Screening for Severe Acute Respiratory Syndrome Coronavirus 2 in Close Contacts of Individuals With Confirmed Infection: Performance and Operational Considerations. (20th May 2022)

• Record Type: Journal Article
• Authors: Zobrist, Stephanie; Oliveira-Silva, Michelle; Vieira, Alexia Martines; Bansil, Pooja; Gerth-Guyette, Emily; Leader, Brandon T; Golden, Allison; Slater, Hannah; Cruz, Catherine Duran de Lucena; Garbin, Eduardo; Sagalovsky, Mariana; Pal, Sampa; Gupta, Vin; Wolansky, Leo; Dall'Acqua, Deusilene Souza Vieira; Naveca, Felipe Gomes; Nascimento, Valdinete Alves do; Salcedo, Juan Miguel Villalobos; Drain, Paul K; Costa, Alexandre Dias Tavares; Domingo, Gonzalo J; Pereira, Dhélio
• Is Part Of: Journal of infectious diseases. Volume 226:Number 12(2022)
• Page Start: 2118
• Page End: 2128
• Publication Date: 2022-05-20
• Subjects: Porto Velho -- Rondônia -- Allplex SARS-CoV-2 assay -- SalivaDirect -- SD Biosensor STANDARD Q COVID-19 Ag -- LumiraDx SARS-CoV-2 Ag test; Communicable diseases -- Periodicals; Diseases -- Causes and theories of causation -- Periodicals; Medicine -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.9
• DOI: 10.1093/infdis/jiac204
• Languages: English
• ISSNs: 0022-1899

Abstract

Abstract: Background: Point-of-care and decentralized testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is critical to inform public health responses. Performance evaluations in priority use cases such as contact tracing can highlight trade-offs in test selection and testing strategies. Methods: A prospective diagnostic accuracy study was conducted among close contacts of coronavirus disease 2019 (COVID-19) cases in Brazil. Two anterior nares swabs (ANS), a nasopharyngeal swab (NPS), and saliva were collected at all visits. Vaccination history and symptoms were assessed. Household contacts were followed longitudinally. Three rapid antigen tests and 1 molecular method were evaluated for usability and performance against reference reverse-transcription polymerase chain reaction (RT-PCR) on nasopharyngeal swab specimens. Results: Fifty index cases and 214 contacts (64 household) were enrolled. Sixty-five contacts were RT-PCR positive during ≥1 visit. Vaccination did not influence viral load. Gamma variants were most prevalent; Delta variants emerged increasingly during implementation. The overall sensitivity of evaluated tests ranged from 33% to 76%. Performance was higher among symptomatic cases and those with cycle threshold (Ct) values <34 and lower among oligosymptomatic or asymptomatic cases. Assuming a 24-hour time to results for RT-PCR, the cumulative sensitivity of an anterior nares swab rapid antigen test was >70% and almost 90% after 4 days. Conclusions: The near-immediate time to results for antigen tests significantly offsets lower analytical sensitivity in settings where RT-PCR results are delayed or unavailable. Abstract : This study evaluated the performance of 3 rapid antigen tests and 1 molecular method for detecting severe acute respiratory syndrome coronavirus 2 among close contacts of coronavirus disease 2019 case patients and found that near-immediate time to results for antigen tests significantly offsets lower sensitivity when polymerase chain reaction results are delayed or unavailable.