What is the true place of the SARS‐CoV‐2 rapid point‐of‐care antigen test in the hospital setting? Lessons learned from real life. Issue 4 (13th December 2021)

• Record Type: Journal Article
• Authors: Roger, Steven; Lefeuvre, Caroline; Pivert, Adeline; Ducancelle, Alexandra; Savary, Dominique; Bouthry, Élise; Le Guillou‐Guillemette, Hélène
• Other Names: Luo Guangxiang (George) guestEditor.; Ly Hinh guestEditor.; Gao Shou‐Jiang guestEditor.
• Is Part Of: Journal of medical virology. Volume 94:Issue 4(2022)
• Page Start: 1723
• Page End: 1727
• Publication Date: 2021-12-13
• Subjects: hospital screening -- point‐of‐care test -- SARS‐CoV‐2 -- SARS‐CoV‐2 antigen; Virology -- Periodicals; 616
• DOI: 10.1002/jmv.27505
• Languages: English
• ISSNs: 0146-6615

Abstract

Abstract: To assist in the clinical management of patients and to support infection control, we tested the use of the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) point‐of‐care antigen test (AgPOC) for unplanned hospitalization, coupled with a nucleic acid amplification test (NAAT) using specimens collected at the same time upon arrival. The aim of this study was to assess the performance of the AgPOC in this specific use compared to NAAT for SARS‐CoV‐2 diagnosis, in the context of the low prevalence of infection. For 5 months (between two peaks in France of the SARS‐CoV‐2 pandemic), all patients admitted who undertook the AgPOC/NAAT paired tests were included in the study. AgPOC performances were determined considering the clinical status and the delay of symptoms onset. NAAT and AgPOC results were available for 4425 subjects. AgPOC results showed a homogeneous specificity (>97%) but a low sensitivity at 45.8%. Considering the national guidelines, sensitivity dropped to 32.5% in cases of symptomatic patients with symptoms older than 5 days or more. This study shows the poor performance of AgPOC for entry screening of patients in hospitals. AgPOC may represent a useful tool in the hospital setting only if the use is restricted to patients with consistent symptoms less than 4 days old. Highlights: – SARS‐CoV‐2 point‐of‐care antigen tests (AgPOC) are poorly evaluated to screen patients for unplanned hospitalization. – Performance of AgPOC showed low sensitivity in hospital setting. – Use of AgPOC in hospital should be restricted to patients with consistent symptoms less than 4 days old.