Utility of the antigen test for coronavirus disease 2019: Factors influencing the prediction of the possibility of disease transmission. (March 2021)

• Record Type: Journal Article
• Authors: Yamamoto, Kei; Suzuki, Michiyo; Yamada, Gen; Sudo, Tsutomu; Nomoto, Hidetoshi; Kinoshita, Noriko; Nakamura, Keiji; Tsujimoto, Yoshie; Kusaba, Yusaku; Morita, Chie; Moriya, Ataru; Maeda, Kenji; Yagi, Shintaro; Kimura, Motoi; Ohmagari, Norio
• Is Part Of: International journal of infectious diseases. Volume 104(2021)
• Page Start: 65
• Page End: 72
• Publication Date: 2021-03
• Subjects: COVID-19 -- Antigen test -- Appropriate timing for antigen test -- Estimating transmissibility; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2020.12.079
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: The rapid antigen test (RAT) and RT-qPCR positive concordance rate is low in COVID-19. In the early stages of disease, positive and negative concordance rates are acceptable. Factors related to disagreement between RAT and RT-qPCR results were investigated. The predictive ability of RAT for disease transmissibility was examined. RAT and RT-qPCR results were highly consistent; results can infer transmissibility. Abstract: Objectives: Rapid antigen testing (RAT) for coronavirus disease 2019 (COVID-19) has lower sensitivity but high accuracy during the early stage when compared to reverse transcription quantitative polymerase chain reaction (RT-qPCR). The aim of this study was to investigate the concordance between RAT and RT-qPCR results, and their prediction of disease transmission. Methods: This single-center retrospective observational study of inpatients with COVID-19 was conducted from March 6 to June 14, 2020. Nasopharyngeal swabs were used to perform RAT and RT-qPCR. The primary endpoint was concordance between RAT and RT-qPCR results. The secondary endpoints were the factors causing disagreement in the results and the estimated transmissibility in RT-qPCR-positive patients with mild symptoms. Results: Overall, 229 samples in viral transport medium (VTM) were obtained from 105 patients. The positive and negative concordance rates for VTM were 41% vs 99% (κ = 0.37) and 72% vs 100% (κ = 0.50) for samples collected on disease days 2–9. An increased body temperature (odds ratio 0.54) and absence of drugs with potential antiviral effect (odds ratio 0.48) yielded conflicting results. RAT was associated with the ability to end isolation (OR 0.11, 95% confidence interval 0.20–0.61). Conclusions: RAT and RT-qPCR results were highly consistent for samples collected at the appropriate time and could be useful for inferring the possibility of transmissibility.