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    Comparison of Rapid Antigen Tests' Performance Between Delta and Omicron Variants of SARS-CoV-2 : A Secondary Analysis From a Serial Home Self-testing Study

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    Authors
    Soni, Apurv
    Herbert, Carly
    Filippaios, Andreas
    Broach, John
    Colubri, Andres
    Fahey, Nisha
    Woods, Kelsey
    Nanavati, Janvi
    Wright, Colton
    Orwig, Taylor
    Gilliam, Karen
    Kheterpal, Vik
    Suvarna, Thejas
    Nowak, Chris
    Schrader, Summer
    Lin, Honghuang
    O'Connor, Laurel
    Pretz, Caitlin
    Ayturk, Didem
    Orvek, Elizabeth
    Flahive, Julie
    Lazar, Peter
    Shi, Qiming
    Achenbach, Chad
    Murphy, Robert
    Robinson, Matthew
    Gibson, Laura
    Stamegna, Pamela
    Hafer, Nathaniel
    Luzuriaga, Katherine
    Barton, Bruce
    Heetderks, William
    Manabe, Yukari C
    McManus, David
    Show allShow less
    UMass Chan Affiliations
    Center for Clinical and Translational Science
    Emergency Medicine
    Medicine
    Microbiology and Physiological Systems
    Morningside Graduate School of Biomedical Sciences
    Pediatrics
    Population and Quantitative Health Sciences
    Program in Bioinformatics and Integrative Biology
    Program in Molecular Medicine
    Document Type
    Journal Article
    Publication Date
    2022-10-11
    Keywords
    UMCCTS funding
    
    Metadata
    Show full item record
    Link to Full Text
    https://doi.org/10.7326/m22-0760
    Abstract
    Background: It is important to document the performance of rapid antigen tests (Ag-RDTs) in detecting SARS-CoV-2 variants. Objective: To compare the performance of Ag-RDTs in detecting the Delta (B.1.617.2) and Omicron (B.1.1.529) variants of SARS-CoV-2. Design: Secondary analysis of a prospective cohort study that enrolled participants between 18 October 2021 and 24 January 2022. Participants did Ag-RDTs and collected samples for reverse transcriptase polymerase chain reaction (RT-PCR) testing every 48 hours for 15 days. Setting: The parent study enrolled participants throughout the mainland United States through a digital platform. All participants self-collected anterior nasal swabs for rapid antigen testing and RT-PCR testing. All Ag-RDTs were completed at home, whereas nasal swabs for RT-PCR were shipped to a central laboratory. Participants: Of 7349 participants enrolled in the parent study, 5779 asymptomatic persons who tested negative for SARS-CoV-2 on day 1 of the study were eligible for this substudy. Measurements: Sensitivity of Ag-RDTs on the same day as the first positive (index) RT-PCR result and 48 hours after the first positive RT-PCR result. Results: A total of 207 participants were positive on RT-PCR (58 Delta, 149 Omicron). Differences in sensitivity between variants were not statistically significant (same day: Delta, 15.5% [95% CI, 6.2% to 24.8%] vs. Omicron, 22.1% [CI, 15.5% to 28.8%]; at 48 hours: Delta, 44.8% [CI, 32.0% to 57.6%] vs. Omicron, 49.7% [CI, 41.6% to 57.6%]). Among 109 participants who had RT-PCR-positive results for 48 hours, rapid antigen sensitivity did not differ significantly between Delta- and Omicron-infected participants (48-hour sensitivity: Delta, 81.5% [CI, 66.8% to 96.1%] vs. Omicron, 78.0% [CI, 69.1% to 87.0%]). Only 7.2% of the 69 participants with RT-PCR-positive results for shorter than 48 hours tested positive by Ag-RDT within 1 week; those with Delta infections remained consistently negative on Ag-RDTs. Limitation: A testing frequency of 48 hours does not allow a finer temporal resolution of the analysis of test performance, and the results of Ag-RDTs are based on self-report. Conclusion: The performance of Ag-RDTs in persons infected with the SARS-CoV-2 Omicron variant is not inferior to that in persons with Delta infections. Serial testing improved the sensitivity of Ag-RDTs for both variants. The performance of rapid antigen testing varies on the basis of duration of RT-PCR positivity. Primary funding source: National Heart, Lung, and Blood Institute of the National Institutes of Health.
    Source
    Soni A, Herbert C, Filippaios A, Broach J, Colubri A, Fahey N, Woods K, Nanavati J, Wright C, Orwig T, Gilliam K, Kheterpal V, Suvarna T, Nowak C, Schrader S, Lin H, O'Connor L, Pretz C, Ayturk D, Orvek E, Flahive J, Lazar P, Shi Q, Achenbach C, Murphy R, Robinson M, Gibson L, Stamegna P, Hafer N, Luzuriaga K, Barton B, Heetderks W, Manabe YC, McManus D. Comparison of Rapid Antigen Tests' Performance Between Delta and Omicron Variants of SARS-CoV-2 : A Secondary Analysis From a Serial Home Self-testing Study. Ann Intern Med. 2022 Oct 11:M22-0760. doi: 10.7326/M22-0760. Epub ahead of print. PMID: 36215709; PMCID: PMC9578286.
    DOI
    10.7326/M22-0760
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/51447
    PubMed ID
    36215709
    ae974a485f413a2113503eed53cd6c53
    10.7326/M22-0760
    Scopus Count
    Collections
    Morningside Graduate School of Biomedical Sciences Scholarly Publications
    COVID-19 Publications by UMass Chan Authors
    Population and Quantitative Health Sciences Publications
    Program in Bioinformatics and Integrative Biology Publications
    UMass Center for Clinical and Translational Science Supported Publications
    Emergency Medicine Publications

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