Antigen-Based Testing but Not Real-Time Polymerase Chain Reaction Correlates With Severe Acute Respiratory Syndrome Coronavirus 2 Viral Culture. (20th January 2021)

• Record Type: Journal Article
• Authors: Pekosz, Andrew; Parvu, Valentin; Li, Maggie; Andrews, Jeffrey C; Manabe, Yukari C; Kodsi, Salma; Gary, Devin S; Roger-Dalbert, Celine; Leitch, Jeffry; Cooper, Charles K
• Is Part Of: Clinical infectious diseases. Volume 73:Number 9(2021)
• Page Start: e2861
• Page End: e2866
• Publication Date: 2021-01-20
• Subjects: SARS-CoV-2 -- antigen testing -- SARS-CoV-2 live culture -- rt-PCR testing -- viral load; Communicable diseases -- Periodicals; 616.905
• DOI: 10.1093/cid/ciaa1706
• Languages: English
• ISSNs: 1058-4838

Abstract

Abstract: Background: Individuals can test positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by molecular assays following the resolution of their clinical disease. Recent studies indicate that SARS-CoV-2 antigen–based tests are likely to be positive early in the disease course, when there is an increased likelihood of high levels of infectious virus. Methods: Upper respiratory specimens from 251 participants with coronavirus disease 2019 symptoms (≤7 days from symptom onset) were prospectively collected and tested with a lateral flow antigen test and a real-time polymerase chain reaction (rt-PCR) assay for detection of SARS-CoV-2. Specimens from a subset of the study specimens were utilized to determine the presence of infectious virus in the VeroE6TMPRSS2 cell culture model. Results: The antigen test demonstrated a higher positive predictive value (90%) than rt-PCR (70%) when compared to culture-positive results. The positive percentage agreement for detection of infectious virus for the antigen test was similar to rt-PCR when compared to culture results. Conclusions: The correlation between SARS-CoV-2 antigen and SARS-CoV-2 culture positivity represents a significant advancement in determining the risk for potential transmissibility beyond that which can be achieved by detection of SARS-CoV-2 genomic RNA. SARS-CoV-2 antigen testing can facilitate low-cost, scalable, and rapid time-to-result, while providing good risk determination of those who are likely harboring infectious virus, compared to rt-PCR. Abstract : Antigen-based, real-time polymerase chain reaction (rt-PCR)–based, and VeroE6TMPRSS2 cell culture–based testing was conducted using upper respiratory specimens from COVID-19–symptomatic individuals. Using VeroE6TMPRSS2 culture as reference, antigen-based testing had similar positive percentage agreement but better positive predictive value, compared to rt-PCR, for detecting infectious virus.