Molecular accuracy vs antigenic speed: SARS-CoV-2 testing strategies

Abstract

The pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has hit every corner of the world faster than any infectious disease ever known. In this context, rapid and accurate testing of positive cases are essential to follow the test-trace-isolate strategy (TETRIS), which has proven to be a key approach to constrain viral spread. Here, we discuss how to interpret and combine molecular or/and antigen-based detection methods for SARS-CoV-2 as well as when they should be used. Their application can be cleverly designed as an algorithm to prevent viral dissemination according to distinct epidemiological contexts within surveillance programs.

Comparison of extraction‐based and elution‐based polymerase chain reaction testing, and automated and rapid antigen testing for the diagnosis of severe acute respiratory syndrome coronavirus 2

“… 14 Although it can detect individuals with replication‐competent viruses with high sensitivity and specificity as PCR assays, the rapid AT generally has a lower testing sensitivity, which means that larger amounts of viral genes are required to show a positive result. 15 Thus, clinical application of the AT should be carefully determined. The testing sensitivity of AT is reportedly higher than that of RDT.…”

“…Compared with PCR testing, antigen testing can offer multiple advantages, such as rapidity, low cost, easy availability, and convenience of performance 14 . Although it can detect individuals with replication‐competent viruses with high sensitivity and specificity as PCR assays, the rapid AT generally has a lower testing sensitivity, which means that larger amounts of viral genes are required to show a positive result 15 . Thus, clinical application of the AT should be carefully determined.…”