SARS-CoV-2 Rapid Antigen Testing of Symptomatic and Asymptomatic Individuals on the University of Arizona Campus

Harris, David T.; Badowski, Michael; Jernigan, Brandon; Sprissler, Ryan; Edwards, Taylor; Cohen, Randall; Paul, Stephen; Merchant, Nirav; Weinkauf, Craig; Bime, Christian; Erickson, Heidi E; Bixby, Billie; Parthasarathy, Sairam; Chaudhary, Sachin; Cristan, Elaine; Aini, Tammer El; Rischard, Franz; Campion, Janet; Chopra, Madhav; Insel, Michael; Sam, Afshin; Knepler, James; Knox, Kenneth S.; Mosier, Jarrod; Spier, Catherine M.; Dake, Michael D.

doi:10.3390/biomedicines9050539

Cited by 20 publications

(22 citation statements)

References 11 publications

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“…The sensitivity was higher in symptomatic persons, with 52.9%, than in asymptomatic with 20.6%. These results are also confirmed by other studies, which suggest that the Se in symptomatic people can be twice as high as in asymptomatic people [33][34][35][36]. The prevalence in this study was 2.2%, possibly because this study was conducted during a major lockdown in Germany, and also because relatives with positive symptoms of a SARS-CoV-2 infection were not allowed to be admitted.…”

Section: Discussionsupporting

confidence: 89%

Diagnostic Performance of SARS-CoV-2 Rapid Antigen Test in a Large, German Cohort

et al. 2021

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We assessed the performance of a rapid antigen test (RAT) in everyday clinical practice. Between 1 November 2020 until 1 April 2021 all in-patients at the Helios University Hospital Wuppertal, Germany, as well as the accompanying relatives at the Children’s Hospital received a SARS-CoV-2 RAT and a SARS-CoV-2 RT-PCR prior to admission. Out of 3686 patients, 22 (0.6%) subjects were tested positive by RT-PCR and RAT, and 3591 (97.4%) were negative by both methods, showing discordant results: RT-PCR+/RAT− in 58 (1.6%) and RT-PCR−/RAT+ in 15 patients (0.4%). Overall sensitivity and specificity of RAT was 27.5% (95%CI 18.1–38.6%) and 99.6% (95%CI 99.3–99.8%), respectively. The sensitivity was slightly higher in adults (30.4%, 95%CI 18.8–90.9%) than in pediatric subjects (20.8%, 95%CI 7.1–42.2%). False negative RAT had a statistically higher Ct-value (p < 0.001) compared to true positive values, and overall sensitivity increased to 80% [59.3–93.2%] with Ct value < 30. While the sensitivity of the RAT was poor compared with the RT-PCR, the specificity was excellent. However, the sensitivity increased with lower Ct value, and with the right anamnesis the RAT can be a quick and easy approach to distinguish people who are infectious with SARS-CoV-2 from noninfectious people, enabling appropriate triage in clinical practice while waiting for the RT-PCR result.

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Section: Discussionsupporting

confidence: 89%

Diagnostic Performance of SARS-CoV-2 Rapid Antigen Test in a Large, German Cohort

et al. 2021

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“…Thus, the likelihood of false-negative antigen test results becomes higher at lower viral loads. While some studies detected no difference in the mean Ct values between symptomatic patients and asymptomatic patients [ 41 ], others reported that symptomatic patients displayed lower Ct values than asymptomatic COVID-19 patients, and a Ct value of 30 is the threshold for SARS-CoV-2 infectivity [ 22 , 38 ]. Moreover, it was shown [ 37 ] that different sensitivity versus Ct value patterns prevail in symptomatic and asymptomatic patient groups.…”

Section: Discussionmentioning

confidence: 99%

Clinical Accuracy of Instrument-Read SARS-CoV-2 Antigen Rapid Diagnostic Tests (Ag-IRRDTs)

Keskïn

2022

International Journal of Microbiology

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This systematic review (PROSPERO registration number: CRD42021282476) aims to collect and analyse current evidence on real-world performance based on clinical accuracy of instrument-read rapid antigen diagnostic tests (Ag-IRRDTs) for SARS-CoV-2 identification. We used PRISMA Checklist and searched databases (PubMed, Web of Science Core Collection and FIND) for publications evaluating the accuracy of SARS-CoV-2 Ag-IRRDTs as of 30 September 2021, and included 40 independent clinical studies resulting in 48 Ag-IRRDT datasets with 137,770 samples. Across all datasets, pooled Ag-IRRDT sensitivity was 67.1% (95% CI: 65.9%–68.3%) and specificity was 99.4% with a tight CI. Pooled sensitivity and specificity of SARS-CoV-2 Ag-IRRDTs did not demonstrate a significant superiority over SARS-CoV-2 rapid antigen tests which do not require a reader instrument, even in the case where surveillance and screening datasets were excluded from the analysis. Nevertheless, they provide connectivity advantages and remove operator interface (in results-reading) issues. The lower sensitivity of certain brands of Ag-IRRDTs can be overcome in high prevalence areas with high frequency of testing. New SARS-CoV-2 variants are major concern for current and future diagnostic performance of these tests.

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“…To facilitate efforts to return to in-person learning, routine screening was proposed to identify infected, asymptomatic individuals and, in combination with other interventions, mitigate the spread of SARS-CoV-2 6 . Many universities developed or implemented screening assays, using a variety of sample types (saliva vs nasal swabs), sample processing (minimal vs RNA extraction), efficiency strategies (pooled vs unpooled), and platforms (qPCR, RT-LAMP, antigen tests), although the majority relied on qPCR [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] . A recent analysis of 1,400 institutions of higher education (IHE) showed that the success of these screening efforts extended to their housed counties, as those with IHEs that conducted widespread testing had fewer hospitalizations and deaths 23 .…”

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confidence: 99%

A multiplexed, paired-pooled droplet digital PCR assay for detection of SARS-CoV-2 in saliva

Wagner

Fox

Gordon

et al. 2023

Sci Rep

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In response to the SARS-CoV-2 pandemic, we developed a multiplexed, paired-pool droplet digital PCR (MP4) screening assay. Key features of our assay are the use of minimally processed saliva, 8-sample paired pools, and reverse-transcription droplet digital PCR (RT-ddPCR) targeting the SARS-CoV-2 nucleocapsid gene. The limit of detection was determined to be 2 and 12 copies per µl for individual and pooled samples, respectively. Using the MP4 assay, we routinely processed over 1,000 samples a day with a 24-h turnaround time and over the course of 17 months, screened over 250,000 saliva samples. Modeling studies showed that the efficiency of 8-sample pools was reduced with increased viral prevalence and that this could be mitigated by using 4-sample pools. We also present a strategy for, and modeling data supporting, the creation of a third paired pool as an additional strategy to employ under high viral prevalence.

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SARS-CoV-2 Rapid Antigen Testing of Symptomatic and Asymptomatic Individuals on the University of Arizona Campus

Cited by 20 publications

References 11 publications

Diagnostic Performance of SARS-CoV-2 Rapid Antigen Test in a Large, German Cohort

Diagnostic Performance of SARS-CoV-2 Rapid Antigen Test in a Large, German Cohort

Clinical Accuracy of Instrument-Read SARS-CoV-2 Antigen Rapid Diagnostic Tests (Ag-IRRDTs)

A multiplexed, paired-pooled droplet digital PCR assay for detection of SARS-CoV-2 in saliva

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