评价两种快速抗原检测在医院环境下检测 SARS-CoV-2 的效果。

Evaluation of two rapid antigen tests to detect SARS-CoV-2 in a hospital setting.

机构信息

Max von Pettenkofer Institute and Gene Center, Virology, National Reference Center for Retroviruses, LMU München, Pettenkoferstr. 9a, 80336, Munich, Germany.

German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany.

出版信息

Med Microbiol Immunol. 2021 Feb;210(1):65-72. doi: 10.1007/s00430-020-00698-8. Epub 2021 Jan 16.

Abstract

Successful containment strategies for the SARS-CoV-2 pandemic will depend on reliable diagnostic assays. Point-of-care antigen tests (POCT) may provide an alternative to time-consuming PCR tests to rapidly screen for acute infections on site. Here, we evaluated two SARS-CoV-2 antigen tests: the STANDARD™ F COVID-19 Ag FIA (FIA) and the SARS-CoV-2 Rapid Antigen Test (RAT). For diagnostic assessment, we used a large set of PCR-positive and PCR-negative respiratory swabs from asymptomatic and symptomatic patients and health care workers in the setting of two University Hospitals in Munich, Germany, i.e. emergency rooms, patient care units or employee test centers. For FIA, overall clinical sensitivity and specificity were 45.4% (n = 381) and 97.8% (n = 360), respectively, and for RAT, 50.3% (n = 445) and 97.7% (n = 386), respectively. For primary diagnosis of asymptomatic and symptomatic individuals, diagnostic sensitivities were 60.9% (FIA) (n = 189) and 64.5% (RAT) (n = 256). This questions these tests' utility for the reliable detection of acute SARS-CoV-2-infected individuals, in particular in high-risk settings. We support the proposal that convincing high-quality outcome data on the impact of false-negative and false-positive antigen test results need to be obtained in a POCT setting. Moreover, the efficacy of alternative testing strategies to complement PCR assays must be evaluated by independent laboratories, prior to widespread implementation in national and international test strategies.

摘要

成功控制 SARS-CoV-2 大流行将取决于可靠的诊断检测方法。即时检测(POCT)抗原检测可能提供替代耗时的 PCR 检测方法,以便在现场快速筛查急性感染。在此,我们评估了两种 SARS-CoV-2 抗原检测:STANDARD™ F COVID-19 Ag FIA(FIA)和 SARS-CoV-2 快速抗原检测(RAT)。用于诊断评估,我们使用了来自德国慕尼黑两家大学医院的大量无症状和有症状患者和医护人员的 PCR 阳性和 PCR 阴性呼吸道拭子,即急诊室、患者护理单元或员工检测中心。对于 FIA,总体临床灵敏度和特异性分别为 45.4%(n=381)和 97.8%(n=360),对于 RAT,分别为 50.3%(n=445)和 97.7%(n=386)。对于无症状和有症状个体的初步诊断,诊断灵敏度分别为 60.9%(FIA)(n=189)和 64.5%(RAT)(n=256)。这使得这些检测方法在可靠检测急性 SARS-CoV-2 感染个体方面的实用性受到质疑,尤其是在高风险环境中。我们支持这样的建议,即在 POCT 环境中需要获得令人信服的高质量数据,说明假阴性和假阳性抗原检测结果的影响。此外,在广泛实施国家和国际检测策略之前,必须由独立实验室评估替代检测策略来补充 PCR 检测的功效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2276/7907041/963d723d797e/430_2020_698_Fig1_HTML.jpg

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