Sensitivity of Reverse Transcription Polymerase Chain Reaction Tests for Severe Acute Respiratory Syndrome Coronavirus 2 Through Time

Rachelle N Binny; Patricia Priest; Nigel P French; Matthew Parry; Audrey Lustig; Shaun C Hendy; Oliver J Maclaren; Kannan M Ridings; Nicholas Steyn; Giorgia Vattiato; Michael J Plank

doi:10.1093/infdis/jiac317

Sensitivity of Reverse Transcription Polymerase Chain Reaction Tests for Severe Acute Respiratory Syndrome Coronavirus 2 Through Time

J Infect Dis. 2022 Dec 28;227(1):9-17. doi: 10.1093/infdis/jiac317.

Authors

Rachelle N Binny^{1

2}, Patricia Priest³, Nigel P French⁴, Matthew Parry^{2

5}, Audrey Lustig^{1

2}, Shaun C Hendy^{2

6}, Oliver J Maclaren⁷, Kannan M Ridings^{2

6}, Nicholas Steyn^{2

6

8}, Giorgia Vattiato^{2

6

9}, Michael J Plank^{2

9}

Affiliations

¹ Manaaki Whenua-Landcare Research, Lincoln, New Zealand.
² Te Pūnaha Matatini, Centre of Research Excellence in Complex Systems, Auckland, New Zealand.
³ Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
⁴ Tāwharau Ora/School of Veterinary Science, Massey University, Palmerson North, New Zealand.
⁵ Department of Mathematics and Statistics, University of Otago, Dunedin, New Zealand.
⁶ Department of Physics, University of Auckland, Auckland, New Zealand.
⁷ Department of Engineering Science, University of Auckland, Auckland, New Zealand.
⁸ Department of Statistics, University of Oxford, Oxford, United Kingdom.
⁹ School of Mathematics and Statistics, University of Canterbury, Christchurch, New Zealand.

Abstract

Background: Reverse transcription polymerase chain reaction (RT-PCR) tests are the gold standard for detecting recent infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Reverse transcription PCR sensitivity varies over the course of an individual's infection, related to changes in viral load. Differences in testing methods, and individual-level variables such as age, may also affect sensitivity.

Methods: Using data from New Zealand, we estimate the time-varying sensitivity of SARS-CoV-2 RT-PCR under varying temporal, biological, and demographic factors.

Results: Sensitivity peaks 4-5 days postinfection at 92.7% (91.4%-94.0%) and remains over 88% between 5 and 14 days postinfection. After the peak, sensitivity declined more rapidly in vaccinated cases compared with unvaccinated, females compared with males, those aged under 40 compared with over 40s, and Pacific peoples compared with other ethnicities.

Conclusions: Reverse transcription PCR remains a sensitive technique and has been an effective tool in New Zealand's border and postborder measures to control coronavirus disease 2019. Our results inform model parameters and decisions concerning routine testing frequency.

Keywords: COVID-19; SARS-CoV-2; reversetranscriptionpolymerase chain reaction; surveillance; test sensitivity.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
COVID-19 Testing
COVID-19* / diagnosis
Clinical Laboratory Techniques / methods
Female
Humans
Male
Real-Time Polymerase Chain Reaction / methods
Reverse Transcriptase Polymerase Chain Reaction
Reverse Transcription
SARS-CoV-2* / genetics
Sensitivity and Specificity