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Performance characteristics of five antigen-detecting rapid diagnostic test (Ag-RDT) for SARS-CoV-2 asymptomatic infection: a head-to-head benchmark comparison

Baro, Barbara; Rodo, Pau; Ouchi, Dan; Bordoy, Antoni E.; Saya Amaro, Emilio N.; Salsench, Sergi, V; Molinos, Sonia; Alemany, Andrea; Ubals, Maria; Corbacho-Monne, Marc; Millat-Martinez, Pere; Marks, Michael; Clotet, Bonaventura; Prat, Nuria; Estrada, Oriol

JOURNAL OF INFECTION
2021
VL / 82 - BP / 269 - EP / 275
abstract
Background: Mass testing for early identification and isolation of infectious COVID-19 individuals is efficacious for reducing disease spread. Antigen-detecting rapid diagnostic tests (Ag-RDT) may be suitable for testing strategies; however, benchmark comparisons are scarce. Methods: We used 286 nasopharyngeal specimens from unexposed asymptomatic individuals collected between December 2020 and January 2021 to assess five Ag-RDTs marketed by Abbott, Siemens, Roche Diagnostics, Lepu Medical, and Surescreen. Results: For the overall sample, the performance parameters of Ag-RDTs were as follows: Abbott assay, sensitivity 38.6% (95%CI 29.1-48.8) and specificity 99.5% (97-100%); Siemens, sensitivity 51.5% (41.3-61.6) and specificity 98.4% (95.3-99.6); Roche, sensitivity 43.6% (33.7-53.8) and specificity 96.2% (92.4-98.5); Lepu, sensitivity 45.5% (35.6-55.8) and specificity 89.2% (83.8-93.3%); Surescreen, sensitivity 28.8% (20.2-38.6) and specificity 97.8% (94.5-99.4%). For specimens with cycle threshold (Ct) <30 in RT-qPCR, all AgRDT achieved a sensitivity >= 70%. The modelled negative- and positive-predictive value for 1% prevalence were >99% and <50%, respectively. Conclusions: When screening unexposed asymptomatic individuals, two Ag-RDTs achieved sensitivity >80% for specimens with Ct<30 and specificity >= 96%. The estimated negative predictive value suggests the suitability of Ag-RDTs for mass screenings of SARS-CoV-2 infection in the general population. (C) 2021 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

AccesS level

Green submitted, Bronze, Green published

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