Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Mar;56(1):66-72.
doi: 10.3947/ic.2023.0077. Epub 2023 Nov 13.

Usefulness of the Rapid Antigen Test in Detecting SARS-CoV-2 for Infection Control in Hospitals

Affiliations

Usefulness of the Rapid Antigen Test in Detecting SARS-CoV-2 for Infection Control in Hospitals

Jeong Young Lee et al. Infect Chemother. 2024 Mar.

Abstract

Background: We aimed at evaluating the diagnostic performance of rapid antigen test (RAT) compared to polymerase chain reaction (PCR) for severe acute respiratory syndrome coronavirus 2 and the possible transmission of infection to close contacts from patients with negative RAT and positive PCR results.

Materials and methods: Patients/guardians urgently requiring admission to the ward on the same day had been hospitalized with RAT-negative result before the PCR results were available. We performed an epidemiologic investigation of the close contacts of those with negative RAT but positive PCR results after hospitalization.

Results: A total of 4,237 RATs were performed from March to August 2022. When the PCR test was used as the reference, RAT had a sensitivity of 28.8% (17/59; 95% confidence interval [CI], 17.8 - 42.1), a specificity of 100% (4,220/4,220; 95% CI, 99.9 - 100.0), a positive predictive value of 100.0% (17/17; 95% CI, 100.0 - 100.0), and a negative predictive value of 99.0% (4,178/4,220; 95% CI, 99.3 - 99.8). The epidemiologic investigation revealed that among the 32 patients with negative RAT and subsequent positive PCR results after admission into multi-patient room, two (6.3%) showed secondary coronavirus disease 2019.

Conclusion: The secondary transmission rate from patients with negative RAT and positive PCR results was low. Our data suggest that RAT may be useful for rapid exclusion of high transmissible cases. However, further evaluation using whole genome sequencing is needed to determine the potential for transmissibility in cases showing a negative RAT but a positive PCR result.

Keywords: COVID-19; Contact tracing; Infection control; Rapid diagnostic test.

PubMed Disclaimer

Conflict of interest statement

No conflict of interest.

Figures

Figure 1
Figure 1. Flowchart of the study.
PCR, polymerase chain reaction; RAT, rapid antigen test.
Figure 2
Figure 2. Epidemiologic investigation of case #1. Case #1 was guardian. Cycle threshold, day of diagnosis, and spatiotemporal relationship were compared among cases. Exposed case of case #1 (E1) showed exposure histories from P1 and P2.
Ct, cycle threshold; COVID-19, coronavirus disease 2019; RAT, rapid antigen test; PCR, polymerase chain reaction.
Figure 3
Figure 3. Epidemiologic investigation of case #2. Case #2 was guardian. Cycle threshold, day of diagnosis, and spatiotemporal relationship were compared among cases. Of the five roommates, 4 subjects had positive results from two to six days after exposure. However, all were exposed to the symptomatic guardian with COVID-19 (E1) diagnosed the next day after case #2.
Ct, cycle threshold; COVID-19, coronavirus disease 2019; RAT, rapid antigen test; PCR, polymerase chain reaction.

Comment in

Similar articles

Cited by

References

    1. Centers for Disease Control and Prevention (CDC) Overview of testing for SARS-CoV-2, the virus that causes COVID-19. [Accessed 4 September, 2023]. Available at: https://www.cdc.gov/coronavirus/2019-ncov/hcp/testing-overview.html.
    1. Yamayoshi S, Sakai-Tagawa Y, Koga M, Akasaka O, Nakachi I, Koh H, Maeda K, Adachi E, Saito M, Nagai H, Ikeuchi K, Ogura T, Baba R, Fujita K, Fukui T, Ito F, Hattori SI, Yamamoto K, Nakamoto T, Furusawa Y, Yasuhara A, Ujie M, Yamada S, Ito M, Mitsuya H, Omagari N, Yotsuyanagi H, Iwatsuki-Horimoto K, Imai M, Kawaoka Y. Comparison of rapid antigen tests for COVID-19. Viruses. 2020;12:1420. - PMC - PubMed
    1. Scheiblauer H, Filomena A, Nitsche A, Puyskens A, Corman VM, Drosten C, Zwirglmaier K, Lange C, Emmerich P, Müller M, Knauer O, Nübling CM. Comparative sensitivity evaluation for 122 CE-marked rapid diagnostic tests for SARS-CoV-2 antigen, Germany, September 2020 to April 2021. Euro Surveill. 2021;26:2100441. - PMC - PubMed
    1. Bekliz M, Adea K, Essaidi-Laziosi M, Sacks JA, Escadafal C, Kaiser L, Eckerle I. SARS-CoV-2 rapid diagnostic tests for emerging variants. Lancet Microbe. 2021;2:e351. - PMC - PubMed
    1. The R Foundation. The R project for statistical computing. [Accessed 31 October 2022]. Available at: https://www.R-project.org/