Comparing SARS-CoV-2 testing positivity rates and COVID-19 impact among different isolation strategies: a rapid systematic review and a modelling study

Gao, Ya; Zhao, Yunli; Zhang, Xi; Tian, Jinhui; Guyatt, Gordon; Qin, Hao

doi:10.1016/j.eclinm.2023.102058

Cited by 2 publications

(3 citation statements)

References 53 publications

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“…When comparing RAg to RT-PCR positive test results, Sabat et al [33] found that 59.5% were asymptomatic. In fifteen studies reviewed, Gao et al [34] concluded that asymptomatic patients had a significantly lower (27.1%) positivity rate than symptomatic patients (68.1%) on day five.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Repeating COVID-19 Rapid Antigen Tests on Prevalence Boundary Performance and Missed Diagnoses

Kost

2023

Diagnostics

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A prevalence boundary (PB) marks the point in prevalence in which the false omission rate, RFO = FN/(TN + FN), exceeds the tolerance limit for missed diagnoses. The objectives were to mathematically analyze rapid antigen test (RAgT) performance, determine why PBs are breeched, and evaluate the merits of testing three times over five days, now required by the US Food and Drug Administration for asymptomatic persons. Equations were derived to compare test performance patterns, calculate PBs, and perform recursive computations. An independent July 2023 FDA–NIH–university–commercial evaluation of RAgTs provided performance data used in theoretical calculations. Tiered sensitivity/specificity comprise the following: tier (1) 90%, 95%; tier (2) 95%, 97.5%; and tier (3) 100%, ≥99%. Repeating a T2 test improves the PB from 44.6% to 95.2% (RFO 5%). In the FDA–NIH-university–commercial evaluation, RAgTs generated a sensitivity of 34.4%, which improved to 55.3% when repeated, and then improved to 68.5% with the third test. With RFO = 5%, PBs are 7.37/10.46/14.22%, respectively. PB analysis suggests that RAgTs should achieve a clinically proven sensitivity of 91.0–91.4%. When prevalence exceeds PBs, missed diagnoses can perpetuate virus transmission. Repeating low-sensitivity RAgTs delays diagnosis. In homes, high-risk settings, and hotspots, PB breaches may prolong contagion, defeat mitigation, facilitate new variants, and transform outbreaks into endemic disease. Molecular diagnostics can help avoid these potential vicious cycles.

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Section: Discussionmentioning

confidence: 99%

The Impact of Repeating COVID-19 Rapid Antigen Tests on Prevalence Boundary Performance and Missed Diagnoses

Kost

2023

Diagnostics

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“…This is due to many factors related to the level of economic development, organization of the health care system, ethnic characteristics of the population, efficiency and volume of restrictive measures taken by the government, health and mentality of society as a whole, the state of the environment, and a number of other factors. Since the beginning of the registration of COVID-19 cases, many countries have developed and started to use statistical reporting forms for the collection of epidemiological and clinical information and the formation of databases on this infection, which have allowed for not only analyzing the features of the epidemic process and course of the disease but also assessing the effectiveness of response strategies to plan future measures aimed at containing epidemics of aerosol infections with pandemic potential [4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

“…Res. 2024,15,8 evolved, and genomic changes led to the emergence of such characteristics as the ability to cause intensive transmission of the virus, to change the clinical symptoms of the disease, and to evade the immune response, diagnostic tools, and drugs (Figure5).…”

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confidence: 99%

COVID-19 Epidemic Process and Evolution of SARS-CoV-2 Genetic Variants in the Russian Federation

Akimkin,

Semenenko,

Ugleva

et al. 2024

Microbiology Research

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The COVID-19 pandemic, etiologically related to a new coronavirus, has had a catastrophic impact on the demographic situation on a global scale. The aim of this study was to analyze the manifestations of the COVID-19 epidemic process, the dynamics of circulation, and the rate of the spread of new variants of the SARS-CoV-2 virus in the Russian Federation. Retrospective epidemiological analysis of COVID-19 incidence from March 2020 to fall 2023 and molecular genetic monitoring of virus variability using next-generation sequencing technologies and bioinformatics methods were performed. Two phases of the pandemic, differing in the effectiveness of anti-epidemic measures and the evolution of the biological properties of the pathogen, were identified. Regularities of SARS-CoV-2 spread were determined, and risk territories (megacities), risk groups, and factors influencing the development of the epidemic process were identified. It was found that with each subsequent cycle of disease incidence rise, the pathogenicity of SARS-CoV-2 decreased against the background of the increasing infectiousness of SARS-CoV-2. Data on the mutational variability of the new coronavirus were obtained using the Russian platform of viral genomic information aggregation (VGARus) deployed at the Central Research Institute of Epidemiology. Monitoring the circulation of SARS-CoV-2 variants in Russia revealed the dominance of Delta and Omicron variants at different stages of the pandemic. Data from molecular genetic studies are an essential component of epidemiologic surveillance for making management decisions to prevent the further spread of SARS-CoV-2 and allow for prompt adaptation to pandemic control tactics.

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Comparing SARS-CoV-2 testing positivity rates and COVID-19 impact among different isolation strategies: a rapid systematic review and a modelling study

Cited by 2 publications

References 53 publications

The Impact of Repeating COVID-19 Rapid Antigen Tests on Prevalence Boundary Performance and Missed Diagnoses

The Impact of Repeating COVID-19 Rapid Antigen Tests on Prevalence Boundary Performance and Missed Diagnoses

COVID-19 Epidemic Process and Evolution of SARS-CoV-2 Genetic Variants in the Russian Federation

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