tetano
Editor, Senior Moderator
J Am Coll Emerg Physicians Open
. 2022 Jan 15;3(1):e12605.
doi: 10.1002/emp2.12605. eCollection 2022 Feb.
Utility of COVID-19 antigen testing in the emergency department
W Frank Peacock[SUP] 1 [/SUP], Karina M Soto-Ruiz[SUP] 2 [/SUP], Stacey L House[SUP] 3 [/SUP], Chad M Cannon[SUP] 4 [/SUP], Gary Headden[SUP] 5 [/SUP], Brian Tiffany[SUP] 6 [/SUP], Sergey Motov[SUP] 7 [/SUP], Kian Merchant-Borna[SUP] 8 [/SUP], Anna Marie Chang[SUP] 9 [/SUP], Claire Pearson[SUP] 10 [/SUP], Brian W Patterson[SUP] 11 [/SUP], Alan E Jones[SUP] 12 [/SUP], Joseph Miller[SUP] 13 [/SUP], Joseph Varon[SUP] 14 [/SUP], Aveh Bastani[SUP] 15 [/SUP], Carol Clark[SUP] 16 [/SUP], Zubaid Rafique[SUP] 1 [/SUP], Bory Kea[SUP] 17 [/SUP], John Eppensteiner[SUP] 18 [/SUP], James M Williams[SUP] 19 [/SUP], Simon A Mahler[SUP] 20 [/SUP], Brian E Driver[SUP] 21 [/SUP], Phyllis Hendry[SUP] 22 [/SUP], Eugenia Quackenbush[SUP] 23 [/SUP], David Robinson[SUP] 24 [/SUP], Jon W Schrock[SUP] 25 [/SUP], James P D'Etienne[SUP] 26 [/SUP], Christopher J Hogan[SUP] 27 [/SUP], Anwar Osborne[SUP] 28 [/SUP], Ralph Riviello[SUP] 29 [/SUP], Stephen Young[SUP] 30 [/SUP]
Affiliations
Abstract
Background: The BinaxNOW coronavirus disease 2019 (COVID-19) Ag Card test (Abbott Diagnostics Scarborough, Inc.) is a lateral flow immunochromatographic point-of-care test for the qualitative detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleocapsid protein antigen. It provides results from nasal swabs in 15 minutes. Our purpose was to determine its sensitivity and specificity for a COVID-19 diagnosis.
Methods: Eligible patients had symptoms of COVID-19 or suspected exposure. After consent, 2 nasal swabs were collected; 1 was tested using the Abbott RealTime SARS-CoV-2 (ie, the gold standard polymerase chain reaction test) and the second run on the BinaxNOW point of care platform by emergency department staff.
Results: From July 20 to October 28, 2020, 767 patients were enrolled, of which 735 had evaluable samples. Their mean (SD) age was 46.8 (16.6) years, and 422 (57.4%) were women. A total of 623 (84.8%) patients had COVID-19 symptoms, most commonly shortness of breath (n = 404; 55.0%), cough (n = 314; 42.7%), and fever (n = 253; 34.4%). Although 460 (62.6%) had symptoms ≤7 days, the mean (SD) time since symptom onset was 8.1 (14.0) days. Positive tests occurred in 173 (23.5%) and 141 (19.2%) with the gold standard versus BinaxNOW test, respectively. Those with symptoms >2 weeks had a positive test rate roughly half of those with earlier presentations. In patients with symptoms ≤7 days, the sensitivity, specificity, and negative and positive predictive values for the BinaxNOW test were 84.6%, 98.5%, 94.9%, and 95.2%, respectively.
Conclusions: The BinaxNOW point-of-care test has good sensitivity and excellent specificity for the detection of COVID-19. We recommend using the BinasNOW for patients with symptoms up to 2 weeks.
Keywords: Covid‐19; antigen testing; diagnostic devices; emergency department; nasal swab; point of care.
. 2022 Jan 15;3(1):e12605.
doi: 10.1002/emp2.12605. eCollection 2022 Feb.
Utility of COVID-19 antigen testing in the emergency department
W Frank Peacock[SUP] 1 [/SUP], Karina M Soto-Ruiz[SUP] 2 [/SUP], Stacey L House[SUP] 3 [/SUP], Chad M Cannon[SUP] 4 [/SUP], Gary Headden[SUP] 5 [/SUP], Brian Tiffany[SUP] 6 [/SUP], Sergey Motov[SUP] 7 [/SUP], Kian Merchant-Borna[SUP] 8 [/SUP], Anna Marie Chang[SUP] 9 [/SUP], Claire Pearson[SUP] 10 [/SUP], Brian W Patterson[SUP] 11 [/SUP], Alan E Jones[SUP] 12 [/SUP], Joseph Miller[SUP] 13 [/SUP], Joseph Varon[SUP] 14 [/SUP], Aveh Bastani[SUP] 15 [/SUP], Carol Clark[SUP] 16 [/SUP], Zubaid Rafique[SUP] 1 [/SUP], Bory Kea[SUP] 17 [/SUP], John Eppensteiner[SUP] 18 [/SUP], James M Williams[SUP] 19 [/SUP], Simon A Mahler[SUP] 20 [/SUP], Brian E Driver[SUP] 21 [/SUP], Phyllis Hendry[SUP] 22 [/SUP], Eugenia Quackenbush[SUP] 23 [/SUP], David Robinson[SUP] 24 [/SUP], Jon W Schrock[SUP] 25 [/SUP], James P D'Etienne[SUP] 26 [/SUP], Christopher J Hogan[SUP] 27 [/SUP], Anwar Osborne[SUP] 28 [/SUP], Ralph Riviello[SUP] 29 [/SUP], Stephen Young[SUP] 30 [/SUP]
Affiliations
- PMID: 35072154
- PMCID: PMC8760952
- DOI: 10.1002/emp2.12605
Abstract
Background: The BinaxNOW coronavirus disease 2019 (COVID-19) Ag Card test (Abbott Diagnostics Scarborough, Inc.) is a lateral flow immunochromatographic point-of-care test for the qualitative detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleocapsid protein antigen. It provides results from nasal swabs in 15 minutes. Our purpose was to determine its sensitivity and specificity for a COVID-19 diagnosis.
Methods: Eligible patients had symptoms of COVID-19 or suspected exposure. After consent, 2 nasal swabs were collected; 1 was tested using the Abbott RealTime SARS-CoV-2 (ie, the gold standard polymerase chain reaction test) and the second run on the BinaxNOW point of care platform by emergency department staff.
Results: From July 20 to October 28, 2020, 767 patients were enrolled, of which 735 had evaluable samples. Their mean (SD) age was 46.8 (16.6) years, and 422 (57.4%) were women. A total of 623 (84.8%) patients had COVID-19 symptoms, most commonly shortness of breath (n = 404; 55.0%), cough (n = 314; 42.7%), and fever (n = 253; 34.4%). Although 460 (62.6%) had symptoms ≤7 days, the mean (SD) time since symptom onset was 8.1 (14.0) days. Positive tests occurred in 173 (23.5%) and 141 (19.2%) with the gold standard versus BinaxNOW test, respectively. Those with symptoms >2 weeks had a positive test rate roughly half of those with earlier presentations. In patients with symptoms ≤7 days, the sensitivity, specificity, and negative and positive predictive values for the BinaxNOW test were 84.6%, 98.5%, 94.9%, and 95.2%, respectively.
Conclusions: The BinaxNOW point-of-care test has good sensitivity and excellent specificity for the detection of COVID-19. We recommend using the BinasNOW for patients with symptoms up to 2 weeks.
Keywords: Covid‐19; antigen testing; diagnostic devices; emergency department; nasal swab; point of care.