Screening for SARS-CoV-2 infection in asymptomatic individuals using the Panbio COVID-19 antigen rapid test (Abbott) compared with RT-PCR: a prospective cohort study.


Journal

BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874

Informations de publication

Date de publication:
13 10 2021
Historique:
entrez: 14 10 2021
pubmed: 15 10 2021
medline: 21 10 2021
Statut: epublish

Résumé

Antigen-based point-of-care tests for identification of SARS-CoV-2 may markedly enhance effectiveness of population-based controlling strategies. Previous studies have demonstrated >70% sensitivity and high specificity compared with reverse transcriptase real-time PCR (RT-PCR) in symptomatic individuals, but test performance for asymptomatic individuals is unknown. Test performance of the Panbio COVID-19 Ag Rapid Test (Abbott) was compared with RT-PCR in a longitudinal cohort study of asymptomatic football players and staff members of professional football clubs. Based on timing of symptoms and prior and subsequent test results, positive RT-PCR tests were categorised as presymptomatic, early or late infection, or persistent RNA shedding. 2425 tests were performed in 824 individuals, of which 52 (6.3%) were SARS-CoV-2 positive based on RT-PCR. There were 2406 paired sets from asymptomatic subjects for analysis. Sixteen Panbio tests were inconclusive, for which sensitivity analyses were performed (considering results as either positive or negative or being excluded). Sensitivity of Panbio for screening of asymptomatic individuals ranged from 80.0% (61.4-92.3) to 86.67% (69.2-96.2) and specificity from 99.53% (95% CI 99.2 to 99.8) to 100% (95% CI 99.8 to 100). Sensitivity of Panbio to detect subjects with presymptomatic/early infection (n=42) ranged from 81.82% (95% CI 67.3 to 91.8) to 90.91% (95% CI 78.3 to 97.5) with specificity always above 99%. The Panbio COVID-19 Ag rapid test identifies 81%-90% of presymptomatic and early asymptomatic SARS-CoV-2 infections with high specificity. This test may therefore be adopted in testing strategies such as targeted screening of specific populations where prevalence is low.

Sections du résumé

BACKGROUND
Antigen-based point-of-care tests for identification of SARS-CoV-2 may markedly enhance effectiveness of population-based controlling strategies. Previous studies have demonstrated >70% sensitivity and high specificity compared with reverse transcriptase real-time PCR (RT-PCR) in symptomatic individuals, but test performance for asymptomatic individuals is unknown.
METHODS
Test performance of the Panbio COVID-19 Ag Rapid Test (Abbott) was compared with RT-PCR in a longitudinal cohort study of asymptomatic football players and staff members of professional football clubs. Based on timing of symptoms and prior and subsequent test results, positive RT-PCR tests were categorised as presymptomatic, early or late infection, or persistent RNA shedding.
FINDINGS
2425 tests were performed in 824 individuals, of which 52 (6.3%) were SARS-CoV-2 positive based on RT-PCR. There were 2406 paired sets from asymptomatic subjects for analysis. Sixteen Panbio tests were inconclusive, for which sensitivity analyses were performed (considering results as either positive or negative or being excluded). Sensitivity of Panbio for screening of asymptomatic individuals ranged from 80.0% (61.4-92.3) to 86.67% (69.2-96.2) and specificity from 99.53% (95% CI 99.2 to 99.8) to 100% (95% CI 99.8 to 100). Sensitivity of Panbio to detect subjects with presymptomatic/early infection (n=42) ranged from 81.82% (95% CI 67.3 to 91.8) to 90.91% (95% CI 78.3 to 97.5) with specificity always above 99%.
INTERPRETATION
The Panbio COVID-19 Ag rapid test identifies 81%-90% of presymptomatic and early asymptomatic SARS-CoV-2 infections with high specificity. This test may therefore be adopted in testing strategies such as targeted screening of specific populations where prevalence is low.

Identifiants

pubmed: 34645658
pii: bmjopen-2020-048206
doi: 10.1136/bmjopen-2020-048206
pmc: PMC8520587
doi:

Substances chimiques

Antigens, Viral 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e048206

Investigateurs

Tim Baijens (T)
Afke H Brandenburg (AH)
Marjan J Bruins (MJ)
Bas Bulder (B)
Wouter Ten Cate (WT)
Juliete Djapo Tiani (JD)
Joost van der Hoek (JV)
Jannes Hornstra (J)
Simon Knops (S)
Patrick Krastman (P)
Maurine Leversteijn van Hall (MLV)
Prabath Lodewijks (P)
Frank Nab (F)
Ron Peters (R)
Mineke Vegter (M)
Wart van Zoest (WV)

Informations de copyright

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Références

Emerg Infect Dis. 2020 Jul;26(7):
pubmed: 32364890
J Infect. 2021 Mar;82(3):391-398
pubmed: 33592253
Clin Microbiol Infect. 2021 Mar;27(3):472.e7-472.e10
pubmed: 33189872
Lancet Public Health. 2020 Aug;5(8):e452-e459
pubmed: 32682487
J Infect. 2021 May;82(5):186-230
pubmed: 33421447
EClinicalMedicine. 2021 Jan;31:100677
pubmed: 33521610
Sci Adv. 2021 Jan 1;7(1):
pubmed: 33219112

Auteurs

Beatrice Winkel (B)

Department of Medical Microbiology, UMC Utrecht, Utrecht, The Netherlands.

Emma Schram (E)

Department of Medical Microbiology, UMC Utrecht, Utrecht, The Netherlands.

Hendrik Gremmels (H)

Department of Medical Microbiology, UMC Utrecht, Utrecht, The Netherlands.

Sylvia Debast (S)

Laboratory of Clinical Microbiology and Infectious Disease, Isala, Zwolle, Overijssel, The Netherlands.

Rob Schuurman (R)

Department of Medical Microbiology, UMC Utrecht, Utrecht, The Netherlands.

Annemarie Wensing (A)

Department of Medical Microbiology, UMC Utrecht, Utrecht, The Netherlands.

Marc Bonten (M)

Department of Medical Microbiology, UMC Utrecht, Utrecht, The Netherlands.

Edwin Goedhart (E)

Royal Netherlands Football Association, KNVB, Zeist, Utrecht, The Netherlands.

Marije Hofstra (M)

Department of Medical Microbiology, UMC Utrecht, Utrecht, The Netherlands l.m.hofstra-4@umcutrecht.nl.

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