Recommendations for use of antigenic tests in the diagnosis of acute SARS-CoV-2 infection in the second pandemic wave: attitude in different clinical settings

Abstract

The high transmissibility of SARS-CoV-2 before and shortly after the onset of symptoms suggests that only diagnosing and isolating symptomatic patients may not be sufficient to interrupt the spread of infection; therefore, public health measures such as personal distancing are also necessary. Additionally, it will be important to detect the newly infected individuals who remain asymptomatic, which may account for 50% or more of the cases. Molecular techniques are the “gold standard” for the diagnosis of SARS-CoV-2 infection. However, the massive use of these techniques has generated some problems. On the one hand, the scarcity of resources (analyzers, fungibles and reagents), and on the other the delay in the notification of results. These two facts translate into a lag in the application of isolation measures among cases and contacts, which favors the spread of the infection. Antigen detection tests are also direct diagnostic methods, with the advantage of obtaining the result in a few minutes and at the very “pointof-care”. Furthermore, the simplicity and low cost of these tests allow them to be repeated on successive days in certain clinical settings. The sensitivity of antigen tests is generally lower than that of nucleic acid tests, although their specificity is comparable. Antigenic tests have been shown to be more valid in the days around the onset of symptoms, when the viral load in the nasopharynx is higher. Having a rapid and real-time viral detection assay such as the antigen test has been shown to be more useful to control the spread of the infection than more sensitive tests, but with greater cost and response time, such as in case of molecular tests. The main health institutions such as the WHO, the CDC and the Ministry of Health of the Government of Spain propose the use of antigenic tests in a wide variety of strategies to respond to the pandemic. This document aims to support physicians involved in the care of patients with suspected SC2 infection, in the context of a growing incidence in Spain since September 2020, which already represents the second pandemic wave of COVID-19.

Panbio™ rapid antigen test for SARS-CoV-2 has acceptable accuracy in symptomatic patients in primary health care

“…The present study is the largest evaluation of the Panbio Ag-RDT in samples from symptomatic and asymptomatic patients in real-world context. This is a strength of our study because this is the setting where the majority of the patients with mild symptoms (up to 75%) 12 and close contacts are visited and followed-up. We incorporated COVID-19 testing into the usual care and management of patients with suspected SARS-CoV-2 infection and less than 2% of participants denied taking part in the study.…”

Diagnostic performance of CerTest and Panbio antigen rapid diagnostic tests to diagnose SARS-CoV-2 infection

“…Some authors have pointed out that, besides the lower sensitivity of Ag-RDTs compared to PCR, they improve the turnaround time for results, which is key to interrupt transmission chains in order to control the spread of this pandemic [ 6 , 7 , 21 , 22 ]. In line with this, some diagnostic algorithms recommend the use of these tests as the first step for symptomatic patients within the first five days after the onset of symptoms [ [21] , [22] , [23] ]. Our results support the use of CerTest and Panbio tests for that purpose.…”

Prevalence of psychiatric diagnosis and related psychopathological symptoms among patients with COVID-19 during the second wave of the pandemic

“…After many countries had controlled the first wave of the pandemic, they relaxed their containment and physical distancing control measures, causing the infection rate to increase accordingly [ 3 , 4 ]. This worldwide resurgence of COVID-19 cases indicated that the second wave of the pandemic was occurring [ 5 – 7 ]. However, few studies have explored the effect of the second wave of the pandemic on mental health.…”