COVID-19 rapid antigen testing strategies must be evaluated in intended use settings

Dinnes, Jacqueline; Davenport, Clare

doi:10.1016/j.lanwpc.2022.100542

Cited by 2 publications

(3 citation statements)

References 6 publications

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“…Serological tests for Mtb may be advantageous due to their low cost and ease of use (58). Rapid serologic tests for COVID-19 have demonstrated the potential of antibody-based diagnostics for transmission control, although many COVID-19 tests were antigen based (59).…”

Section: Existing Tb Diagnosticsmentioning

confidence: 99%

Antibodies as clinical tools for tuberculosis

McIntyre,

Warner,

Rush

et al. 2023

Front. Immunol.

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Tuberculosis (TB) is a leading cause of morbidity and mortality worldwide. Global research efforts to improve TB control are hindered by insufficient understanding of the role that antibodies play in protective immunity and pathogenesis. This impacts knowledge of rational and optimal vaccine design, appropriate diagnostic biomarkers, and development of therapeutics. Traditional approaches for the prevention and diagnosis of TB may be less efficacious in high prevalence, remote, and resource-poor settings. An improved understanding of the immune response to the causative agent of TB, Mycobacterium tuberculosis (Mtb), will be crucial for developing better vaccines, therapeutics, and diagnostics. While memory CD4+ T cells and cells and cytokine interferon gamma (IFN-g) have been the main identified correlates of protection in TB, mounting evidence suggests that other types of immunity may also have important roles. TB serology has identified antibodies and functional characteristics that may help diagnose Mtb infection and distinguish between different TB disease states. To date, no serological tests meet the World Health Organization (WHO) requirements for TB diagnosis, but multiplex assays show promise for improving the sensitivity and specificity of TB serodiagnosis. Monoclonal antibody (mAb) therapies and serum passive infusion studies in murine models of TB have also demonstrated some protective outcomes. However, animal models that better reflect the human immune response to Mtb are necessary to fully assess the clinical utility of antibody-based TB prophylactics and therapeutics. Candidate TB vaccines are not designed to elicit an Mtb-specific antibody response, but evidence suggests BCG and novel TB vaccines may induce protective Mtb antibodies. The potential of the humoral immune response in TB monitoring and control is being investigated and these studies provide important insight into the functional role of antibody-mediated immunity against TB. In this review, we describe the current state of development of antibody-based clinical tools for TB, with a focus on diagnostic, therapeutic, and vaccine-based applications.

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Section: Existing Tb Diagnosticsmentioning

confidence: 99%

Antibodies as clinical tools for tuberculosis

McIntyre,

Warner,

Rush

et al. 2023

Front. Immunol.

View full text Add to dashboard Cite

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“…COVID-19 testing was initially a challenge because the availability of tests were limited . Once testing was made more widely available, the timeliness of testing subsequently became a critical factor; identification of a positive test allows for modification of behaviors (eg, isolation and quarantine), contact tracing, and receipt of treatment as part of effective public health strategies for reducing community-level spread of the infection and improving population-based outcomes …”

Section: Introductionmentioning

confidence: 99%

“…9 Once testing was made more widely available, the timeliness of testing subsequently became a critical factor; identification of a positive test allows for modification of behaviors (eg, isolation and quarantine), contact tracing, and receipt of treatment as part of effective public health strategies for reducing community-level spread of the infection and improving population-based outcomes. 10,11 In this study, we investigated the timeliness of COVID-19 testing in a population that had access to employer-based testing. We aimed to assess whether demographic variables such as sex, age, race, and ethnicity were associated with delays in testing in a cohort of health care personnel (HCP) who had symptoms consistent with COVID-19.…”

Section: Introductionmentioning

confidence: 99%

Race, Ethnicity, and Delayed Time to COVID-19 Testing Among US Health Care Workers

Baymon,

Vakkalanka,

Krishnadasan

et al. 2024

JAMA Netw Open

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ImportanceAccess to COVID-19 testing is critical to reducing transmission and supporting early treatment decisions; when made accessible, the timeliness of testing may also be an important metric in mitigating community spread of the infection. While disparities in transmission and outcomes of COVID-19 have been well documented, the extent of timeliness of testing and the association with demographic factors is unclear.ObjectivesTo evaluate demographic factors associated with delayed COVID-19 testing among health care personnel (HCP) during the COVID-19 pandemic.Design, Setting, and ParticipantsThis cross-sectional study used data from the Preventing Emerging Infections Through Vaccine Effectiveness Testing study, a multicenter, test-negative, case-control vaccine effectiveness study that enrolled HCP who had COVID-19 symptoms and testing between December 2020 and April 2022. Data analysis was conducted from March 2022 to Junne 2023.ExposureDisplaying COVID-19–like symptoms and polymerase chain reaction testing occurring from the first day symptoms occurred up to 14 days after symptoms occurred.Main Outcomes and MeasuresVariables of interest included patient demographics (sex, age, and clinical comorbidities) and COVID-19 characteristics (vaccination status and COVID-19 wave). The primary outcome was time from symptom onset to COVID-19 testing, which was defined as early testing (≤2 days) or delayed testing (≥3 days). Associations of demographic characteristics with delayed testing were measured while adjusting for clinical comorbidities, COVID-19 characteristics, and test site using multivariable modeling to estimate relative risks and 95% CIs.ResultsA total of 5551 HCP (4859 female [82.9%]; 1954 aged 25-34 years [35.2%]; 4233 non-Hispanic White [76.3%], 370 non-Hispanic Black [6.7%], and 324 non-Hispanic Asian [5.8%]) were included in the final analysis. Overall, 2060 participants (37.1%) reported delayed testing and 3491 (62.9%) reported early testing. Compared with non-Hispanic White HCP, delayed testing was higher among non-Hispanic Black HCP (adjusted risk ratio, 1.18; 95%CI, 1.10-1.27) and for non-Hispanic HCP of other races (adjusted risk ratio, 1.17; 95% CI, 1.03-1.33). Sex and age were not associated with delayed testing. Compared with clinical HCP with graduate degrees, all other professional and educational groups had significantly delayed testing.Conclusions and RelevanceIn this cross-sectional study of HCP, compared with non-Hispanic White HCP and clinical HCP with graduate degrees, non-Hispanic Black HCP, non-Hispanic HCP of other races, and HCP all other professional and education backgrounds were more likely to have delayed COVID-19 testing. These findings suggest that time to testing may serve as a valuable metric in evaluating sociodemographic disparities in the response to COVID-19 and future health mitigation strategies.

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COVID-19 rapid antigen testing strategies must be evaluated in intended use settings

Cited by 2 publications

References 6 publications

Antibodies as clinical tools for tuberculosis

Antibodies as clinical tools for tuberculosis

Race, Ethnicity, and Delayed Time to COVID-19 Testing Among US Health Care Workers

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