The impact of population-wide rapid antigen testing on SARS-CoV-2 prevalence in Slovakia

Pavelka, Martin; Zandvoort, Kevin van; Abbott, Sam; Sherratt, Katharine; Majdán, Marek; Analýz, Inštitút Zdravotných; Jarčuška, Peter; Krajčí, Marek; Flasche, Stefan; Funk, Sebastian

doi:10.1101/2020.12.02.20240648

Cited by 63 publications

(60 citation statements)

References 30 publications

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“…To evaluate the performance of MassMark in a larger background of samples, we also included an additional 415 negative no-template samples. This translates to 12 SARS-CoV-2 positive samples (2.7%) out of a total of 437 samples, which would be in line with the approximately 1-4% prevalence of SARS-CoV-2 infections observed from a number of surveillance 5,7,28 and mass screening 29 efforts in places where the virus is actively spreading. Each plate also includes negative controls (0 copies) and positive controls from SARS-CoV-2 RNA at the analytical LOD of each of the three amplicons (100 copies or 250 copies) at fixed well positions per plate (Fig S1).…”

Section: Resultssupporting

confidence: 63%

MassMark: A Highly Scalable Multiplex NGS-based Method for High-Throughput, Accurate and Sensitive Detection of SARS-CoV-2 for Mass Testing

Ngeow¹,

Xie²,

Teo

et al. 2021

Preprint

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Mass testing has been proposed as a strategy to address and contain the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic1,2. We have developed MassMark, a novel and highly scalable multiplex method that employs next generation sequencing for high-throughput, accurate and sensitive detection of SARS-CoV-2, while minimizing handling complexity and resources by utilizing a serial pooling strategy to accommodate over 9,000 samples per workflow. Analytical validation showed that MassMark was able to detect SARS-CoV-2 RNA down to a level of 100 copies per reaction. We evaluated the clinical performance of MassMark in a simulated screening testing with 22 characterized samples from three different sources (nasopharyngeal swabs, nasal swabs and saliva), comprising of 12 SARS-CoV-2 positive samples with mid to late Ct values (range: 22.98-32.72) and 10 negative samples. There was one false negative and no false positives, giving an overall sensitivity and specificity of 91.67% and 100% respectively, when compared against an optimized RT-PCR test with a target size within 70 bp (CDC 2019-nCoV Real-Time RT-PCR Diagnostic Panel3).

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Section: Resultssupporting

confidence: 63%

MassMark: A Highly Scalable Multiplex NGS-based Method for High-Throughput, Accurate and Sensitive Detection of SARS-CoV-2 for Mass Testing

Ngeow¹,

Xie²,

Teo

et al. 2021

Preprint

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“…Preprint research has reported on the findings of Slovakia's 2 rounds of countrywide mass testing in October and November 2020; this involved 60 000 (20 000 medical and 40 000 nonmedical) staf and 5 million rapid antigen tests. 14 In the first and second rounds, the rate of positivity was 1.01% (range across counties 0.13% to 3.22%) and 0.62% (range 0.28% to 1.65%), respectively, an adjusted decrease in SARS-CoV-2 infections of 61% (95% confidence interval 50%-70%) from the first to second round. A subsequent evaluation in the UK found that the Innova rapid antigen test detected more than 90% of samples with Ct values for RT-PCR less than 25.5 as positive, 15 and a program of rapid antigen testing for staf and visitors in long-term care homes was implemented.…”

Section: What Is the International Experience With Rapid Antigen Scrementioning

confidence: 89%

Rapid antigen screening of asymptomatic people as a public health tool to combat COVID-19

Schwartz

McGeer

Bogoch

2021

CMAJ

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J urisdictions across Canada have been trying to combat a second wave of the coronavirus disease 2019 (COVID-19) pandemic without using all the available tools. Accumulating evidence has shown that people who are infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who are either presymptomatic (but subsequently develop symptoms) or paucisymptomatic (have mild symptoms that do not prompt a medical visit) are major contributors to transmission. However, current approaches of testing predominately symptomatic patients and relying on the results of expensive and slow laboratory-based testing for contact tracing have proven inadequate to control the spread of the disease, with associated economic and societal impacts. Frequent rapid antigen testing is a scalable public health tool that can efectively identify asymptomatic and paucisymptomatic people with SARS-CoV-2 infection and improve contact tracing and control of outbreaks. Why test people who have no symptoms of COVID-19? A 2020 study of transmission dynamics in Taiwan showed that the infectious period for COVID-19 starts 2-3 days before symptom onset and continues to about 5 days afer. 1 Modelling has estimated that more than 50% of SARS-CoV-2 transmissions occur during the presymptomatic period or during asymptomatic infection. 2,3 A study in which the authors reconstructed transmission in China up to April 2020 found that presymptomatic transmission accounted for a high proportion (40%-90%) of transmissions. 4 Furthermore, higher viral loads have been shown to be significantly associated with higher transmission risk irrespective of symptoms. 5 Even with ideal public health resources for testing and tracing, the strategy of testing only symptomatic cases will not identify many of the contacts before they transmit infection. A report from the Ofice of the Auditor General of Ontario indicated that the average time from specimen collection to the start of case and contact management was 4.25 days. 6 In this scenario, for patients who seek testing on their first day of symptoms, on KEY POINTS • People who are presymptomatic and paucisymptomatic are important contributors to the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). What rapid antigen tests are available and how should they be evaluated? Although many diferent devices are being produced, the Abbott Panbio lateral flow assay is the only device with Health Canada approval at the time of writing. Lateral flow assays detect a protein

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“…Mass testing for early identification and isolation of individuals infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), irrespective of symptoms, is potentially an efficacious strategy to reduce disease transmission. 1 Recent advances on the validation of Antigen-detecting Rapid Diagnostic Tests (Ag-RDTs) show promise to replace central laboratory techniques for epidemiological control of the SARS-CoV-2 through mass testing.…”

Section: Introductionmentioning

confidence: 99%

Performance characteristics of five antigen-detecting rapid diagnostic test (Ag-RDT) for SARS-CoV-2 asymptomatic infection: a head-to-head benchmark comparison

Baró

Rodó

Ouchi

et al. 2021

Preprint

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Background: Mass testing for early identification and isolation of infectious COVID-19 individuals, irrespective of concurrent symptoms, is an efficacious strategy to reduce disease transmission. Antigen-detecting rapid diagnostic tests (Ag-RDT) appear as a potentially suitable tool for mass testing on account of their ease-of-use, fast turnaround time, and low cost. However, benchmark comparisons are scarce, particularly in the context of unexposed asymptomatic individuals. Methods: We used nasopharyngeal specimens from unexposed asymptomatic individuals to assess five Ag-RDTs: PanBioTM COVID-19 Ag Rapid test (Abbott), CLINITEST Rapid COVID-19 Antigen Test (Siemens), SARS-CoV-2 Rapid Antigen Test (Roche Diagnostics), SARS-CoV-2 Antigen Rapid Test Kit (Lepu Medical), and COVID-19 Coronavirus Rapid Antigen Test Cassette (Surescreen). Samples were collected between December 2020-January 2021 during the third wave of the epidemic in Spain. Findings: The analysis included 101 specimens with confirmed positive PCR results and 185 with negative PCR. For the overall sample, the performance parameters of Ag-RDTs were as follows: Abbott assay, sensitivity 38,6% (95% CI 29,1 to 48,8) and specificity 99,5% (9 to 100%); Siemens, sensitivity 51,5% (41,3 to 61,6) and specificity 98,4% (95,3 to 99,6); Roche, sensitivity 43,6% (33,7 to 53,8) and specificity 96,2% (92,4 to 98,5); Lepu, sensitivity 45,5% (35,6 to 55,8) and specificity 89,2% (83,8 to 93,3%); Surescreen, sensitivity 28,8% (20,2 to 38,6) and specificity 97,8% (94,5 to 99,4%). For specimens with cycle threshold (Ct) <30 in RT-qPCR, all Ag-RDT achieved a sensitivity of at least 70%, with Siemens, Roche, and Lepu assays showing sensitivities higher than 80%. In models according to population prevalence, all Ag-RDTs will have a NPV >99% and a PPV<50% at 1% prevalence. Interpretation: Two commercial, widely available assays can be used for SARS-CoV-2 antigen testing to achieve sensitivity in specimens with a Ct<30 and specificity of at least 80% and 96%, respectively. Estimated negative and positive predictive values suggests the suitability of Ag-RDTs for mass screenings of SARS-CoV-2 infection in the general population.

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The impact of population-wide rapid antigen testing on SARS-CoV-2 prevalence in Slovakia

Cited by 63 publications

References 30 publications

MassMark: A Highly Scalable Multiplex NGS-based Method for High-Throughput, Accurate and Sensitive Detection of SARS-CoV-2 for Mass Testing

MassMark: A Highly Scalable Multiplex NGS-based Method for High-Throughput, Accurate and Sensitive Detection of SARS-CoV-2 for Mass Testing

Rapid antigen screening of asymptomatic people as a public health tool to combat COVID-19

Performance characteristics of five antigen-detecting rapid diagnostic test (Ag-RDT) for SARS-CoV-2 asymptomatic infection: a head-to-head benchmark comparison

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