Positivity of Rapid Antigen Testing for SARS-CoV-2 With Serial Followed-up Nasopharyngeal Swabs in Hospitalized Patients due to COVID-19

J Korean Med Sci. 2022 May 30;37(21):e168. doi: 10.3346/jkms.2022.37.e168.

Abstract

Despite the accuracy of nucleic acid amplification tests (NAATs), rapid antigen tests (RATs) for severe acute respiratory syndrome coronavirus-2 are widely used as point-of-care tests. A total of 282 pairs of reverse transcription-polymerase chain reaction and Standard Q COVID-19 Ag tests were serially conducted for 68 patients every 3-4 days until their discharge. Through a field evaluation of RATs using direct nasopharyngeal swabs, the sensitivities were 84.6% and 87.3% for E and RNA-dependent RNA polymerase (RdRp) genes, respectively, for specimens with cycle thresholds (Cts) < 25. The Ct values of E and RdRp genes for 95% detection rates by RATs were 16.9 and 18.1, respectively. The sensitivity of RAT was 48.4% after the onset of symptoms, which was not sufficient. RAT positivity gradually decreased with increased time after symptom onset and had continuously lower sensitivity than NAATs.

Keywords: Antigen Test; COVID-19; Nucleic Acid Amplification Techniques; SARS-CoV-2.

MeSH terms

  • Antigens, Viral
  • COVID-19 Testing* / methods
  • COVID-19* / diagnosis
  • Humans
  • Nasopharynx
  • RNA-Dependent RNA Polymerase
  • SARS-CoV-2* / isolation & purification
  • Sensitivity and Specificity

Substances

  • Antigens, Viral
  • RNA-Dependent RNA Polymerase

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