Performance of Blood-Based Nucleocapsid Antigen Tests for Diagnosis of Severe Acute Respiratory Syndrome Coronavirus 2 Infection and Infectious Viral Shedding: A Systematic Review

Mathur, Sujata; So, Matthew; Tahir, Peggy; Peluso, Michael J.; Martin, Jeffrey N.; Kelly, John D.

doi:10.1093/ofid/ofad346

Cited by 3 publications

(1 citation statement)

References 32 publications

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“…It has a higher detection limit when compared to RT-PCR 24 . According to a systemic review by Mathur et al 25 , the N-antigen tests generally have high specificity for infectious viral shedding, despite having a wide range of sensitivity 25 . A further aspect that needs exploration, is whether the decrease in CoLab score is also present in a less strictly defined population for reasons of generalizability.…”

Section: Discussionmentioning

confidence: 99%

The laboratory parameters-derived CoLab score as an indicator of the host response in ICU COVID-19 patients decreases over time: a prospective cohort study

Schoenmakers,

Leers,

Gorissen

et al. 2024

Sci Rep

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The CoLab score was developed and externally validated to rule out COVID-19 among suspected patients presenting at the emergency department. We hypothesized a within-patient decrease in the CoLab score over time in an intensive care unit (ICU) cohort. Such a decrease would create the opportunity to potentially rule out the need for isolation when the infection is overcome. Using linear mixed-effects models, data from the Maastricht Intensive Care COVID (MaastrICCht) cohort were used to investigate the association between time and the CoLab score. Models were adjusted for sex, APACHE II score, ICU mortality, and daily SOFA score. The CoLab score decreased by 0.30 points per day (95% CI − 0.33 to − 0.27), independent of sex, APACHE II, and Mortality. With increasing SOFA score over time, the CoLab score decreased more strongly (− 0.01 (95% CI − 0.01 to − 0.01) additional decrease per one-point increase in SOFA score.) The CoLab score decreased in ICU patients on mechanical ventilation for COVID-19, with a one-point reduction per three days, independent of sex, APACHE II, and ICU mortality, and somewhat stronger with increasing multi-organ failure over time. This suggests that the CoLab score would decrease below a threshold where COVID-19 can be excluded.

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Section: Discussionmentioning

confidence: 99%

The laboratory parameters-derived CoLab score as an indicator of the host response in ICU COVID-19 patients decreases over time: a prospective cohort study

Schoenmakers,

Leers,

Gorissen

et al. 2024

Sci Rep

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Diagnostic Utility of SARS-CoV-2 Nucleocapsid Antigenemia: A Meta-analysis

Damhorst,

Martin,

Wilber

et al. 2024

Open Forum Infectious Diseases

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Background Studies of the diagnostic performance of SARS-CoV-2 nucleocapsid antigen in blood (antigenemia) have reached variable conclusions. To potential utility of antigenemia measurements as a clinical diagnostic test need clarification. Methods We performed a systematic review of Pubmed, Embase and Scopus through July 15, 2023 and requested source data from corresponding authors. Results Summary sensitivity from 16 studies (4,543 cases) sampled at ≤14 days of symptoms was 0.83 (0.75-0.89) and specificity was 0.98 (0.87-1.00) from 6 studies (792 RT-PCR negative controls). Summary sensitivity and specificity for paired respiratory specimens with Ct values ≤33 were 0.91 (0.85-0.95) and 0.56 (0.39-0.73) from 10 studies (612 individuals). Source data from 1,779 cases reveal >70% have antigenemia 2 weeks following symptom onset, which persists in <10% at 28 days. The available studies suffer from heterogeneity and omicron era data are scarce. Conclusions Nucleocapsid antigenemia currently has limited utility due to limitations of existing studies and lack of omicron era data. Improved study designs targeting potential clinical uses in screening, surveillance, and complex clinical decision making – especially in immunocompromised patients – are needed.

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The CoLab score is associated with SARS-CoV-2 viral load during admission in individuals admitted to the intensive care unit: the CoLaIC cohort study

Schoenmakers,

Leers,

Deneer

et al. 2024

Clinical Chemistry and Laboratory Medicine (CCLM)

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Objectives The present study examines the temporal association between the changes in SARS-CoV-2 viral load during infection and whether the CoLab-score can facilitate de-isolation. Methods Nasal swabs and blood samples were collected from ICU-admitted SARS-CoV-2 positive patients at Maastricht UMC+ from March 25, 2020 to October 1, 2021. The CoLab-score was calculated based on 10 blood parameters and age and can range from −43 to 6. Three mixed effects analyses compared patient categories based on initial PCR Ct values (low; Ct≤20, mid; 20>Ct≤30, high; Ct>30), serial PCR Ct values to CoLab-scores over time, and the association between within-patient delta Ct values and CoLab-scores. Results In 324 patients, the median Ct was 33, and the median CoLab-score was −1.78. Mid (n=110) and low (n=41) Ct-categories had higher CoLab-scores over time (+0.60 points, 95 % CI; 0.04–1.17, and +0.28 points, 95 % CI −0.49 to 1.04) compared to the high Ct (n=87) category. Over time, higher serial Ct values were associated with lower serial CoLab-scores, decreasing by −0.07 points (95 % CI; −0.11 to −0.02) per day. Increasing delta Ct values were associated with a decreasing delta CoLab-score of −0.12 (95 % CI; −0.23; −0.01). Conclusions The study found an association between lower viral load on admission and reduced CoLab-score. Additionally, a decrease in viral load over time was associated with a decrease in CoLab-score. Therefore, the CoLab-score may make patient de-isolation an option based on the CoLab-score.

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Performance of Blood-Based Nucleocapsid Antigen Tests for Diagnosis of Severe Acute Respiratory Syndrome Coronavirus 2 Infection and Infectious Viral Shedding: A Systematic Review

Cited by 3 publications

References 32 publications

The laboratory parameters-derived CoLab score as an indicator of the host response in ICU COVID-19 patients decreases over time: a prospective cohort study

The laboratory parameters-derived CoLab score as an indicator of the host response in ICU COVID-19 patients decreases over time: a prospective cohort study

Diagnostic Utility of SARS-CoV-2 Nucleocapsid Antigenemia: A Meta-analysis

The CoLab score is associated with SARS-CoV-2 viral load during admission in individuals admitted to the intensive care unit: the CoLaIC cohort study

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