Rapid screening for severe acute respiratory syndrome coronavirus 2 infection with a combined point-of-care antigen test and an immunoglobulin G antibody test

PLoS One. 2022 Feb 1;17(2):e0263327. doi: 10.1371/journal.pone.0263327. eCollection 2022.

Abstract

Rapid screening and diagnosis of coronavirus disease 2019 in the emergency department is important for controlling infections. When polymerase chain reaction tests cannot be rapidly performed, rapid antigen testing is often used, albeit with insufficient sensitivity. Therefore, we evaluated the diagnostic accuracy of combining rapid antigen and antibody test results. This was a retrospective review of patients who visited our emergency department between February and May 2021 and underwent rapid antigen, immunoglobulin G antibody, and reverse transcription-polymerase chain reaction tests. The study included 1,070 patients, of whom 56 (5.2%) tested positive on reverse transcription-polymerase chain reaction. The sensitivity, specificity, and area under the curve of rapid antigen testing were 73.7%, 100.0%, and 0.87, respectively. The combined rapid antigen and antibody test result had improved diagnostic accuracy, with 91.2% sensitivity, 97.9% specificity, and an area under the curve of 0.95. The results of the rapid antigen and antibody tests could be combined as a reliable alternative to reverse transcription-polymerase chain reaction.

MeSH terms

  • Aged
  • Aged, 80 and over
  • COVID-19 / diagnosis*
  • COVID-19 Serological Testing / methods
  • COVID-19 Testing / methods*
  • Female
  • Humans
  • Immunoglobulin G / analysis
  • Male
  • Middle Aged
  • Point-of-Care Testing*
  • Retrospective Studies
  • Sensitivity and Specificity

Substances

  • Immunoglobulin G

Grants and funding

The author(s) received no specific funding for this work.