Department of Viroscience, ErasmusMC, Rotterdam, the Netherlands.
Department Infectious Disease Control, Public Health Service Rotterdam-Rijnmond, Rotterdam, The Netherlands.
Euro Surveill. 2022 Feb;27(8). doi: 10.2807/1560-7917.ES.2022.27.8.2100702.
BackgroundSARS-CoV-2 RT-PCR assays are more sensitive than rapid antigen detection assays (RDT) and can detect viral RNA even after an individual is no longer infectious. RDT can reduce the time to test and the results might better correlate with infectiousness.AimWe assessed the ability of five RDT to identify infectious COVID-19 cases and systematically recorded the turnaround time of RT-PCR testing.MethodsSensitivity of RDT was determined using a serially diluted SARS-CoV-2 stock with known viral RNA concentration. The probability of detecting infectious virus at a given viral load was calculated using logistic regression of viral RNA concentration and matched culture results of 78 specimens from randomly selected non-hospitalised cases. The probability of each RDT to detect infectious cases was calculated as the sum of the projected probabilities for viral isolation success for every viral RNA load found at the time of diagnosis in 1,739 confirmed non-hospitalised COVID-19 cases.ResultsThe distribution of quantification cycle values and estimated RNA loads for patients reporting to drive-through testing was skewed to high RNA loads. With the most sensitive RDT (Abbott and SD Biosensor), 97.30% (range: 88.65-99.77) of infectious individuals would be detected. This decreased to 92.73% (range: 60.30-99.77) for Coris BioConcept and GenBody, and 75.53% (range: 17.55-99.77) for RapiGEN. Only 32.9% of RT-PCR results were available on the same day as specimen collection.ConclusionThe most sensitive RDT detected infectious COVID-19 cases with high sensitivity and may considerably improve containment through more rapid isolation and contact tracing.
背景
SARS-CoV-2 RT-PCR 检测比快速抗原检测 (RDT) 更灵敏，甚至可以在个体不再具有传染性后检测到病毒 RNA。RDT 可以减少检测时间，并且结果可能与传染性更好地相关。
目的
我们评估了五种 RDT 识别传染性 COVID-19 病例的能力，并系统地记录了 RT-PCR 检测的周转时间。
方法
使用具有已知病毒 RNA 浓度的 SARS-CoV-2 稀释储备液来确定 RDT 的灵敏度。使用逻辑回归对病毒 RNA 浓度和随机选择的非住院病例的 78 个标本的匹配培养结果进行分析，计算在给定病毒载量下检测到传染性病毒的概率。计算每种 RDT 检测传染性病例的概率，方法是将在 1739 例确诊的非住院 COVID-19 病例中诊断时发现的每一个病毒 RNA 载量的预测成功概率相加。
结果
报告进行驾车检测的患者的定量循环值和估计 RNA 载量分布呈偏态分布，偏向高 RNA 载量。使用最敏感的 RDT（雅培和 SD 生物科学），97.30%（范围：88.65-99.77）的传染性个体将被检测到。这对于 Coris BioConcept 和 GenBody 降低到 92.73%（范围：60.30-99.77），对于 RapiGEN 降低到 75.53%（范围：17.55-99.77）。只有 32.9%的 RT-PCR 结果与标本采集当天可用。
结论
最敏感的 RDT 以高灵敏度检测传染性 COVID-19 病例，通过更快速的隔离和接触者追踪，可以大大改善控制效果。
