1. Self-testing for the detection of SARS-CoV-2 infection with rapid antigen tests for people with suspected COVID-19 in the community
- Author
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Carla R.S. Nagel-Imming, Joep J.J.M. Stohr, Vivian F. Zwart, Adam Meijer, Wouter van den Bijllaardt, Jean-Luc Murk, Femke van den Oetelaar, Ariene Rietveld, Marjolein F.Q. Kluytmans-van den Bergh, Jaco J. Verweij, Suzan D. Pas, Gabriel Goderski, Kim H. Gan, Marloes Hellwich, and Jan Kluytmans
- Subjects
Microbiology (medical) ,medicine.medical_specialty ,2019-20 coronavirus outbreak ,Rapid antigen detection test ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Self-testing ,Sensitivity and Specificity ,COVID-19 Testing ,Antigen ,Internal medicine ,parasitic diseases ,medicine ,Humans ,Severe acute respiratory syndrome coronavirus 2 ,Antigens, Viral ,Public health ,Coronavirus disease 2019 ,SARS-CoV-2 ,business.industry ,Viral culture ,COVID-19 ,General Medicine ,Odds ratio ,Infectious Diseases ,Positive culture ,Original Article ,business - Abstract
Objectives To evaluate the performance of nasal mid-turbinate self-testing using rapid antigen detection tests (RDT) for persons with suspected coronavirus disease 2019 (COVID-19) in the community. Self-testing for COVID-19 infection with lateral flow assay severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RDT, provides rapid results and could enable frequent and extensive testing in the community, thereby improving the control of SARS-CoV-2. Methods Participants visiting a municipal SARS-CoV-2 testing centre, received self-testing kits containing either the BD Veritor System (BD-RDT) or Roche SARS-CoV-2 antigen detection test (Roche-RDT). Oro-nasopharyngeal swabs were collected from the participants for quantitative RT-PCR (qRT-PCR) testing. As a proxy for contagiousness, viral culture was performed on a selection of qRT-PCR positive samples to determine the Ct-value at which the chance of a positive culture dropped below 0.5 (Ct-value cut-off). Sensitivity and specificity of self-testing were compared to qRT-PCR with a Ct-value below the Ct value cut-off. Determinants independently associated with a false-negative self-test result were determined. Results A total of 3201 participants were included (BD-RDT n = 1595; Roche-RDT n = 1606). Sensitivity and specificity of self-testing compared with the qRT-PCR results with a Ct-value below the Ct-value cut-off were 78.4% (95% CI 73.2%–83.5%) and 99.4% (95% CI 99.1%–99.7%), respectively. A higher age was independently associated with a false-negative self-testing result with an odds ratio of 1.024 (95% CI 1.003–1.044). Conclusions Self-testing using currently available RDT has a high specificity and relatively high sensitivity to identify individuals with a high probability of contagiousness.
- Published
- 2022