Longitudinal assessment of diagnostic test performance over the course of acute SARS-CoV-2 infection
Author:
Smith Rebecca L., Gibson Laura L., Martinez Pamela P., Ke RuianORCID, Mirza Agha, Conte Madison, Gallagher Nicholas, Conte Abigail, Wang Leyi, Fredrickson Rick, Edmonson Darci C., Baughman Melinda E., Chiu Karen K., Choi Hannah, Jensen Tor W., Scardina Kevin R., Bradley Shannon, Gloss Stacy L., Reinhart Crystal, Yedetore Jagadeesh, Owens Alyssa N., Broach John, Barton Bruce, Lazar Peter, Henness Darcy, Young Todd, Dunnett Alastair, Robinson Matthew L.ORCID, Mostafa Heba H., Pekosz AndrewORCID, Manabe Yukari C., Heetderks William J., McManus David D., Brooke Christopher B.
Abstract
SUMMARYWhat is already known about this topic?Diagnostic tests and sample types for SARS-CoV-2 vary in sensitivity across the infection period.What is added by this report?We show that both RTqPCR (from nasal swab and saliva) and the Quidel SARS Sofia FIA rapid antigen tests peak in sensitivity during the period in which live virus can be detected in nasal swabs, but that the sensitivity of RTqPCR tests rises more rapidly in the pre-infectious period. We also use empirical data to estimate the sensitivities of RTqPCR and antigen tests as a function of testing frequency.What are the implications for public health practice?RTqPCR tests will be more effective than rapid antigen tests at identifying infected individuals prior to or early during the infectious period and thus for minimizing forward transmission (provided results reporting is timely). All modalities, including rapid antigen tests, showed >94% sensitivity to detect infection if used at least twice per week. Regular surveillance/screening using rapid antigen tests 2-3 times per week can be an effective strategy to achieve high sensitivity (>95%) for identifying infected individuals.
Publisher
Cold Spring Harbor Laboratory
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