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    Longitudinal assessment of diagnostic test performance over the course of acute SARS-CoV-2 infection

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    Authors
    Smith, Rebecca L.
    Gibson, Laura L.
    Owens, Alyssa N.
    Broach, John P.
    Barton, Bruce A.
    Lazar, Peter
    McManus, David D.
    Brooke, Christopher B.
    UMass Chan Affiliations
    Department of Medicine, Division of Cardiovascular Medicine
    Division of Biostatistics and Health Services Research, Department of Population and Quantitative Health Sciences
    Department of Emergency Medicine
    UMass Center for Clinical and Translational Science
    Department of Pediatrics
    Division of Infectious Diseases and Immunology, Department of Medicine
    Document Type
    Accepted Manuscript
    Publication Date
    2021-06-30
    Keywords
    Diagnostic testing
    RTqPCR testing
    SARS-CoV-2
    antigen testing
    test sensitivity
    COVID-19
    Diagnosis
    Epidemiology
    Immunology of Infectious Disease
    Immunoprophylaxis and Therapy
    Infectious Disease
    Microbiology
    Virus Diseases
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    Abstract
    BACKGROUND: Serial screening is critical for restricting spread of SARS-CoV-2 by facilitating the timely identification of infected individuals to interrupt transmission chains. The variation in sensitivity of different diagnostic tests at different stages of infection has not been well documented. METHODS: This is a longitudinal study of 43 adults newly infected with SARS-CoV-2. All participants provided daily samples for saliva and nasal swab RTqPCR, Quidel SARS Sofia antigen FIA, and live virus culture. RESULTS: We show that both RTqPCR and the Quidel SARS Sofia antigen FIA peak in sensitivity during the period in which live virus is detected in nasal swabs, but the sensitivity of RTqPCR tests rises more rapidly prior to this period. We also estimate the sensitivities of RTqPCR and antigen tests as a function of testing frequency. CONCLUSIONS: RTqPCR 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 three days. Daily screening using antigen tests can achieve ~90% sensitivity for identifying infected individuals while they are viral culture positive.
    Source

    Smith RL, Gibson LL, Martinez PP, Ke R, Mirza A, Conte M, Gallagher N, Conte A, Wang L, Fredrickson R, Edmonson DC, Baughman ME, Chiu KK, Choi H, Jensen TW, Scardina KR, Bradley S, Gloss SL, Reinhart C, Yedetore J, Owens AN, Broach J, Barton B, Lazar P, Henness D, Young T, Dunnett A, Robinson ML, Mostafa HH, Pekosz A, Manabe YC, Heetderks WJ, McManus DD, Brooke CB. Longitudinal assessment of diagnostic test performance over the course of acute SARS-CoV-2 infection. J Infect Dis. 2021 Jun 30:jiab337. doi: 10.1093/infdis/jiab337. Epub ahead of print. PMID: 34191025. Link to article on publisher's site

    DOI
    10.1093/infdis/jiab337
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/27471
    PubMed ID
    34191025
    Notes

    This article is based on a previously available preprint in medRxiv.

    Full author list omitted for brevity. For the full list of authors, see article.

    Related Resources

    Link to Article in PubMed

    Rights
    Copyright © 2021, Oxford University Press. This is a PDF file of an accepted manuscript that has been accepted for publication and posted with a 12-month embargo as allowed by the publisher’s self-archiving policy at https://academic.oup.com/journals/pages/access_purchase/rights_and_permissions/author_self_archiving_policy.
    ae974a485f413a2113503eed53cd6c53
    10.1093/infdis/jiab337
    Scopus Count
    Collections
    COVID-19 Publications by UMass Chan Authors
    Population and Quantitative Health Sciences Publications
    Emergency Medicine Publications

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