Self-testing for the detection of SARS-CoV-2 infection with rapid antigen tests for people with suspected COVID-19 in the community

To evaluate the performance of nasal mid-turbinate self-testing using rapid antigen detection tests (RDT) for persons with suspected coronavirus disease 2019 (COVID-19) in the community. Self-testing for COVID-19 infection with lateral flow assay severe acute respiratory syndrome coronavirus 2 (SARS...

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Bibliographic Details
Published in:	Clinical microbiology and infection Vol. 28; no. 5; pp. 695 - 700
Main Authors:	Stohr, Joep J.J.M., Zwart, Vivian F., Goderski, Gabriel, Meijer, Adam, Nagel-Imming, Carla R.S., Kluytmans-van den Bergh, Marjolein F.Q., Pas, Suzan D., van den Oetelaar, Femke, Hellwich, Marloes, Gan, Kim H., Rietveld, Ariene, Verweij, Jaco J., Murk, Jean-Luc, van den Bijllaardt, Wouter, Kluytmans, Jan A.J.W.
Format:	Journal Article
Language:	English
Published:	England Elsevier Ltd 01-05-2022 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd
Subjects:	Antigens, Viral - analysis Coronavirus disease 2019 COVID-19 - diagnosis COVID-19 Testing Humans Original Public health Rapid antigen detection test SARS-CoV-2 - genetics Self-Testing Sensitivity and Specificity Severe acute respiratory syndrome coronavirus 2 Self-testing Severe acute respiratory syndrome coronavirus 2 Rapid antigen detection test Coronavirus disease 2019 Public health
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Summary:	To evaluate the performance of nasal mid-turbinate self-testing using rapid antigen detection tests (RDT) for persons with suspected coronavirus disease 2019 (COVID-19) in the community. Self-testing for COVID-19 infection with lateral flow assay severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RDT, provides rapid results and could enable frequent and extensive testing in the community, thereby improving the control of SARS-CoV-2. Participants visiting a municipal SARS-CoV-2 testing centre, received self-testing kits containing either the BD Veritor System (BD-RDT) or Roche SARS-CoV-2 antigen detection test (Roche-RDT). Oro-nasopharyngeal swabs were collected from the participants for quantitative RT-PCR (qRT-PCR) testing. As a proxy for contagiousness, viral culture was performed on a selection of qRT-PCR positive samples to determine the Ct-value at which the chance of a positive culture dropped below 0.5 (Ct-value cut-off). Sensitivity and specificity of self-testing were compared to qRT-PCR with a Ct-value below the Ct value cut-off. Determinants independently associated with a false-negative self-test result were determined. A total of 3201 participants were included (BD-RDT n = 1595; Roche-RDT n = 1606). Sensitivity and specificity of self-testing compared with the qRT-PCR results with a Ct-value below the Ct-value cut-off were 78.4% (95% CI 73.2%–83.5%) and 99.4% (95% CI 99.1%–99.7%), respectively. A higher age was independently associated with a false-negative self-testing result with an odds ratio of 1.024 (95% CI 1.003–1.044). Self-testing using currently available RDT has a high specificity and relatively high sensitivity to identify individuals with a high probability of contagiousness.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1198-743X 1469-0691
DOI:	10.1016/j.cmi.2021.07.039