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Real-world performance of SARS-CoV-2 rapid antigen testing through the Alpha-, Delta- and Omicron-dominant waves of the COVID-19 pandemic

Title: Real-world performance of SARS-CoV-2 rapid antigen testing through the Alpha-, Delta- and Omicron-dominant waves of the COVID-19 pandemic
Authors: Alexander Domnich; Andrea Orsi; Valentina Ricucci; Vanessa De Pace; Elvira Massaro; Matilde Ogliastro; Bianca Bruzzone; Giancarlo Icardi
Source: International Journal of Infectious Diseases, Vol 135, Iss , Pp 18-20 (2023)
Publisher Information: Elsevier
Publication Year: 2023
Collection: Directory of Open Access Journals: DOAJ Articles
Subject Terms: SARS-CoV-2; COVID-19; Rapid antigen detection test; Diagnostic accuracy; Real-world performance; Infectious and parasitic diseases; RC109-216
Description: Objectives: Compared with reverse transcription polymerase chain reaction (RT-PCR), rapid antigen detection tests (RADTs) for SARS-CoV-2 diagnostics are faster, less expensive, but also less accurate. Performance of RADTs is context-specific and depends on disease prevalence. In this real-world study, we assessed impact of RADTs in an inpatient setting through the entire COVID-19 emergency phase. Methods: In this matched retrospective study, data on RT-PCR and RADT laboratory diagnoses of SARS-CoV-2 made between February 2020 and May 2023 in a large hospital were analyzed. To be included in the study, samples used for both RT-PCR and RADT had to be collected on the same day. Results: Of 278,867 RT-PCR tests available, 13,321 same-day RADTs could be matched to RT-PCR. Over the entire period, RADT sensitivity and specificity were 76.4% and 99.4%, respectively. With the observed positivity rate of 9.4%, positive and negative predictive values were 92.7% and 97.6%, respectively. Compared with the periods dominated by the Alpha and Delta variants of concern, RADT accuracy was slightly lower during the Omicron phase. Conclusion: This real-world experience demonstrates that despite suboptimal sensitivity and some variation by predominant variants of concern and positivity prevalence, the use of RADTs is useful in hospital settings. Public health implications were discussed.
Document Type: article in journal/newspaper
Language: English
Relation: http://www.sciencedirect.com/science/article/pii/S1201971223006793; https://doaj.org/toc/1201-9712; https://doaj.org/article/63c5d11e592e41379333b48a07de2879
DOI: 10.1016/j.ijid.2023.07.029
Availability: https://doi.org/10.1016/j.ijid.2023.07.029; https://doaj.org/article/63c5d11e592e41379333b48a07de2879
Accession Number: edsbas.375BF438
Database: BASE