Evaluation of four laboratory-based high-throughput SARS-CoV-2 automated antigen tests compared to RT-PCR on nasal and oropharyngeal samples

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  • Thomas Daell Leineweber
  • Khaled Ghathian
  • Jan Gorm Lisby
  • Friis-Hansen, Lennart Jan
  • Afzal, Shoaib
  • Svend Ellermann-Eriksen
  • Chih Man German Ma
  • Arieh S. Cohen
  • Rikke Lind Jørgensen
  • Matilde Bøgelund Hansen
  • Pia Rørbæk Kamstrup
  • Helene Larsen
  • Nina Steenhard
  • Christel Barker Jensen
  • Thomas Kallemose
  • Maria Wendelboe Forsberg
  • Nikolai Søren Kirkby
  • Schneider, Uffe Vest

Background: The demand for RT-PCR testing has been unprecedented during the SARS-CoV-2 pandemic. Fully automated antigen tests (AAT) are less cumbersome than RT-PCR, but data on performance compared to RT-PCR are scarce. Methods: The study consists of two parts. A retrospective analytical part, comparing the performance of four different AAT on 100 negative and 204 RT-PCR positive deep oropharyngeal samples divided into four groups based on RT-PCR cycle of quantification levels. In the prospective clinical part, 206 individuals positive for and 199 individuals negative for SARS-CoV-2 were sampled from either the anterior nasal cavity (mid-turbinate) or by deep oropharyngeal swabs or both. The performance of AATs was compared to RT-PCR. Results: The overall analytical sensitivity of the AATs differed significantly from 42% (95% CI 35–49) to 60% (95% CI 53–67) with 100% analytical specificity. Clinical sensitivity of the AATs differed significantly from 26% (95% CI 20–32) to 88% (95% CI 84–93) with significant higher sensitivity for mid-turbinate nasal swabs compared to deep oropharyngeal swabs. Clinical specificity varied from 97% to 100%. Conclusion: All AATs were highly specific for detection of SARS-CoV-2. Three of the four AATs were significantly more sensitive than the fourth AAT both in terms of analytical and clinical sensitivity. Anatomical test location significantly influenced the clinical sensitivity of AATs.

Original languageEnglish
Article number105472
JournalJournal of Clinical Virology
Volume164
Number of pages6
ISSN1386-6532
DOIs
Publication statusPublished - 2023

Bibliographical note

Publisher Copyright:
© 2023 The Author(s)

    Research areas

  • Analytical performance, Automated antigen tests, Clinical performance, Rapid antigen tests, RT-PCR, SARS-CoV-2

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