1. Performance of SARS-CoV-2 antigen testing in symptomatic and asymptomatic adults: a single-center evaluation
- Author
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Joe Suyama, Meredith Axe, Steven R. Orris, Alan Wells, Tanner J Freeman, Megan Culler Freeman, Stephanie L. Mitchell, Michelle Adam, Jamie Gribschaw, and Alejandro Hoberman
- Subjects
Adult ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Symptomatic ,Antigen test ,Infectious and parasitic diseases ,RC109-216 ,Single Center ,Asymptomatic ,Sensitivity and Specificity ,Medical microbiology ,Internal medicine ,Medicine ,Humans ,Antigen testing ,business.industry ,Diagnostic Tests, Routine ,SARS-CoV-2 ,Reproducibility of Results ,COVID-19 ,Infectious Diseases ,PCR ,Nasal Swab ,Cohort ,medicine.symptom ,business ,Research Article - Abstract
Background Antigen testing offers rapid and inexpensive testing for SARS-CoV-2 but concerns regarding performance, especially sensitivity, remain. Limited data exists for use of antigen testing in asymptomatic patients; thus, performance and reliability of antigen testing remains unclear. Methods 148 symptomatic and 144 asymptomatic adults were included. A nasal swab was collected for testing by Quidel Sofia SARS IFA (Sofia) as point of care. A nasopharyngeal swab was also collected and transported to the laboratory for testing by Cepheid Xpert Xpress SARS-CoV-2/Flu/RSV RT-PCR (Cepheid). Results Overall, Sofia had good agreement with Cepheid (> 95%) in adults, however was less sensitive. Sofia had a sensitivity of 87.8% and 33.3% for symptomatic and asymptomatic patients, respectively. Among symptomatic patients, testing > 5 days post symptom onset resulted in lower sensitivity (82%) when compared with testing within 5 days of symptom onset (90%). Of the four Sofia false-negative results in the asymptomatic cohort, 50% went on to develop COVID-19 disease within 5 days of testing. Specificity in both symptomatic and asymptomatic cohorts was 100%. Conclusions Sofia has acceptable performance in symptomatic adults when tested 5 days of symptom onset and asymptomatic patients.
- Published
- 2021