Longitudinal assessment of diagnostic test performance over the course of acute SARS-CoV-2 infection
AuthorsSmith, Rebecca L.
Gibson, Laura L.
Owens, Alyssa N.
Broach, John P.
Barton, Bruce A.
McManus, David D.
Brooke, Christopher B.
UMass Chan AffiliationsDepartment 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 TypeAccepted Manuscript
Immunology of Infectious Disease
Immunoprophylaxis and Therapy
MetadataShow full item record
AbstractBACKGROUND: 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.
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
Permanent Link to this Itemhttp://hdl.handle.net/20.500.14038/27471
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.