in recent history. Testing is one of the main components of the public health response to contain the virus spreading. There is an urgent need to expand testing capacity and antigen rapid tests (Ag RDT) represent good candidates for point-of-care and mass surveillance testing to rapidly identify people with SARS-CoV-2 infection, counterbalancing lower sensitivity as compared to the gold standard molecular tests with timeliness of results and possibility of recurred testing. Here, we report preliminary data of the testing algorithm implemented at the points-of-entry (airports and port) in Lazio Region (Central Italy) on travelers arriving between 17th of August to 15th of October, 2020, using the STANDARD F COVID-19 Antigen Fluorescence ImmunoAssay. Our findings show that the probability of molecular confirmation of Ag RDT positive results is directly dependent from the semi-quantitative results of this Ag RDT, and that the molecularly confirmed samples actually harbor infectious virus. These results support the public health strategies based on early screening campaigns in settings where molecular testing is not feasible or easily accessible, using rapid and simple point of care tests, able to rapidly identify those subjects who are at highest risk of spreading SARS-CoV-2 infection.

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“…The positive rate of rRT-PCR detection is dependent on the sample type, with differences between bronchoalveolar lavage fluid (93%), fibrobronchoscopy brush biopsy (46%), sputum (72%), nasal swabs (63%), pharyngeal swabs (32%), feces (29%), and blood (1%) . Combining nasopharyngeal and oropharyngeal swabs is now one of the most commonly used specimen types for diagnosing COVID-19 active infection (Lai and Lam, 2020). In September 2020, the WHO published a guideline not recommending saliva as the only specimen type for routine clinical diagnostics, because of the wide variation in collection methods (World Health Organization, 2020a).…”

Section: Real-time Reverse Transcriptase Polymerase Chain Reaction (Rmentioning

confidence: 99%

“…A confirmatory test (e.g. repeated rRT-PCR) may be warranted if the initial results are negative, and the clinical characteristics are suggestive of infection (Lai and Lam, 2020) (Lorentzen et al, 2020) .…”

Section: Real-time Reverse Transcriptase Polymerase Chain Reaction (Rmentioning

confidence: 99%

“…In comparison with rRT-PCR, rapid antigen detection tests tend to have a lower sensitivity, and owing to the increased risk of false-negative results, some authors consider such tests only as an adjunct to rRT-PCR tests (Siam et al, 2020). Alternatively, antigen detection tests have the advantage of being simple to perform and can play a role in settings where accessibility to rRT-PCR tests is limited or in symptomatic patients with a high viral load and within the first 5-7 days after symptom onset (Lai and Lam, 2020). The viral load is directly related to the sensitivity of the test (Dinnes et al, 2020).…”

Section: Antigen Detection Assaymentioning

confidence: 99%

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A simplified alternative diagnostic algorithm for SARS-CoV-2 suspected symptomatic patients and confirmed close contacts (asymptomatic): A consensus of Latin American experts

Fay¹,

Álvarez-Moreno

Bonvehí³

et al. 2020

Preprint

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Latin America accounts for roughly one-quarter of global COVID-19 cases and one-third of deaths. Health inequalities in the region lead to barriers regarding the best use of diagnostic tests during the pandemic. There is a need for a simplified guideline in the region that takes into consideration the available health resources, international guidelines, medical literature, and local expertise. Nine experts from different Latin American countries developed a simplified algorithm for COVID-19 diagnosis in the region, using a modified Delphi method. Twenty-four questions related to diverse diagnostic settings were initially proposed, followed by an extensive discussion of the literature and experts’ experience. According to time from close contact or symptom onset, the algorithm considers three different timeframes (≤7 days, 8–13 days, and ≥14 days) and discusses diagnostic options for each one. SARS-CoV-2 real-time reverse transcription polymerase chain reaction (rRT-PCR) continues to be the diagnostic test of choice from Day 1 to Day 14 after symptom onset or close contact, although antigen testing may be used in high-prevalence settings or in particular situations (such as from Day 0 to Days 5–7 of symptom onset). Antibody assays may be used for diagnostic confirmation, mainly after Day 14, if there is an epidemiological or individual need. If the clinical suspicion is very high, but other tests are negative, these assays may be used as an adjunct to decision-making from Days 8–13. The proposed algorithm is intended to be used as a support for COVID-19 diagnosis decision-making in Latin America.

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Laboratory testing for the diagnosis of COVID-19

Cited by 108 publications

References 76 publications

COVID-19 Rapid Antigen Test as Screening Strategy at Points of Entry: Experience in Lazio Region, Central Italy, August–October 2020

COVID-19 Rapid Antigen Test as Screening Strategy at Points of Entry: Experience in Lazio Region, Central Italy, August–October 2020

COVID-19 Antigen Rapid Test as Screening Strategy at the Points-of-Entry: Experience in Lazio Region, Central Italy, August-October 2020

A simplified alternative diagnostic algorithm for SARS-CoV-2 suspected symptomatic patients and confirmed close contacts (asymptomatic): A consensus of Latin American experts

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