Serial antigen rapid testing in staff of a large acute hospital

Wu, Sean M.; Archuleta, Sophia; Ming, Lim See; Somani, Jyoti; Chye, Quek Swee; Fisher, Dale

doi:10.1016/s1473-3099(21)00723-4

Cited by 4 publications

(4 citation statements)

References 12 publications

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“…A hospital in Singapore implemented self-testing twice per week of 8000 staff, identifying 20 truepositive staff (and 11 false-positive tests) over 8 weeks. The hospital reported no workplace transmissions during this time period and attributed this success in part to rapid antigen screening (Wu et al, 2022). Serial at-home testing is highly sensitive for detecting those infected with SARS-CoV-2 when they are most likely to be infectious (Harmon et al, 2021), as well as providing a scalable solution to test large numbers of employees without risk for transmission during testing or biosafety concerns with testing on site.…”

Section: Discussionmentioning

confidence: 97%

SARS-CoV-2 rapid antigen screening of asymptomatic employees: a pilot project

Schwartz

Bogoch

MacInTosh³

et al. 2022

Can J Public Health

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Setting Rapid antigen screening can be effective in identifying infectious individuals in occupational settings to reduce transmission and outbreaks. We report results from a pilot project at the Greater Toronto Airports Authority (GTAA) and describe the operationalization. Toronto Pearson is a large international airport encompassing over 400 employers and, pre-pandemic, with approximately 50,000 employees. Intervention An employee screening program was piloted between March 8 and May 28, 2021, to implement rapid antigen testing for asymptomatic employees. Recruitment targeted enrolment of 400 employees and yielded participation of 717 from 58 companies. Employees were recommended to book three times per week for nasal swabs on site, and were tested on the Abbot Panbio TM rapid antigen test. No action was taken from a negative result, and if positive, the employee was told to isolate at home and obtain a confirmatory polymerase chain reaction test. Outcomes A total of 5117 tests were performed on 717 individuals over 12 weeks; 5091 tests were negative (99.5%), and 22 individuals tested positive (3.1% positivity rate). One hundred twenty-four (17%) completed the post-participation survey. All respondents reported that testing did not change their behaviour at work with respect to public health recommendations, and only 1 (1%) reported behaviour change outside of work (socializing with family) as a result of the program. Implications This pilot program identified 22 (3.1%) potentially infectious employees. Onsite testing was feasible and highly accepted by this group of employees who completed the survey. Education resulted in reasonable uptake and no substantial change in behaviour, although the survey response rate may limit generalizability. Home-based testing may facilitate larger recruitment.

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Section: Discussionmentioning

confidence: 97%

SARS-CoV-2 rapid antigen screening of asymptomatic employees: a pilot project

Schwartz

Bogoch

MacInTosh³

et al. 2022

Can J Public Health

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“…Furthermore, we performed RATs once only and not in series. Serial testing for SARS-CoV-2 with RATs may substantially increase their diagnostic performance ( 32 ).…”

Section: Discussionmentioning

confidence: 99%

“…For patients with previous COVID-19 the sensitivities for Abbott-RAT and Roche-RAT were very low (26.7%). These low sensitivities are attributable to the high Ct values in these patients (Median 30, IQR [25][26][27][28][29][30][31][32][33]. This is plausible because patients with a previous COVID-19 infection may have lower viral loads due to mucous IgA built in response to the previous infection (28).…”

Section: Influence Of the Covid-19 Vaccination And Previous Infection...mentioning

confidence: 99%

Diagnostic performance of rapid antigen testing for SARS-CoV-2: the COVid-19 AntiGen (COVAG) extension study

Wertenauer,

Dressel,

Wieland

et al. 2024

Front. Med.

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BackgroundThis study is the extension of the COVAG study. We compared two RATs, the Panbio COVID-19 Ag Rapid Test (Abbott) and the SD Biosensor Q SARS-CoV-2 Rapid Antigen Test (Roche), against RT-PCR on the foil of new variants.MethodsWe included 888 all-comers at a diagnostic center between October 20, 2021, and March 18, 2022. RT-PCR-positive samples with a Ct value ≤32 were examined for SARS-CoV-2 variants.FindingsThe sensitivity of the Abbott-RAT and Roche-RAT were 65 and 67%, respectively. For both RATs, lower Ct values were significantly correlated with higher sensitivity. For samples with Ct values ≤25, the sensitivities of the Roche-RAT and of the Abbott-RAT were 96 and 95%, for Ct values 25–30 both were 19%, and for Ct values ≥30 they were 6 and 2%, respectively. The RATs had substantially higher sensitivities in symptomatic than asymptomatic participants (76, 77%, vs. 29, 31%, for Abbott-RAT, Roche-RAT, respectively) and in participants referred to testing by their primary care physician (84, 85%) compared to participants who sought testing due to referral by the health department (55, 58%) or a warning by the Corona-Warn-App (49, 49%). In persons with self-reported previous COVID-19 sensitivities were markedly lower than in patients without previous COVID-19: 27% vs. 75% for Roche-RAT and 27% vs. 73% for Abbott-RAT. We did not find significant correlation between vaccination status and sensitivity. The Omicron variant was detected with a sensitivity of 94 and 92%, the delta variant with a sensitivity of 80 and 80% for Abbott-RAT and Roche-RAT, respectively. This difference is attributable to the lower Ct values of the Omicron samples compared to the Delta samples. When adjusted for the Ct value, a multivariate logistic regression did not show a significant difference between Omicron and Delta. In terms of sensitivity, we found no significant difference between the wild-type and the Omicron and Delta variants, but a significantly lower sensitivity to the alpha variant compared to the other variants.The specificities were > 99% overall.

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“…For patients with previous Covid-19 the sensitivities for Abbott-RAT and Roche-RAT were very low (26.7%). These low sensitivities are attributable to the high Ct values in these patients (Median 30, IQR [25][26][27][28][29][30][31][32][33]. This is plausible because patients with a previous Covid-19 infection may have lower viral loads due to mucous IgA built in response to the previous infection.…”

Section: Influence Of the Covid-19 Vaccination And Previous Infection...mentioning

confidence: 99%

Diagnostic Performance of Rapid Antigen Testing for SARS-CoV-2: The COVid-19 AntiGen (COVAG) Extension study

Wertenauer,

Dressel,

Wieland

et al. 2023

Preprint

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BackgroundRapid antigen tests (RATs) for SARS-CoV-2 have been used to combat the still ongoing Covid-19 pandemic. This study is the extension of the COVAG study originally performed from February 1 to March 31, 2021. We compared two RATs, the Panbio COVID-19 Ag Rapid Test (Abbott) and the SD Biosensor Q SARS-CoV-2 Rapid Antigen Test (Roche), against RT-PCR on the foil of new variants.MethodsWe included 888 all-comers at a diagnostic center between October 20, 2021, and March 18, 2022. RT-PCR-positive samples with a Ct value ≤ 32 were examined for SARS-CoV-2 variants.FindingsThe sensitivity of the Abbott-RAT and Roche-RAT were 65% and 67%, respectively. For both RATs, lower Ct values were significantly correlated with higher sensitivity. For samples with Ct values ≤ 25, the sensitivities of the Roche-RAT and of the Abbott-RAT were 96% and 95%, for Ct values 25-30 both were 19%, and for Ct values ≥ 30 they were 6% and 2%, respectively. The RATs had substantially higher sensitivities in symptomatic than asymptomatic participants (76, 77%, vs. 29, 31%, for Abbott-RAT, Roche-RAT, respectively) and in participants referred to testing by their primary care physician (84%, 85%) compared to participants who sought testing due to referral by the health department (55%, 58%) or a warning by the Corona-Warn-App (49%, 49%). In persons with self-reported previous Covid-19 sensitivities were markedly lower than in patients without previous Covid-19: 27% vs. 75% for Roche-RAT and 27% vs. 73% for Abbott-RAT. Depending on the vaccination status, the sensitivity of the RATs is 67.6%, 61.5% and 70.6% for non-vaccinated, vaccinated and boostered participants, respectively. For the considered subpopulation of 888 participants, we find no significant correlation between vaccination status and sensitivity.The Omicron variant was detected with a sensitivity of 94% and 92%, the delta variant with a sensitivity of 80% and 80% for Abbott-RAT and Roche-RAT, respectively. This difference is attributable to the lower Ct values of the Omicron samples compared to the Delta samples. When adjusted for the Ct value, a multivariate logistic regression did not show a significant difference between Omicron and Delta. In terms of sensitivity, we found no significant difference between the wild-type and the Omicron and Delta variants, but a significantly lower sensitivity to the alpha variant compared to the other variants.For a Ct value ≤ 25 the sensitivities were 95.2% and 96.0% for the Abbott-RAT and the Roche-RAT, respectively (Table 4). For a Ct value of 25-30 both RATs had a sensitivity of 18.8%. For a Ct value of 30-32, the sensitivities were 0.0% and 7.1% respectively, for Ct values ≥32 the sensitivities were 3.0% and 6.0% for Abbott-RAT and Roche-RAT, respectively.The specificities were >99% overall.Interpretation: The sensitivity of the RATs for asymptomatic carriers is unsatisfactory questioning their use for screening. When used in symptomatic patients or when requested by a primary care physician the sensitivities were higher. Our study does not suggest that the vaccination status influences the sensitivity of RATs.

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Serial antigen rapid testing in staff of a large acute hospital

Cited by 4 publications

References 12 publications

SARS-CoV-2 rapid antigen screening of asymptomatic employees: a pilot project

SARS-CoV-2 rapid antigen screening of asymptomatic employees: a pilot project

Diagnostic performance of rapid antigen testing for SARS-CoV-2: the COVid-19 AntiGen (COVAG) extension study

Diagnostic Performance of Rapid Antigen Testing for SARS-CoV-2: The COVid-19 AntiGen (COVAG) Extension study

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