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Observational Study
. 2021 Mar:104:65-72.
doi: 10.1016/j.ijid.2020.12.079. Epub 2021 Jan 2.

Utility of the antigen test for coronavirus disease 2019: Factors influencing the prediction of the possibility of disease transmission

Kei Yamamoto  1 , Michiyo Suzuki  2 , Gen Yamada  3 , Tsutomu Sudo  4 , Hidetoshi Nomoto  5 , Noriko Kinoshita  6 , Keiji Nakamura  7 , Yoshie Tsujimoto  8 , Yusaku Kusaba  9 , Chie Morita  10 , Ataru Moriya  11 , Kenji Maeda  12 , Shintaro Yagi  13 , Motoi Kimura  14 , Norio Ohmagari  15
Affiliations
Observational Study

Utility of the antigen test for coronavirus disease 2019: Factors influencing the prediction of the possibility of disease transmission

Kei Yamamoto et al. Int J Infect Dis. 2021 Mar.

Erratum in

Abstract

Objectives: Rapid antigen testing (RAT) for coronavirus disease 2019 (COVID-19) has lower sensitivity but high accuracy during the early stage when compared to reverse transcription quantitative polymerase chain reaction (RT-qPCR). The aim of this study was to investigate the concordance between RAT and RT-qPCR results, and their prediction of disease transmission.

Methods: This single-center retrospective observational study of inpatients with COVID-19 was conducted from March 6 to June 14, 2020. Nasopharyngeal swabs were used to perform RAT and RT-qPCR. The primary endpoint was concordance between RAT and RT-qPCR results. The secondary endpoints were the factors causing disagreement in the results and the estimated transmissibility in RT-qPCR-positive patients with mild symptoms.

Results: Overall, 229 samples in viral transport medium (VTM) were obtained from 105 patients. The positive and negative concordance rates for VTM were 41% vs 99% (κ = 0.37) and 72% vs 100% (κ = 0.50) for samples collected on disease days 2-9. An increased body temperature (odds ratio 0.54) and absence of drugs with potential antiviral effect (odds ratio 0.48) yielded conflicting results. RAT was associated with the ability to end isolation (OR 0.11, 95% confidence interval 0.20-0.61).

Conclusions: RAT and RT-qPCR results were highly consistent for samples collected at the appropriate time and could be useful for inferring the possibility of transmissibility.

Keywords: Antigen test; Appropriate timing for antigen test; COVID-19; Estimating transmissibility.

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Figures

Figure 1
Figure 1
Rapid antigen testing procedures. VTM, viral transport medium; Ct, cycle threshold.
Figure 2
Figure 2
Correlations between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load and day after the onset of coronavirus disease 2019 (COVID-19) symptoms with the results of rapid antigen testing. (A) Samples in viral transport medium; the rapid antigen testing results for viral transport medium samples. (B) Samples in the reagent of the rapid antigen test (ESPLINE kit); the rapid antigen testing results for the reagent samples.
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