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Review
. 2023 Mar 7;54(2):e37-e43.
doi: 10.1093/labmed/lmac089.

Combined Diagnosis of SARS-CoV-2: Rapid Antigen Detection as an Adjunct to Nucleic Acid Detection

Xuewen Li  1 , Yiting Wang  1 , Junqi Pan  2 , Jiancheng Xu  1 , Qi Zhou  3
Affiliations
Review

Combined Diagnosis of SARS-CoV-2: Rapid Antigen Detection as an Adjunct to Nucleic Acid Detection

Xuewen Li et al. Lab Med. .

Abstract

Coronavirus disease 2019 is a serious threat to human life, and early diagnosis and screening can help control the COVID-19 pandemic. The high sensitivity of reverse transcriptase-polymerase chain reaction (RT-PCR) assay is the gold standard for the diagnosis of COVID-19, but there are still some false-negative results. Rapid antigen detection (RAD) is recommended by the World Health Organization (WHO) as a screening method for COVID-19. This review analyzed the characteristics of RDT and found that although the overall sensitivity of RAD was not as high as that of RT-PCR, but RAD was more sensitive in COVID-19 patients within 5 days of the onset of symptoms and in COVID-19 patients with Ct ≤ 25. Therefore, RAD can be used as an adjunct to RT-PCR for screening patients with early COVID-19. Finally, this review provides a combined diagnostic protocol for RAD and nucleic acid testing with the aim of providing a feasible approach for COVID-19 screening.

Keywords: COVID-19; Early screening; Lateral flow immunoassay; RT-PCR; Sensitivity.

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Figures

FIGURE 1
FIGURE 1
A, Sensitivity of different LFIA kits in COVID-19 patients at different days after the onset of symptoms. B, Sensitivity of different LFIA kits for Ct values in different ranges of RT-PCR. The legend indicates the types of kits used in the different references.
FIGURE 2
FIGURE 2
Flow chart of the combined detection of SARS-COV-2 using NAAT and RAD in different populations. NAAT, nucleic acid amplification test; RAD, rapid antigen detection.
See this image and copyright information in PMC

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