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PLoS One . Evaluation of a novel, rapid antigen detection test for the diagnosis of SARS-CoV-2

tetano

Editor, Senior Moderator
PLoS One


. 2021 Nov 29;16(11):e0259527.
doi: 10.1371/journal.pone.0259527. eCollection 2021.
Evaluation of a novel, rapid antigen detection test for the diagnosis of SARS-CoV-2


Rainer Thell[SUP] 1 2 [/SUP], Verena Kallab[SUP] 1 2 [/SUP], Wolfgang Weinhappel[SUP] 3 [/SUP], Wolfgang Mueckstein[SUP] 3 [/SUP], Lukas Heschl[SUP] 4 [/SUP], Martina Heschl[SUP] 4 [/SUP], Stefan Korsatko[SUP] 5 [/SUP], Franz Toedling[SUP] 6 [/SUP], Amelie Blaschke[SUP] 1 2 [/SUP], Theresa Herzog[SUP] 1 2 [/SUP], Anna Klicpera[SUP] 1 2 [/SUP], Clara Koeller[SUP] 7 8 [/SUP], Moritz Haugk[SUP] 1 7 [/SUP], Anna Kreil[SUP] 1 9 [/SUP], Alexander Spiel[SUP] 1 10 [/SUP], Philipp Kreuzer[SUP] 11 [/SUP], Robert Krause[SUP] 12 [/SUP], Christian Sebesta[SUP] 1 2 [/SUP], Stefan Winkler[SUP] 13 [/SUP], Brenda Laky[SUP] 14 15 [/SUP], Marton Szell[SUP] 1 2 [/SUP]



Affiliations

Abstract

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease 2019 (COVID-19) is currently finally determined in laboratory settings by real-time reverse-transcription polymerase-chain-reaction (rt-PCR). However, simple testing with immediately available results are crucial to gain control over COVID-19. The aim was to evaluate such a point-of-care antigen rapid test (AG-rt) device in its performance compared to laboratory-based rt-PCR testing in COVID-19 suspected, symptomatic patients.
Methods: For this prospective study, two specimens each of 541 symptomatic female (54.7%) and male (45.3%) patients aged between 18 and 95 years tested at five emergency departments (ED, n = 296) and four primary healthcare centres (PHC, n = 245), were compared, using AG-rt (positive/negative/invalid) and rt-PCR (positive/negative and cycle threshold, Ct) to diagnose SARS-CoV-2. Diagnostic accuracy, sensitivity, specificity, positive predictive values (PPV), negative predictive value (NPV), and likelihood ratios (LR+/-) of the AG-rt were assessed.
Results: Differences between ED and PHC were detected regarding gender, age, symptoms, disease prevalence, and diagnostic performance. Overall, 174 (32.2%) were tested positive on AG-rt and 213 (39.4%) on rt-PCR. AG correctly classified 91.7% of all rt-PCR positive cases with a sensitivity of 80.3%, specificity of 99.1%, PPV of 98.3, NPV of 88.6%, LR(+) of 87.8, and LR(-) of 0.20. The highest sensitivities and specificities of AG-rt were detected in PHC (sensitivity: 84.4%, specificity: 100.0%), when using Ct of 30 as cut-off (sensitivity: 92.5%, specificity: 97.8%), and when symptom onset was within the first three days (sensitivity: 82.9%, specificity: 99.6%).
Conclusions: The highest sensitivity was detected with a high viral load. Our findings suggest that AG-rt are comparable to rt-PCR to diagnose SARS-CoV-2 in COVID-19 suspected symptomatic patients presenting both at emergency departments and primary health care centres.
 
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