Lateral flow tests cannot rule out SARS- CoV-2 infection

Deeks, Jonathan J; Raffle, Angela E.

doi:10.1136/bmj.m4787

Cited by 77 publications

(85 citation statements)

References 7 publications

(7 reference statements)

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“…Mass testing risks the harmful diversion of scarce resources. A further concern is the use of inadequately evaluated tests as screening tools in healthy populations 20…”

Section: Missed Opportunitymentioning

confidence: 99%

Asymptomatic transmission of covid-19

Pollock

Lancaster

2020

BMJ

137

114

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“…Mass testing risks the harmful diversion of scarce resources. A further concern is the use of inadequately evaluated tests as screening tools in healthy populations 20…”

Section: Missed Opportunitymentioning

confidence: 99%

Asymptomatic transmission of covid-19

Pollock

Lancaster

2020

BMJ

137

114

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“…Effective screening tests must be accurate and reliable (5) . However, current tools such as lateral flow assays (LFAs) for SARS-CoV-2 antigens appear to have inadequate sensitivity to effectively rule out active infection and may have limited value for contact and general population screening (6) . Reverse-transcriptase PCR (RT-PCR) tests, which identify viral RNA, are the current gold standard for diagnosis of SARS-CoV-2 infection but pose different challenges including test speed and the requirement of a skilled laboratory operator (7) .…”

Section: Introductionmentioning

confidence: 99%

Blood transcriptional biomarkers of acute viral infection for detection of pre-symptomatic SARS-CoV-2 infection

Rosenheim

Bell

et al. 2021

Preprint

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We hypothesised that host-response biomarkers of viral infections may contribute to early identification of SARS-CoV-2 infected individuals, critical to breaking chains of transmission. We identified 20 candidate blood transcriptomic signatures of viral infection by systematic review and evaluated their ability to detect SARS-CoV-2 infection, compared to the gold-standard of virus PCR tests, among a prospective cohort of 400 hospital staff subjected to weekly testing when fit to attend work. The transcriptional signatures had limited overlap, but were mostly co-correlated as components of type 1 interferon responses. We reconstructed each signature score in blood RNA sequencing data from 41 individuals over sequential weeks spanning a first positive SARS-CoV-2 PCR, and after 6-month convalescence. A single blood transcript for IFI27 provided the highest accuracy for discriminating individuals at the time of their first positive viral PCR result from uninfected controls, with area under the receiver operating characteristic curve (AUROC) of 0.95 (95% confidence interval 0.91–0.99), sensitivity 0.84 (0.7–0.93) and specificity 0.95 (0.85–0.98) at a predefined test threshold. The test performed equally well in individuals with and without symptoms, correlated with viral load, and identified incident infections one week before the first positive viral PCR with sensitivity 0.4 (0.17–0.69) and specificity 0.95 (0.85–0.98). Our findings strongly support further urgent evaluation and development of blood IFI27 transcripts as a biomarker for early phase SARS-CoV-2 infection, for screening individuals such as contacts of index cases, in order to facilitate early case isolation and early antiviral treatments as they emerge.

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“…Selling for-profit tests lacking the foundation of robust kinetic data and scientific field testing without proper controls are criminal practices. University of Oxford considered forty devices but only nine met some of the performance criteria, and only one was advanced enough for assessment 573…”

Section: Appendix VIII -Field Testing the Aptamer Sensor Alone Maymentioning

confidence: 99%

Aptamers for Detection and Diagnostics (ADD): Can mobile systems process optical data from aptamer sensors to identify molecules indicating presence of SARS-CoV-2 virus? Should healthcare explore aptamers as drugs for prevention as well as its use as adjuvants with antibodies and vaccines?

Datta

2021

Preprint

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Proposed SARS-CoV-2 surveillance tool using a mobile app for non-invasive monitoring of humans and animals. <p>Engineering a biomedical device as a low-cost, non-invasive, detection, and diagnostic platform for surveillance of infections in humans, and animals. The system embraces the IoT <i>“digital by design”</i> metaphor by incorporating elements of connectivity, data sharing and (secure) information arbitrage. Using an array of aptamers to bind viral targets may help in detection, diagnostics, and potentially prevention in case of SARS-CoV-2. The ADD tool may become part of a broader platform approach.</p>

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Lateral flow tests cannot rule out SARS- CoV-2 infection

Abstract: People testing negative must stick to infection control recommendations

Cited by 77 publications

References 7 publications

Asymptomatic transmission of covid-19

Asymptomatic transmission of covid-19

Blood transcriptional biomarkers of acute viral infection for detection of pre-symptomatic SARS-CoV-2 infection

Aptamers for Detection and Diagnostics (ADD): Can mobile systems process optical data from aptamer sensors to identify molecules indicating presence of SARS-CoV-2 virus? Should healthcare explore aptamers as drugs for prevention as well as its use as adjuvants with antibodies and vaccines?

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