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Longitudinal Assessment of Diagnostic Test Performance Over the Course of Acute SARS-CoV-2 Infection.


ABSTRACT:

Background

Serial screening is critical for restricting spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by facilitating timely identification of infected individuals to interrupt transmission. Variation in sensitivity of different diagnostic tests at different stages of infection has not been well documented.

Methods

In a longitudinal study of 43 adults newly infected with SARS-CoV-2, all provided daily saliva and nasal swabs for quantitative reverse transcription polymerase chain reaction (RT-qPCR), Quidel SARS Sofia antigen fluorescent immunoassay (FIA), and live virus culture.

Results

Both RT-qPCR and Quidel SARS Sofia antigen FIA peaked in sensitivity during the period in which live virus was detected in nasal swabs, but sensitivity of RT-qPCR tests rose more rapidly prior to this period. We also found that serial testing multiple times per week increases the sensitivity of antigen tests.

Conclusions

RT-qPCR tests are more effective than antigen tests at identifying infected individuals prior to or early during the infectious period and thus for minimizing forward transmission (given timely results reporting). All tests showed >98% sensitivity for identifying infected individuals if used at least every 3 days. Daily screening using antigen tests can achieve approximately 90% sensitivity for identifying infected individuals while they are viral culture positive.

SUBMITTER: Smith RL 

PROVIDER: S-EPMC8448437 | biostudies-literature | 2021 Sep

REPOSITORIES: biostudies-literature

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Longitudinal Assessment of Diagnostic Test Performance Over the Course of Acute SARS-CoV-2 Infection.

Smith Rebecca L RL   Gibson Laura L LL   Martinez Pamela P PP   Ke Ruian R   Mirza Agha A   Conte Madison M   Gallagher Nicholas N   Conte Abigail A   Wang Leyi L   Fredrickson Richard R   Edmonson Darci C DC   Baughman Melinda E ME   Chiu Karen K KK   Choi Hannah H   Jensen Tor W TW   Scardina Kevin R KR   Bradley Shannon S   Gloss Stacy L SL   Reinhart Crystal C   Yedetore Jagadeesh J   Owens Alyssa N AN   Broach John J   Barton Bruce B   Lazar Peter P   Henness Darcy D   Young Todd T   Dunnett Alastair A   Robinson Matthew L ML   Mostafa Heba H HH   Pekosz Andrew A   Manabe Yukari C YC   Heetderks William J WJ   McManus David D DD   Brooke Christopher B CB  

The Journal of infectious diseases 20210901 6


<h4>Background</h4>Serial screening is critical for restricting spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by facilitating timely identification of infected individuals to interrupt transmission. Variation in sensitivity of different diagnostic tests at different stages of infection has not been well documented.<h4>Methods</h4>In a longitudinal study of 43 adults newly infected with SARS-CoV-2, all provided daily saliva and nasal swabs for quantitative reverse transcr  ...[more]

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