N-antigenemia detection by a rapid lateral flow test predicts 90-day mortality in COVID-19: A prospective cohort study

Almansa, Raquel; Eirós, José María; Gonzalo‐Calvo, David de; Postigo, Tamara; Ortega, Alicia; López-Izquierdo, Raúl; Moncusí‐Moix, Anna; Gort‐Paniello, Clara; Domínguez‐Gil, Marta; Fuente, Amanda de la; González-González, Laura; Luis-García, Tania; García-Mateo, Nadia; Tedim, Ana P.; Rodríguez-Jara, Fátima; Jorge, Noelia; González, Jessica; Torres, Gerard; Gutierrez-Perez, Oliver Norberto; Villegas, Maria José; Campo, Sonia; Ayllon, Eva; Albi, Tomás Ruíz; Arribas, Julio de Frutos; Domingo, Ainhoa Arroyo; Abadía-Otero, Jésica; Barquero, Julia Gómez; Trapiello, Wysali; Frade, L.J. García; Inglada, Luís; Campo, Félix del; Bermejo-Martín, Jesús F.; Barbé, Ferrán; Torres, Antoni

doi:10.1016/j.cmi.2022.05.023

Cited by 5 publications

(3 citation statements)

References 15 publications

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“…Strengths of our study include prospective enrollment in a diverse observational cohort with a range of illness severity levels. In contrast to other studies of N-antigen levels in the plasma, our results are quantitative [ 37 ]. Study participants were well phenotyped both clinically and biologically.…”

Section: Discussioncontrasting

confidence: 99%

“…There is increasing interest in the utility of the detection of viral protein antigens in the blood, which are detectable within 2 weeks of symptom onset [27][28][29][30] and are quantifiable even in patients with mild or minimal symptoms [28][29][30][31]. However, there are currently limited studies of how SARS-CoV-2 viral antigen detection in the blood is related to disease severity and outcomes [32][33][34][35][36][37].…”

Section: Introductionmentioning

confidence: 99%

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Plasma SARS-CoV-2 nucleocapsid antigen levels are associated with progression to severe disease in hospitalized COVID-19

et al. 2022

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Background Studies quantifying SARS-CoV-2 have focused on upper respiratory tract or plasma viral RNA with inconsistent association with clinical outcomes. The association between plasma viral antigen levels and clinical outcomes has not been previously studied. Our aim was to investigate the relationship between plasma SARS-CoV-2 nucleocapsid antigen (N-antigen) concentration and both markers of host response and clinical outcomes. Methods SARS-CoV-2 N-antigen concentrations were measured in the first study plasma sample (D0), collected within 72 h of hospital admission, from 256 subjects admitted between March 2020 and August 2021 in a prospective observational cohort of hospitalized patients with COVID-19. The rank correlations between plasma N-antigen and plasma biomarkers of tissue damage, coagulation, and inflammation were assessed. Multiple ordinal regression was used to test the association between enrollment N-antigen plasma concentration and the primary outcome of clinical deterioration at one week as measured by a modified World Health Organization (WHO) ordinal scale. Multiple logistic regression was used to test the association between enrollment plasma N-antigen concentration and the secondary outcomes of ICU admission, mechanical ventilation at 28 days, and death at 28 days. The prognostic discrimination of an externally derived “high antigen” cutoff of N-antigen ≥ 1000 pg/mL was also tested. Results N-antigen on D0 was detectable in 84% of study participants. Plasma N-antigen levels significantly correlated with RAGE (r = 0.61), IL-10 (r = 0.59), and IP-10 (r = 0.59, adjusted p = 0.01 for all correlations). For the primary outcome of clinical status at one week, each 500 pg/mL increase in plasma N-antigen level was associated with an adjusted OR of 1.05 (95% CI 1.03–1.08) for worse WHO ordinal status. D0 plasma N-antigen ≥ 1000 pg/mL was 77% sensitive and 59% specific (AUROC 0.68) with a positive predictive value of 23% and a negative predictive value of 93% for a worse WHO ordinal scale at day 7 compared to baseline. D0 N-antigen concentration was independently associated with ICU admission and 28-day mechanical ventilation, but not with death at 28 days. Conclusions Plasma N-antigen levels are readily measured and provide important insight into the pathogenesis and prognosis of COVID-19. The measurement of N-antigen levels early in-hospital course may improve risk stratification, especially for identifying patients who are unlikely to progress to severe disease.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Plasma SARS-CoV-2 nucleocapsid antigen levels are associated with progression to severe disease in hospitalized COVID-19

et al. 2022

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“…N-antigenaemia was defined as a positive result for the presence of N-antigen of SARS-CoV-2 in plasma using the Panbio COVID-19 Ag Rapid Test (Abbott, Chicago, IL, USA), as previously described. 24 …”

Section: Methodsmentioning

confidence: 99%

Effect of viral storm in patients admitted to intensive care units with severe COVID-19 in Spain: a multicentre, prospective, cohort study

Bermejo-Martín¹,

García-Mateo²,

Motos³

et al. 2023

The Lancet Microbe

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Synergistic impact of N-antigenemia profiled by a rapid antigen test and low anti-S1 antibodies on the risk of hospitalization in COVID-19

de la Fuente,

Postigo,

Sanus Ferri

et al. 2024

International Journal of Infectious Diseases

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N-antigenemia detection by a rapid lateral flow test predicts 90-day mortality in COVID-19: A prospective cohort study

Cited by 5 publications

References 15 publications

Plasma SARS-CoV-2 nucleocapsid antigen levels are associated with progression to severe disease in hospitalized COVID-19

Plasma SARS-CoV-2 nucleocapsid antigen levels are associated with progression to severe disease in hospitalized COVID-19

Effect of viral storm in patients admitted to intensive care units with severe COVID-19 in Spain: a multicentre, prospective, cohort study

Synergistic impact of N-antigenemia profiled by a rapid antigen test and low anti-S1 antibodies on the risk of hospitalization in COVID-19

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