A SARS-CoV-2 negative antigen rapid diagnostic in RT-qPCR positive samples correlates with a low likelihood of infectious viruses in the nasopharynx

Author:

Corrêa Isadora Alonso,Faffe Débora Souza,Galliez Rafael Mello,Gonçalves Cássia Cristina Alves,Araújo Maia Richard,da Silva Gustavo Peixoto,Rebello Moreira Filipe Romero,Mariani Diana,Campos Mariana Freire,de Carvalho Leitão Isabela,de Souza Marcos Romário,Cunha Marcela Sabino,dos Santos Nascimento Érica Ramos,de Jesus Ribeiro Liane,da Cruz Thais Felix Cordeiro,Policarpo Cintia,Gonzales Luis,Rodgers Mary A,Berg Michael,Vijesurier Roy,Cloherty Gavin A,Hackett John,da Costa Ferreira Orlando,Castiñeiras Terezinha Marta Pereira Pinto,Tanuri Amilcar,da Costa Luciana Jesus

Abstract

AbstractSARS-CoV-2 transmission occurs even among fully vaccinated individuals; thus, prompt identification of infected patients is central to control viral circulation. Antigen rapid diagnostic tests (Ag-RDT) are highly specific, but sensitivity is variable.Discordant RT-qPCR vs Ag-RDT results are reported, raising the question of whether negative Ag-RDT in positive RT-qPCR samples could imply the absence of infectious viruses. To study the relationship between a negative Ag-RDT results with virological, molecular, and serological parameters, we selected a cross sectional and a follow-up dataset and analyzed virus culture, subgenomic RNA quantification, and sequencing to determine infectious viruses and mutations. We demonstrated that a positive SARS-CoV-2 Ag-RDT result correlates with the presence of infectious virus in nasopharyngeal samples. A decrease in sgRNA detection together with an expected increase in detectable anti-S and anti-N IgGs was verified in negative Ag-RDT / positive RT-qPCR samples. The data clearly demonstrates the less likelihood of a negative Ag-RDT sample to harbor infectious SARS-CoV-2 and consequently with a lower transmissible potential.

Publisher

Cold Spring Harbor Laboratory

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