tetano
Editor, Senior Moderator
Microbiol Spectr
. 2025 Aug 13:e0074925.
doi: 10.1128/spectrum.00749-25. Online ahead of print. Comparison of the analytical and clinical sensitivities of 34 rapid antigen tests with prevalent SARS-CoV-2 variants of concern during the COVID-19 pandemic in the UK
Rachel L Byrne[SUP] #[/SUP][SUP] 1 [/SUP], Rachel S Owen[SUP] #[/SUP][SUP] 1 [/SUP], Ghaith Aljayyoussi[SUP] 1 [/SUP], Caitlin Greenland-Bews[SUP] 1 [/SUP], Konstantina Kontogianni[SUP] 1 [/SUP], Anushri Somasundaran[SUP] 1 [/SUP], Dominic Wooding[SUP] 1 [/SUP], Christopher T Williams[SUP] 1 [/SUP]; LSTM Diagnostics Group; Falcon Steering Group; Margaretha de Vos[SUP] 2 [/SUP], Richard Body[SUP] 3 [/SUP], Emily R Adams[SUP] 1 [/SUP], Camille Escadafal[SUP] 2 [/SUP], Thomas Edwards[SUP] 1 [/SUP], Ana I Cubas-Atienzar[SUP] 1 [/SUP]
Collaborators, Affiliations
Antigen-detection rapid diagnostic tests (Ag-RDTs) have become a central pillar for the management of coronavirus disease worldwide due to their speed and ease of use and are now being developed for use in other emerging outbreaks. Like other viruses, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is subject to rapid mutation as it spreads, and new variants of concern (VOCs) emerge frequently, posing a significant challenge for the detection of newer, highly mutated variants. It is, therefore, important that the performance of Ag-RDTs is regularly evaluated, particularly in outbreak scenarios where rapid diagnostics are key to limiting disease spread. Here, we present a comprehensive evaluation of the analytical and clinical sensitivities of 34 commercially available Ag-RDTs with five SARS-CoV-2 VOCs, all of which were highly prevalent in the UK at various times between 2019 and 2023. This study highlights the importance of regular evaluation of the Ag-RDT performance, with several Ag-RDTs demonstrating a reduced performance with some VOCs. We conclude that a regular performance evaluation through our proposed pipeline, combined with a broad consensus approval threshold across global organizations, is essential to maintaining the effectiveness of Ag-RDTs as a disease management tool during outbreaks.IMPORTANCEAntigen-detection rapid diagnostic tests (Ag-RDTs) came to global prominence during the coronavirus disease pandemic, where they offered a quick and simple at-home diagnostic, which could be used to manage disease spread. A major ongoing challenge for the broad use of Ag-RDTs is the speed at which new SARS-CoV-2 variants emerge, each of which has the potential to reduce the performance of available Ag-RDTs. As Ag-RDTs are explored for use in other viral disease outbreaks, pipelines for the regular evaluation of test performance are essential for ensuring that Ag-RDTs can be employed effectively. Here, we have developed a robust pipeline for the large-scale evaluation of commercially available Ag-RDTs against several major SARS-CoV-2 variants, which can be adapted and applied to other emerging outbreaks to ensure that test performance is maintained as a virus evolves.
Keywords: B.1.1.529; COVID-19; Delta; Omicron; SARS-CoV-2 variant of concern (VOC), B.1.617.2; antigen detection; limit of detection (LOD); rapid diagnostic test (RDT).
. 2025 Aug 13:e0074925.
doi: 10.1128/spectrum.00749-25. Online ahead of print. Comparison of the analytical and clinical sensitivities of 34 rapid antigen tests with prevalent SARS-CoV-2 variants of concern during the COVID-19 pandemic in the UK
Rachel L Byrne[SUP] #[/SUP][SUP] 1 [/SUP], Rachel S Owen[SUP] #[/SUP][SUP] 1 [/SUP], Ghaith Aljayyoussi[SUP] 1 [/SUP], Caitlin Greenland-Bews[SUP] 1 [/SUP], Konstantina Kontogianni[SUP] 1 [/SUP], Anushri Somasundaran[SUP] 1 [/SUP], Dominic Wooding[SUP] 1 [/SUP], Christopher T Williams[SUP] 1 [/SUP]; LSTM Diagnostics Group; Falcon Steering Group; Margaretha de Vos[SUP] 2 [/SUP], Richard Body[SUP] 3 [/SUP], Emily R Adams[SUP] 1 [/SUP], Camille Escadafal[SUP] 2 [/SUP], Thomas Edwards[SUP] 1 [/SUP], Ana I Cubas-Atienzar[SUP] 1 [/SUP]
Collaborators, Affiliations
- PMID: 40801538
- DOI: 10.1128/spectrum.00749-25
Antigen-detection rapid diagnostic tests (Ag-RDTs) have become a central pillar for the management of coronavirus disease worldwide due to their speed and ease of use and are now being developed for use in other emerging outbreaks. Like other viruses, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is subject to rapid mutation as it spreads, and new variants of concern (VOCs) emerge frequently, posing a significant challenge for the detection of newer, highly mutated variants. It is, therefore, important that the performance of Ag-RDTs is regularly evaluated, particularly in outbreak scenarios where rapid diagnostics are key to limiting disease spread. Here, we present a comprehensive evaluation of the analytical and clinical sensitivities of 34 commercially available Ag-RDTs with five SARS-CoV-2 VOCs, all of which were highly prevalent in the UK at various times between 2019 and 2023. This study highlights the importance of regular evaluation of the Ag-RDT performance, with several Ag-RDTs demonstrating a reduced performance with some VOCs. We conclude that a regular performance evaluation through our proposed pipeline, combined with a broad consensus approval threshold across global organizations, is essential to maintaining the effectiveness of Ag-RDTs as a disease management tool during outbreaks.IMPORTANCEAntigen-detection rapid diagnostic tests (Ag-RDTs) came to global prominence during the coronavirus disease pandemic, where they offered a quick and simple at-home diagnostic, which could be used to manage disease spread. A major ongoing challenge for the broad use of Ag-RDTs is the speed at which new SARS-CoV-2 variants emerge, each of which has the potential to reduce the performance of available Ag-RDTs. As Ag-RDTs are explored for use in other viral disease outbreaks, pipelines for the regular evaluation of test performance are essential for ensuring that Ag-RDTs can be employed effectively. Here, we have developed a robust pipeline for the large-scale evaluation of commercially available Ag-RDTs against several major SARS-CoV-2 variants, which can be adapted and applied to other emerging outbreaks to ensure that test performance is maintained as a virus evolves.
Keywords: B.1.1.529; COVID-19; Delta; Omicron; SARS-CoV-2 variant of concern (VOC), B.1.617.2; antigen detection; limit of detection (LOD); rapid diagnostic test (RDT).