Comparative Evaluation of Nasopharyngeal and Oropharyngeal Swab Based Rapid SARS-CoV-2 Antigen Detection and Real-Time RT-PCR for Diagnosis of COVID-19 in Tertiary Care Hospital

Singh, Arpana; Gupta, Pratima; Mathuria, Yogendra Pratap; Kalita, Deepjyoti; Prasad, Amber; Panda, Prasan Kumar; Bahurupi, Yogesh; Sahoo, Biswajeet; Omar, Balram Ji

doi:10.7759/cureus.16785

Cited by 6 publications

(12 citation statements)

References 15 publications

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“…Regarding the pediatric samples, we found lower sensitivity values when compared with samples from adult patients [22,24,25,28]. Furthermore, age was associated with antigen-test performance irrespective of Ct values and symptom duration [17].…”

Section: Discussionmentioning

confidence: 71%

“…Lower sensitivity was also observed in samples that showed high Ct values in RT-PCR [17][18][19]24,[26][27][28][30][31][32][33][34]36,38,39,42,43,47,53], indicating a lower viral load. In SARS-CoV-2 infection, the viral load peaks in the first week after the onset of symptoms in the upper respiratory tract.…”

Section: Discussionmentioning

confidence: 95%

“…Notable differences were observed in sensitivity values among studies that used nasal swab samples (20% [39], 44.7% [17], and >96% [41]). Likewise, NPS/OP swab samples [28,29,36] showed suboptimal values of sensitivity between studies (35.29%, 75%, and 78.2%). In saliva samples, the sensitivity was lower compared with that of NPS/throat swab samples (23.1% [17] versus >98% [35]).…”

Section: Direct Detection Testsmentioning

confidence: 93%

“…Suboptimal sensitivity was also observed in samples with low viral loads (high Ct value in RT-PCR) [17][18][19]24,[26][27][28][30][31][32][33][34]36,38,39,42] and in pediatric samples, when compared with samples from adult patients [22,24,25,28]. Only two studies showed values of specificity lower than 98% (64.2% and 83.3%) [36,42].…”

Section: Direct Detection Testsmentioning

confidence: 95%

“…Overall, Ag-RDT studies used nasopharyngeal swabs samples (NPS). However, two of them used nasal swabs [39,41]; one used NPS/throat swabs [35]; one used both swabs' NPs, such as nasal and saliva swabs [17]; and three used NPS/oropharyngeal swabs (OP) [28,29,36].…”

Section: Direct Detection Testsmentioning

confidence: 99%

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Update on Rapid Diagnostics for COVID-19: A Systematic Review

Dias

Gonçalves

Ferreira

et al. 2022

IJTM

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An accurate and rapid diagnosis of COVID-19 is an effective strategy for pandemic control, allowing disease screening and timely therapeutic intervention. We analyzed scientific reports about rapid tests for the diagnosis of COVID-19 to assess their reliability parameters. Medical Subject Headings terms or keywords related to point-of-care and rapid diagnostic testing for SARS-CoV-2 and COVID-19 were searched in data published from November 2020 to November 2021 in PubMed and Google Scholar databases. Notable differences were observed in sensitivity among direct tests that used different samples, and good accuracy was reported in a significant number of studies (>80%). Pediatric samples and samples with high Ct values (RT-PCR) had suboptimal sensitivity (range 45.4% to 66%). Further, a lack of sensitivity (<46.2%) was observed in point-of-care tests and in rapid diagnostic tests for antibody detection in the first days after infection, with increasing values in postinfection analysis (>60%). For serological detection of IgM or Antigen rapid diagnostic tests, no cross-reactivity was found with other coronaviruses. Therefore, although these tests are very important in facing the pandemic, they still need to be improved to test cross-reactivity against other pathogens, especially against other coronaviruses.

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 95%

Section: Direct Detection Testsmentioning

confidence: 93%

Section: Direct Detection Testsmentioning

confidence: 95%

Section: Direct Detection Testsmentioning

confidence: 99%

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Update on Rapid Diagnostics for COVID-19: A Systematic Review

Dias

Gonçalves

Ferreira

et al. 2022

IJTM

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Biomedical detection dogs for the identification of SARS-CoV-2 infections from axillary sweat and breath samples ^**

et al. 2022

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A PCR test of a nasal swab is still the “gold standard” for detecting a SARS-CoV-2 infection. However, PCR testing could be usefully complemented by non-invasive, fast, reliable, cheap methods for detecting infected individuals in busy areas (e.g. airports and railway stations) or remote areas. Detection of the volatile, semivolatile and non-volatile compound signature of SARS-CoV-2 infection by trained sniffer dogs might meet these requirements. Previous studies have shown that well-trained dogs can detect SARS-CoV-2 in sweat, saliva and urine samples. The objective of the present study was to assess the performance of dogs trained to detect the presence of SARS-CoV-2 in axillary-sweat-stained gauzes and on expired breath trapped in surgical masks. The samples were provided by individuals suffering from mild-to-severe coronavirus disease 2019 (COVID-19), asymptomatic individuals, and individuals vaccinated against COVID-19. Results: Seven trained dogs tested on 886 presentations of sweat samples from 241 subjects and detected SARS-CoV-2 with a diagnostic sensitivity (relative to the PCR test result) of 89.6% (95% confidence interval (CI): 86.4-92.2%) and a specificity of 83.9% (95% CI: 80.3-87.0%) - even when people with a low viral load were included in the analysis. When considering the 207 presentations of sweat samples from vaccinated individuals, the sensitivity and specificity were respectively 85.7% (95% CI: 68.5-94.3) and 86.0% (95% CI: 80.2-90.3%). The likelihood of a false-positive result was greater in the two weeks immediately after COVID-19 vaccination. Four of the seven dogs also tested on 262 presentations of mask samples from 98 subjects; the diagnostic sensitivity was 83.1% (95% CI: 73.2-89.9) and the specificity was 88.6% (95% CI: 83.3-92.4%). There was no difference (McNemar's test P=0.999) in the dogs’ abilities to detect the presence of SARS-CoV-2 in paired samples of sweat-stained gauzes vs. surgical masks worn for only 10 minutes. Conclusion: Our findings confirm the promise of SARS-CoV-2 screening by detection dogs and broaden the method’s scope to vaccinated individuals and easy-to-obtain face masks, and suggest that a “dogs + confirmatory rapid antigen detection tests” screening strategy might be worth investigating.

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Diagnostic accuracy of a SARS-CoV-2 rapid antigen test among military and civilian personnel of an Air Force airport in central Italy

et al. 2022

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Background Most SARS-CoV-2 rapid antigen detection tests (RADTs) validation studies have been performed on specimens from COVID-19 patients and negative controls or from mostly symptomatic individuals. Herein we evaluated the diagnostic accuracy of AFIAS COVID-19 Ag, hereinafter denominated as AFIAS, during a COVID-19 screening program surveillance testing conducted among personnel of an Italian military airport. Methods Nasopharyngeal swabs (NPSs) were collected from study participants and were analysed by both AFIAS and RT-PCR assay. A questionnaire collecting demographic and exposure data were administered to all participants. AFIAS accuracy parameters including Cohen’s kappa (K) were determined. Results Overall, from November 2020 to April 2021, 1294 (NPSs) were collected from 1183 participants (88.6% males, 11.4% females; mean age were 41.3, median age 42). Forty-nine NPSs (3.78%) were positive by RT-PCR, while 54 NPSs were positive by AFIAS. Overall baseline sensitivity, specificity, positive and negative predictive values were 0.633, 0.981, 0.574, 0.985, respectively and K was 0.585 (moderate). AFIAS sensitivity tended to be higher for NPSs with higher viral load. A higher sensitivity (0.944) compared to the overall baseline sensitivity (0.633) was also found for NPSs from participants with COVID-19 compatible symptoms, for which K was 0.891 (almost perfect). Instead, AFIAS sensitivity was quite poor for NPSs from asymptomatic participants. Most false negative NPSs in this group had moderate viral load. Conclusion Overall, AFIAS showed high specificity but only moderate sensitivity, mainly because of the high proportion of asymptomatic participants. However, AFIAS showed good sensitivity for NPSs with high viral load and nearly optimal accuracy parameters for NPSs from participants with COVID-19 compatible symptoms. Thus, taking into consideration its performance features, this test can be useful for COVID-19 case identification and management as well as for infection control.

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Comparative Evaluation of Nasopharyngeal and Oropharyngeal Swab Based Rapid SARS-CoV-2 Antigen Detection and Real-Time RT-PCR for Diagnosis of COVID-19 in Tertiary Care Hospital

Cited by 6 publications

References 15 publications

Update on Rapid Diagnostics for COVID-19: A Systematic Review

Update on Rapid Diagnostics for COVID-19: A Systematic Review

Biomedical detection dogs for the identification of SARS-CoV-2 infections from axillary sweat and breath samples ^**

Diagnostic accuracy of a SARS-CoV-2 rapid antigen test among military and civilian personnel of an Air Force airport in central Italy

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Comparative Evaluation of Nasopharyngeal and Oropharyngeal Swab Based Rapid SARS-CoV-2 Antigen Detection and Real-Time RT-PCR for Diagnosis of COVID-19 in Tertiary Care Hospital

Cited by 6 publications

References 15 publications

Update on Rapid Diagnostics for COVID-19: A Systematic Review

Update on Rapid Diagnostics for COVID-19: A Systematic Review

Biomedical detection dogs for the identification of SARS-CoV-2 infections from axillary sweat and breath samples **

Diagnostic accuracy of a SARS-CoV-2 rapid antigen test among military and civilian personnel of an Air Force airport in central Italy

Contact Info

Product

Resources

About

Biomedical detection dogs for the identification of SARS-CoV-2 infections from axillary sweat and breath samples ^**