Longitudinal assessment of diagnostic test performance over the course of acute SARS-CoV-2 infection
Division of Infectious Diseases and Immunology, Department of Medicine; UMass Center for Clinical and Translational Science; Department of Emergency Medicine; Division of Biostatistics and Health Services Research, Department of Population and Quantitative Health Sciences; Division of Cardiovascular Medicine, Department of Medicine
Diagnosis | Immunology and Infectious Disease | Infectious Disease | Microbiology | Public Health | Virus Diseases
What 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.
Infectious Diseases (except HIV/AIDS), COVID-19, testing, SARS-CoV-2 infection
DOI of Published Version
Smith RL, Gibson LL, Martinez PP, Ke R, Mirza A, Conte M, Gallagher N, Conte A, Wang L, Fredrickson R, Edmonson DC, Baughman ME, Chiu KK, Choi H, Jensen TW, Scardina KR, Bradley S, Gloss SL, Reinhart C, Yedetore J, Owens AN, Broach J, Barton B, Lazar P, Henness D, Young T, Dunnett A, Robinson ML, Mostafa HH, Pekosz A, Manabe YC, Heetderks WJ, McManus DD, Brooke CB. Longitudinal assessment of diagnostic test performance over the course of acute SARS-CoV-2 infection. medRxiv [Preprint]. 2021 Mar 22:2021.03.19.21253964. doi: 10.1101/2021.03.19.21253964. PMID: 33791719; PMCID: PMC8010751. Link to article on publisher's site
medRxiv : the preprint server for health sciences
Smith RL, Gibson LL, Owens AN, Broach JP, Barton BA, Lazar P, McManus DD, Brooke CB. (2021). Longitudinal assessment of diagnostic test performance over the course of acute SARS-CoV-2 infection. University of Massachusetts Medical School Faculty Publications. https://doi.org/10.1101/2021.03.19.21253964. Retrieved from https://escholarship.umassmed.edu/faculty_pubs/1983