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Int J Infect Dis . Utility of the antigen test for coronavirus disease 2019: Factors influencing the prediction of the possibility of disease transm

tetano

Editor, Senior Moderator
Int J Infect Dis


. 2021 Jan 2;S1201-9712(20)32603-5.
doi: 10.1016/j.ijid.2020.12.079. Online ahead of print.
Utility of the antigen test for coronavirus disease 2019: Factors influencing the prediction of the possibility of disease transmission


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



Affiliations
Free PMC article

Abstract

Objectives: Rapid antigen test (RAT) for coronavirus disease 2019 (COVID-19) has lower sensitivity but high accuracy during early-stage compared to reverse transcription-quantitative polymerase chain reaction (RT-qPCR). We aimed to investigate the concordance between the RAT and RT-qPCR results, and their prediction of disease transmission.
Methods: This single-center retrospective observational study conducted from March 6 to June 14, 2020, included COVID-19 inpatients. We used nasopharyngeal swabs to perform RAT and RT-qPCR. The primary endpoint was concordance between RAT and RT-qPCR results. The secondary endpoints were the factors causing result disagreement and estimated transmissibility in RT-qPCR positive cases with mild symptoms.
Results: Overall, 229 viral transport media (VTM) samples 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. Body temperature increase (odds ratio [OR]: 0.54) and absence of drugs with potential antiviral effect (OR: 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: The 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: COVID-19; antigen test; appropriate timing for antigen test; estimating transmissibility.
 
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