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China CDC Wkly . Development and Diagnosis Performance of IgM-Based Rapid Antigen Test for Early Detection of SARS-CoV-2 Infection in a Large Cohor

tetano

Editor, Senior Moderator
China CDC Wkly


. 2024 Sep 13;6(37):953-961.
doi: 10.46234/ccdcw2024.199. Development and Diagnosis Performance of IgM-Based Rapid Antigen Test for Early Detection of SARS-CoV-2 Infection in a Large Cohort of Suspected COVID-19 Cases - USA, Poland, and Sweden, 2021-2022

Yihua Huang[SUP] 1 [/SUP], Yiyi Pu[SUP] 2 [/SUP], Youhong Weng[SUP] 3 4 [/SUP], Yahan Wu[SUP] 3 [/SUP], Qing He[SUP] 3 [/SUP], Sofia Litchev[SUP] 5 [/SUP], Longyou Zhao[SUP] 1 [/SUP], Haojie Ding[SUP] 3 [/SUP], Yunru Lai[SUP] 1 [/SUP], Jie Li[SUP] 1 [/SUP], Xiaojun Zheng[SUP] 6 [/SUP], Jinshu Chen[SUP] 6 [/SUP], Xianqin Xiong[SUP] 6 [/SUP], Shaohong Lu[SUP] 3 [/SUP], Fei Gao[SUP] 6 [/SUP], Meng Gao[SUP] 3 [/SUP], Qingming Kong[SUP] 2 [/SUP]



Affiliations
Abstract

Introduction: Antigen testing has been crucial in effectively managing the coronavirus disease 2019 (COVID-19) pandemic. This study evaluated the clinical performance of a nasopharyngeal swab (NPS)-based antigen rapid diagnostic test (Ag-RDT) compared to the gold standard real-time reverse transcription-polymerase chain reaction (RT-PCR) for early detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Methods: We developed an IgM-based rapid antigen test for early detection of SARS-CoV-2 infection. Between July 2021 and January 2022, we analyzed 1,030 NPS samples from participants at three centers in different countries, using both antigen rapid diagnostic tests (Ag-RDT) and RT-PCR.
Results: The Ag-RDT demonstrated minimal detection limits as low as 0.1 ng/mL for recombinant N antigen and 100 TCID50/mL for heat-inactivated SARS-CoV-2 virus. Specificity assessments involving four human coronaviruses and 13 other respiratory viruses showed no cross-reactivity. The Ag-RDT assay (ALLtest) exhibited high sensitivity (93.18%-100%) and specificity (99.67%-100%) across all centers. Factors such as cycle threshold (Ct) values and the timing of symptoms since onset were influential, with sensitivity increasing at lower Ct values (<30) and within the first week of symptoms.
Conclusion: The ALLtest Ag-RDT demonstrated high reliability and significant potential for diagnosing suspected COVID-19 cases.

Keywords: IgM; SARS-CoV-2; antigen; early rapid diagnostic test; lateral flow chromatographic immunoassay; nasopharyngeal swab.

 
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