tetano
Editor, Senior Moderator
J Chin Med Assoc
. 2023 Sep 8.
doi: 10.1097/JCMA.0000000000000987. Online ahead of print. Assessment of the detection accuracy of SARS-CoV-2 rapid antigen test in children and adolescents: An updated meta-analysis
Cheng-Chieh Chen[SUP] 1 [/SUP], Mei-Hui Lee[SUP] 2 [/SUP], Shih-Yen Chen[SUP] 3 4 [/SUP], Shou-Cheng Lu[SUP] 5 [/SUP], Chyi-Huey Bai[SUP] 6 [/SUP], Yu-Ling Ko[SUP] 7 [/SUP], Chien-Ying Wang[SUP] 8 9 10 [/SUP], Yuan-Hung Wang[SUP] 11 12 [/SUP]
Affiliations
Background: Real-time and appropriate antigen tests play a pivotal role in preventing severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. However, a previous meta-analysis reported that the antigen test had lower sensitivity for the detection of SARS-CoV-2 in children. To provide a comprehensive evaluation of diagnostic efficiency, we performed an updated meta-analysis to assess the detection accuracy of SARS-CoV-2 antigen tests stratified by days after symptom onset and specimen type in children and adolescents.
Methods: We comprehensively searched for appropriate studies in the PubMed, Embase, and Cochrane Library databases. Studies on the diagnostic accuracy of antigen tests for SARS-CoV-2 in children and adolescents were included. The relevant data of the included studies were extracted to construct a 2 × 2 table on a per-patient basis. The overall sensitivity and specificity of the SARS-CoV-2 antigen tests were estimated using a bivariate random-effects model.
Results: Seventeen studies enrolling 10,912 patients were included in the present meta-analysis. For the detection accuracy of SARS-CoV-2 antigen tests, the meta-analysis generated a pooled sensitivity of 77.9% (95% confidence interval (CI): 67.3-85.8%) and a pooled specificity of 99.6% (95% CI: 98.9-99.8%). The subgroup analysis of studies that examined antigen tests in symptomatic participants ≦7 days after symptom onset generated a pooled sensitivity of 79.4% (95% CI: 47.6-94.2%) and a pooled specificity of 99.4% (95% CI: 98.2-99.8%). Another subgroup analysis of studies that evaluated nasal swab specimens demonstrated a pooled sensitivity of 80.1% (95% CI: 65.0-89.7%) and a pooled specificity of 98.5% (95% CI: 97.3-99.2%).
Conclusion: Our findings demonstrated that the antigen test performed using nasal swab specimens exhibited high sensitivity for the detection of SARS-CoV-2 within 7 days after symptom onset. Therefore, antigen testing using nasal swabs may be effective in blocking SARS-CoV-2 transmission in children.
. 2023 Sep 8.
doi: 10.1097/JCMA.0000000000000987. Online ahead of print. Assessment of the detection accuracy of SARS-CoV-2 rapid antigen test in children and adolescents: An updated meta-analysis
Cheng-Chieh Chen[SUP] 1 [/SUP], Mei-Hui Lee[SUP] 2 [/SUP], Shih-Yen Chen[SUP] 3 4 [/SUP], Shou-Cheng Lu[SUP] 5 [/SUP], Chyi-Huey Bai[SUP] 6 [/SUP], Yu-Ling Ko[SUP] 7 [/SUP], Chien-Ying Wang[SUP] 8 9 10 [/SUP], Yuan-Hung Wang[SUP] 11 12 [/SUP]
Affiliations
- PMID: 37683135
- DOI: 10.1097/JCMA.0000000000000987
Background: Real-time and appropriate antigen tests play a pivotal role in preventing severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. However, a previous meta-analysis reported that the antigen test had lower sensitivity for the detection of SARS-CoV-2 in children. To provide a comprehensive evaluation of diagnostic efficiency, we performed an updated meta-analysis to assess the detection accuracy of SARS-CoV-2 antigen tests stratified by days after symptom onset and specimen type in children and adolescents.
Methods: We comprehensively searched for appropriate studies in the PubMed, Embase, and Cochrane Library databases. Studies on the diagnostic accuracy of antigen tests for SARS-CoV-2 in children and adolescents were included. The relevant data of the included studies were extracted to construct a 2 × 2 table on a per-patient basis. The overall sensitivity and specificity of the SARS-CoV-2 antigen tests were estimated using a bivariate random-effects model.
Results: Seventeen studies enrolling 10,912 patients were included in the present meta-analysis. For the detection accuracy of SARS-CoV-2 antigen tests, the meta-analysis generated a pooled sensitivity of 77.9% (95% confidence interval (CI): 67.3-85.8%) and a pooled specificity of 99.6% (95% CI: 98.9-99.8%). The subgroup analysis of studies that examined antigen tests in symptomatic participants ≦7 days after symptom onset generated a pooled sensitivity of 79.4% (95% CI: 47.6-94.2%) and a pooled specificity of 99.4% (95% CI: 98.2-99.8%). Another subgroup analysis of studies that evaluated nasal swab specimens demonstrated a pooled sensitivity of 80.1% (95% CI: 65.0-89.7%) and a pooled specificity of 98.5% (95% CI: 97.3-99.2%).
Conclusion: Our findings demonstrated that the antigen test performed using nasal swab specimens exhibited high sensitivity for the detection of SARS-CoV-2 within 7 days after symptom onset. Therefore, antigen testing using nasal swabs may be effective in blocking SARS-CoV-2 transmission in children.