Gras-Valenti P, Vidal I, Montiel-Higuero I, Escribano I, Algado-Selles N, Chico-Sánchez P, Ventero M P, Jiménez-Sepulveda N, Molina-Pardines C, Merino-Lucas E, Sánchez-Payá J, Rodríguez J C
Maria Paz Ventero Martín. Hospital General Universitario de Alicante, C/Pintor Baeza, 12. CP:03010. Spain.
Rev Esp Quimioter. 2021 Dec;34(6):618-622. doi: 10.37201/req/054.2021. Epub 2021 Sep 22.
To assess the validity of SARS-CoV-2 Antigen (Ag) detection for the diagnosis of SARS-CoV-2 infection in mildly infected or asymptomatic patients.
Observational study to evaluate diagnostic tests. Non-hospitalized patients with indication for diagnostic testing for SARS-CoV-2 infection were included. The diagnostic test to be evaluated was the determination of Ag and as a reference standard to determine the presence of viral RNA the RT-PCR was used.
A total of 494 patients were included. Of these 71.5% (353/494) had symptoms and 28.5% (141/494) were asymptomatic (presurgery screening (35/494) and confirmed case-contact (106/494). The overall sensitivity of the Ag test was 61.1% and the specificity was 99.7%. The sensitivity and specificity in the asymptomatic group were 40% and 100% respectively, and in the symptomatic group 63.5% and 99.6% respectively. In turn, the sensitivity and specificity in the group of symptomatic patients varied according to the time of symptom evolution: in patients with recent symptoms, they were 71.4% and 99.6% respectively, while in patients with symptoms of more than 5 days of evolution, they were 26.7% and 100% respectively. In all groups studied, the presence of antigen is associated with a high viral load (Ct<30 cycles).
The use of Ag detection test is not indicated for the diagnosis of SARS-CoV-2 infection in asymptomatic patients or with symptoms of more than 5 days of evolution, but it could be useful in patients with symptoms of 1-5 days of evolution.
评估严重急性呼吸综合征冠状病毒2(SARS-CoV-2)抗原(Ag)检测用于诊断轻度感染或无症状患者SARS-CoV-2感染的有效性。
进行观察性研究以评估诊断检测。纳入有SARS-CoV-2感染诊断检测指征的非住院患者。待评估的诊断检测为Ag测定,以逆转录聚合酶链反应(RT-PCR)作为确定病毒RNA存在的参考标准。
共纳入494例患者。其中71.5%(353/494)有症状,28.5%(141/494)无症状(术前筛查(35/494)和确诊病例接触者(106/494))。Ag检测的总体敏感性为61.1%,特异性为99.7%。无症状组的敏感性和特异性分别为40%和100%,有症状组分别为63.5%和99.6%。反过来,有症状患者组的敏感性和特异性根据症状演变时间而有所不同:近期有症状的患者分别为71.4%和99.6%,而症状演变超过5天的患者分别为26.7%和100%。在所有研究组中,抗原的存在与高病毒载量(Ct<30个循环)相关。
Ag检测试验不适用于诊断无症状患者或症状演变超过5天的患者的SARS-CoV-2感染,但对症状演变1-5天的患者可能有用。