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. 2022 May;37(6):1494-1500.
doi: 10.1007/s11606-022-07448-x. Epub 2022 Mar 17.

Evaluation of Five Commercial SARS-CoV-2 Antigen Tests in a Clinical Setting

Tamara Seitz  1 , Benno Lickefett  2 , Marianna Traugott  2 , Erich Pawelka  2 , Mario Karolyi  2 , Sebastian Baumgartner  2 , Sonja Jansen-Skoupy  3   4 , Johanna Atamaniuk  3   4 , Robert Fritsche-Polanz  3   4 , Johannes Asenbaum  3   4 , Christoph Wenisch  2 , Manuela Födinger  3   4 , Alexander Zoufaly  2   4
Affiliations

Evaluation of Five Commercial SARS-CoV-2 Antigen Tests in a Clinical Setting

Tamara Seitz et al. J Gen Intern Med. 2022 May.

Abstract

Background: Point-of-care antigen tests (AgTs) for the detection of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) enable the rapid testing of infected individuals and are easy-to-use. However, there are few studies evaluating their clinical use.

Objective: The present study aimed to evaluate and compare the clinical performance characteristics of various commercial SARS-CoV-2 AgTs.

Design: The sensitivity of five AgTs, comprising four rapid antigen tests (RAT; AMP Rapid Test SARS-CoV-2 Ag, NADAL COVID-19 Antigen Rapid Test, CLINITEST Rapid COVID-19 Antigen Test, and Roche SARS-CoV-2 Rapid Antigen Test) and one sandwich chemiluminescence immunoassay (CLIA; LIAISON SARS-CoV-2 Assay), were evaluated in 300 nasopharyngeal (NP) swabs. Reverse transcriptase (RT) polymerase chain reaction (PCR) was used as a reference method.

Participants: NP swabs were collected from patients admitted to hospital due to COVID-19.

Key results: Sensitivities of the AgTs ranged from 64.9 to 91.7% for samples with RT-PCR cycle threshold (Ct) values lower than 30 and were 100% for cycle threshold (Ct) values lower than 20. The highest sensitivity was observed for CLINITEST Rapid COVID-19 Antigen Test, and Roche SARS-CoV-2 rapid antigen test. Multivariate analysis using time from symptom onset and the Ct value for AgT sensitivity showed an inverse correlation. Further, the female sex was an independent factor of lower RAT sensitivity.

Conclusions: Antigen tests from NP swab samples show high sensitivity in patients with a Ct value < 20. The best clinical sensitivity can be obtained using AgTs within the first 6 days after symptom onset.

Keywords: COVID-19; RAT; SARS-CoV-2; pandemic; rapid antigen testing.

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Conflict of interest statement

The authors declare that they do not have a conflict of interest.

Figures

Figure 1
Figure 1
Overall sensitivity and confidence intervals of the AMP, NADAL, CLINITEST, and ROCHE rapid antigen tests in relation to time from symptom onset.
Figure 2
Figure 2
Overall sensitivity and confidence intervals of the CLIA in relation to time from symptom onset.
See this image and copyright information in PMC

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