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    Limitations of Molecular and Antigen Test Performance for SARS-CoV-2 in Symptomatic and Asymptomatic COVID-19 Contacts

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    Authors
    Robinson, Matthew L
    Mirza, Agha
    Gallagher, Nicholas
    Boudreau, Alec
    Garcia Jacinto, Lydia
    Yu, Tong
    Norton, Julie
    Luo, Chun Huai
    Conte, Abigail
    Zhou, Ruifeng
    Kafka, Kim
    Hardick, Justin
    McManus, David D
    Gibson, Laura L
    Pekosz, Andrew
    Mostafa, Heba H
    Manabe, Yukari C
    Show allShow less
    UMass Chan Affiliations
    Medicine
    Pediatrics
    Document Type
    Journal Article
    Publication Date
    2022-06-22
    Keywords
    COVID-19
    SARS-CoV-2
    rapid diagnostics
    test performance
    
    Metadata
    Show full item record
    Link to Full Text
    https://doi.org/10.1128/jcm.00187-22
    Abstract
    COVID-19 has brought unprecedented attention to the crucial role of diagnostics in pandemic control. We compared severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test performance by sample type and modality in close contacts of SARS-CoV-2 cases. Close contacts of SARS-CoV-2-positive individuals were enrolled after informed consent. Clinician-collected nasopharyngeal (NP) swabs in viral transport media (VTM) were tested with a routine clinical reference nucleic acid test (NAT) and PerkinElmer real-time reverse transcription-PCR (RT-PCR) assay; positive samples were tested for infectivity using a VeroE6TMPRSS2 cell culture model. Self-collected passive drool was also tested using the PerkinElmer RT-PCR assay. For the first 4 months of study, midturbinate swabs were tested using the BD Veritor rapid antigen test. Between 17 November 2020 and 1 October 2021, 235 close contacts of SARS-CoV-2 cases were recruited, including 95 with symptoms (82% symptomatic for ≤5 days) and 140 asymptomatic individuals. Reference NATs were positive for 53 (22.6%) participants; 24/50 (48%) were culture positive. PerkinElmer testing of NP and saliva samples identified an additional 28 (11.9%) SARS-CoV-2 cases who tested negative by reference NAT. Antigen tests performed for 99 close contacts showed 83% positive percent agreement (PPA) with reference NAT among early symptomatic persons, but 18% PPA in others; antigen tests in 8 of 11 (72.7%) culture-positive participants were positive. Contacts of SARS-CoV-2 cases may be falsely negative early after contact, but more sensitive platforms may identify these cases. Repeat or serial SARS-CoV-2 testing with both antigen and molecular assays may be warranted for individuals with high pretest probability for infection.
    Source
    Robinson ML, Mirza A, Gallagher N, Boudreau A, Garcia Jacinto L, Yu T, Norton J, Luo CH, Conte A, Zhou R, Kafka K, Hardick J, McManus DD, Gibson LL, Pekosz A, Mostafa HH, Manabe YC. Limitations of Molecular and Antigen Test Performance for SARS-CoV-2 in Symptomatic and Asymptomatic COVID-19 Contacts. J Clin Microbiol. 2022 Jul 20;60(7):e0018722. doi: 10.1128/jcm.00187-22. Epub 2022 Jun 22. PMID: 35730949; PMCID: PMC9297839.
    DOI
    10.1128/jcm.00187-22
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/51533
    PubMed ID
    35730949
    Related Resources
    This article is based on a previously available preprint in bioRxiv, https://doi.org/10.1101/2022.02.05.22270481.
    Rights
    © 2022 American Society for Microbiology. All Rights Reserved.
    ae974a485f413a2113503eed53cd6c53
    10.1128/jcm.00187-22
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