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Am J Infect Control
. 2022 Nov 9;S0196-6553(22)00784-2.
doi: 10.1016/j.ajic.2022.11.002. Online ahead of print.
SARS-CoV-2 Antigen Rapid Tests and Universal Screening for COVID-19 Omicron Variant among Hospitalised Children
Kai-Qian Kam 1 , Matthias Maiwald 2 , Chia Yin Chong 3 , Koh Cheng Thoon 3 , Karen Donceras Nadua 3 , Liat Hui Loo 4 , Yelen 5 , Natalie Woon Hui Tan 3 , Jiahui Li 3 , Chee Fu Yung 6
Affiliations
- PMID: 36370867
- DOI: 10.1016/j.ajic.2022.11.002
Abstract
Background: Clinical utility of universal antigen rapid test (ART) in the paediatric setting are unknown. We aimed to assess the performance and utility of universal ART in hospitalised children (≥ 5-year-old) to prevent nosocomial COVID-19 transmission.
Methods: Cross-sectional study involving all hospitalized paediatric patients aged ≥ 5-year-old from 2 periods during Omicron wave. Clinical data, ART and polymerase chain reaction (PCR) test results were collected.
Results: A total of 444 patients were included from the 2 study periods, and 416 patients (93.7%) had concordant results between ART and PCR. The overall sensitivity and specificity of ART were 83.3% (95% CI: 75.2-89.3) and 97.5% (95% CI: 95.0-98.8), respectively. Negative predictive values (NPV) of ART between the Omicron emergence and Omicron peak periods for a probable case group were 71.4% and 66.7%, respectively, and for a suspect case group 91.4% and 75.0%, respectively. NPV for an unlikely case group was >95% in both periods. Positive predictive value of ART was >85% for probable and suspect case groups in both periods. Seventy-five percent of patients (n=15) who were incorrectly classified as SARS-CoV-2 negative by ART had potentially viable virus. No large nosocomial transmission clusters were detected.
Conclusions: Universal ART screening may limit nosocomial outbreaks in hospitalised children. The performance can be optimised by considering clinical symptoms, exposure and periods within COVID waves.
Keywords: COVID-19; Coronavirus disease 2019; Severe Acute Respiratory Syndrome Coronavirus 2; antigen rapid test; children; screening; sensitivity; specificity.