1
|
Wu F, Jiang Y, Yang H, Ma L. Development of Detection Antibody Targeting the Linear Epitope in SARS-CoV-2 Nucleocapsid Protein with Ultra-High Sensitivity. Int J Mol Sci 2024; 25:4436. [PMID: 38674021 PMCID: PMC11050370 DOI: 10.3390/ijms25084436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/04/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
The COVID-19 pandemic caused by SARS-CoV-2 highlighted the importance of reliable detection methods for disease control and surveillance. Optimizing detection antibodies by rational screening antigens would improve the sensitivity and specificity of antibody-based detection methods such as colloidal gold immunochromatography. In this study, we screened three peptide antigens with conserved sequences in the N protein of SARS-CoV-2 using bioinformatical and structural biological analyses. Antibodies that specifically recognize these peptides were prepared. The epitope of the peptide that had the highest binding affinity with its antibody was located on the surface of the N protein, which was favorable for antibody binding. Using the optimal antibody that can recognize this epitope, we developed colloidal gold immunochromatography, which can detect the N protein at 10 pg/mL. Importantly, this antibody could effectively recognize both the natural peptide antigen and mutated peptide antigen in the N protein, showing the feasibility of being applied in the large-scale population testing of SARS-CoV-2. Our study provides a platform with reference significance for the rational screening of detection antibodies with high sensitivity, specificity, and reliability for SARS-CoV-2 and other pathogens.
Collapse
Affiliation(s)
- Feng Wu
- Institute of Biopharmaceutical and Health Engineering, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China; (F.W.); (H.Y.)
- Shenzhen Institute of Drug Control, Shenzhen 518057, China
| | - Yike Jiang
- Institute of Biomedical Health Technology and Engineering, Shenzhen Bay Laboratory, Shenzhen 518132, China;
| | - Hongtian Yang
- Institute of Biopharmaceutical and Health Engineering, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China; (F.W.); (H.Y.)
- Institute of Biomedical Health Technology and Engineering, Shenzhen Bay Laboratory, Shenzhen 518132, China;
| | - Lan Ma
- Institute of Biopharmaceutical and Health Engineering, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China; (F.W.); (H.Y.)
- Institute of Biomedical Health Technology and Engineering, Shenzhen Bay Laboratory, Shenzhen 518132, China;
- State Key Laboratory of Chemical Oncogenomics, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
| |
Collapse
|
2
|
Liu Y, Li Y, Hang Y, Wang L, Wang J, Bao N, Kim Y, Jang HW. Rapid assays of SARS-CoV-2 virus and noble biosensors by nanomaterials. Nano Converg 2024; 11:2. [PMID: 38190075 PMCID: PMC10774473 DOI: 10.1186/s40580-023-00408-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/07/2023] [Indexed: 01/09/2024]
Abstract
The COVID-19 outbreak caused by SARS-CoV-2 in late 2019 has spread rapidly across the world to form a global epidemic of respiratory infectious diseases. Increased investigations on diagnostic tools are currently implemented to assist rapid identification of the virus because mass and rapid diagnosis might be the best way to prevent the outbreak of the virus. This critical review discusses the detection principles, fabrication techniques, and applications on the rapid detection of SARS-CoV-2 with three categories: rapid nuclear acid augmentation test, rapid immunoassay test and biosensors. Special efforts were put on enhancement of nanomaterials on biosensors for rapid, sensitive, and low-cost diagnostics of SARS-CoV-2 virus. Future developments are suggested regarding potential candidates in hospitals, clinics and laboratories for control and prevention of large-scale epidemic.
Collapse
Affiliation(s)
- Yang Liu
- School of Public Health, Nantong University, Nantong, 226019, Jiangsu, People's Republic of China
- Department of Materials Science and Engineering, Research Institute of Advanced Materials, Seoul National University, Seoul, 08826, Republic of Korea
- NantongEgens Biotechnology Co., LTD, Nantong, 226019, Jiangsu, People's Republic of China
| | - Yilong Li
- School of Public Health, Nantong University, Nantong, 226019, Jiangsu, People's Republic of China
| | - Yuteng Hang
- School of Public Health, Nantong University, Nantong, 226019, Jiangsu, People's Republic of China
| | - Lei Wang
- NantongEgens Biotechnology Co., LTD, Nantong, 226019, Jiangsu, People's Republic of China
| | - Jinghan Wang
- Department of Materials Science and Engineering, Research Institute of Advanced Materials, Seoul National University, Seoul, 08826, Republic of Korea
| | - Ning Bao
- School of Public Health, Nantong University, Nantong, 226019, Jiangsu, People's Republic of China
| | - Youngeun Kim
- Department of Materials Science and Engineering, Research Institute of Advanced Materials, Seoul National University, Seoul, 08826, Republic of Korea.
| | - Ho Won Jang
- Department of Materials Science and Engineering, Research Institute of Advanced Materials, Seoul National University, Seoul, 08826, Republic of Korea.
| |
Collapse
|
3
|
Johnson L, Bartlett ML, Ramirez F, Heger CD, Smith DR. Development of automated microfluidic immunoassays for the detection of SARS-CoV-2 antibodies and antigen. J Immunol Methods 2024; 524:113586. [PMID: 38040191 DOI: 10.1016/j.jim.2023.113586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/09/2023] [Accepted: 11/27/2023] [Indexed: 12/03/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of the coronavirus disease 2019 (COVID-19) global pandemic. Rapid and sensitive detection of the virus soon after infection is important for the treatment and prevention of transmission of COVID-19, and detection of antibodies is important for epidemiology, assessment of vaccine immunogenicity, and identification of the natural reservoir and intermediate host(s). Patient nasal or oropharyngeal swabs or saliva used in conjunction with polymerase chain reaction (PCR) detect SARS-CoV-2 RNA, whereas lateral flow immunoassays (LFI) detect SARS-CoV-2 proteins. Enzyme-linked immunosorbent assays (ELISA) detect anti-SARS-CoV-2 antibodies in blood. Although effective, these assays have poor sensitivity (e.g., LFI) or are labor intensive and time consuming (PCR and ELISA). Here we describe the development of rapid, automated ELISA-based immunoassays to detect SARS-CoV-2 antigens and antibodies against the virus. The Simple Plex™ platform uses rapid microfluidic reaction kinetics for sensitive analyte detection with small sample volumes. We developed three sensitive <90-min Simple Plex immunoassays that measure either the SARS-CoV-2 antigens or the immune response to SARS-CoV-2, including neutralizing antibodies, in serum from COVID-19 patients.
Collapse
Affiliation(s)
- Linwood Johnson
- Microbiology and Immunology Department, Biological Defense Research Directorate, Naval Medical Research Command, Fort Detrick, MD, USA
| | - Maggie L Bartlett
- Microbiology and Immunology Department, Biological Defense Research Directorate, Naval Medical Research Command, Fort Detrick, MD, USA
| | | | | | - Darci R Smith
- Microbiology and Immunology Department, Biological Defense Research Directorate, Naval Medical Research Command, Fort Detrick, MD, USA.
| |
Collapse
|
4
|
Fischl MJ, Young J, Kardos K, Roehler M, Miller T, Wooten M, Holmes N, Gula N, Baglivo M, Steen J, Zelenz N, Joyee AG, Munster V, Weishampel Z, Yinda CK, Rouse KG, Gvozden C, Wever D, Yanez G, Anderson M, Yu S, Bearie B, Young S, Berry JD. Development and Clinical Performance of InteliSwab ® COVID-19 Rapid Test: Evaluation of Antigen Test for the Diagnosis of SARS-CoV-2 and Analytical Sensitivity to Detect Variants of Concern Including Omicron and Subvariants. Viruses 2023; 16:61. [PMID: 38257761 PMCID: PMC10821026 DOI: 10.3390/v16010061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 12/22/2023] [Accepted: 12/26/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Timely detection of SARS-CoV-2 infection with subsequent contact tracing and rapid isolation are considered critical to containing the pandemic, which continues with the emergence of new variants. Hence, there is an ongoing need for reliable point-of-care antigen rapid diagnostic tests (Ag-RDT). This report describes the development, evaluation, and analytical sensitivity of the diagnostic performance of the InteliSwab® COVID-19 Rapid Test. Methods: Samples from 165 symptomatic subjects were tested with InteliSwab® and the results were compared to RT-PCR to determine the antigen test performance. The analytical sensitivity of InteliSwab® for the detection of different variants was assessed by limit of detection (LOD) determination using recombinant nucleocapsid proteins (NPs) and testing with virus isolates. Western immunoblot independently confirmed that each monoclonal Ab is capable of binding to all variants tested thus far. RESULTS The overall positivity rate by RT-PCR was 37% for the 165 symptomatic subjects. Based on RT-PCR results as the reference standard, InteliSwab® showed clinical sensitivity and specificity of 85.2% (95% CI, 74.3-92.0%) and 98.1% (95% CI, 93.3-99.7%), respectively. The overall agreement was 93.3% (Kappa index value 0.85; 95% CI, 0.77-0.74) between RT-PCR and InteliSwab® test results. Furthermore, the evaluation of analytical sensitivity for different SARS-CoV-2 variants by InteliSwab® was comparable in the detection of all the variants tested, including Omicron subvariants, BA.4, BA.5, and BQ.1. CONCLUSIONS Due to the surge of infections caused by different variants from time to time, there is a critical need to evaluate the sensitivity of rapid antigen-detecting tests for new variants. The study findings showed the robust diagnostic performance of InteliSwab® and analytical sensitivity in detecting different SARS-CoV-2 variants, including the Omicron subvariants. With the integrated swab and excellent sensitivity and variant detection, this test has high potential as a point-of-care Ag-RDT in various settings when molecular assays are in limited supply and rapid diagnosis of SARS-CoV-2 is necessary.
Collapse
Affiliation(s)
- Mark J. Fischl
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Janean Young
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Keith Kardos
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Michele Roehler
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Tiffany Miller
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Melinda Wooten
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Natalie Holmes
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Nicole Gula
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Mia Baglivo
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Justin Steen
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Nori Zelenz
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Antony George Joyee
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| | - Vincent Munster
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Hamilton, MT 59840, USA; (V.M.); (Z.W.); (C.K.Y.)
| | - Zack Weishampel
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Hamilton, MT 59840, USA; (V.M.); (Z.W.); (C.K.Y.)
| | - Claude Kwe Yinda
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Hamilton, MT 59840, USA; (V.M.); (Z.W.); (C.K.Y.)
| | | | | | - David Wever
- Cahaba Research Inc., Pelham, AL 35124, USA;
| | - Giralt Yanez
- South Florida Research Organization, Medley, FL 33166, USA;
| | | | - Song Yu
- Cahaba Research Inc., MedHelp Urgent Care, Birmingham, AL 32535, USA;
| | - Brian Bearie
- Urgent Care of Colton, Benchmark Research Group, Colton, CA 92324, USA
| | - Stephen Young
- TriCore Reference Laboratories, Albuquerque, NM 87102, USA;
| | - Jody D. Berry
- OraSure Technologies, Inc., 220 East First St., Bethlehem, PA 18015, USA; (J.Y.); (M.R.); (T.M.); (M.W.); (M.B.); (A.G.J.); (J.D.B.)
| |
Collapse
|
5
|
Bottino P, Pizzo V, Castaldo S, Scomparin E, Bara C, Cerrato M, Sisinni S, Penpa S, Roveta A, Gerbino M, Maconi A, Rocchetti A. Clinical Evaluation and Comparison of Two Microfluidic Antigenic Assays for Detection of SARS-CoV-2 Virus. Microorganisms 2023; 11:2709. [PMID: 38004721 PMCID: PMC10673207 DOI: 10.3390/microorganisms11112709] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 10/27/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023] Open
Abstract
Given the ongoing pandemic, there is a need to identify SARS-CoV-2 and differentiate it from other respiratory viral infections in various critical settings. Since its introduction, rapid antigen testing is spreading worldwide, but diagnostic accuracy is extremely variable and often in disagreement with the manufacturer's specifications. Our study compared the clinical performances of two microfluidic rapid antigen tests towards a molecular assay, starting from positive samples. A total of 151 swabs collected at the Microbiology and Virology Laboratory of A.O. "SS Antonio e Biagio e C. Arrigo" (Alessandria, Italy) for the diagnosis of SARS-CoV-2 were simultaneously tested to evaluate accuracy, specificity, and agreement with the RT-qPCR results. Both assays showed an overall agreement of 100% for negative specimens, while positive accuracy comprised between 45.10% and 54.90%. According to the manufacturer's instructions, the greatest correlation between the antigenic and molecular assays was observed for the subset with high viral load (18/19, 94.74%), while it dramatically decreased for other subsets. Moreover, the ability to differentiate between SARS-CoV-2 and Flu provides an added value and could be addressed in an epidemic context. However, an in-house validation should be performed due to differences observed in performance declared by manufacturers and those actually obtained.
Collapse
Affiliation(s)
- Paolo Bottino
- Microbiology and Virology Laboratory, A.O. “SS Antonio e Biagio e C. Arrigo”, Via Venezia 16, 15121 Alessandria, Italy; (V.P.); (S.C.); (E.S.); (C.B.); (M.C.); (A.R.)
| | - Valentina Pizzo
- Microbiology and Virology Laboratory, A.O. “SS Antonio e Biagio e C. Arrigo”, Via Venezia 16, 15121 Alessandria, Italy; (V.P.); (S.C.); (E.S.); (C.B.); (M.C.); (A.R.)
| | - Salvatore Castaldo
- Microbiology and Virology Laboratory, A.O. “SS Antonio e Biagio e C. Arrigo”, Via Venezia 16, 15121 Alessandria, Italy; (V.P.); (S.C.); (E.S.); (C.B.); (M.C.); (A.R.)
| | - Elisabetta Scomparin
- Microbiology and Virology Laboratory, A.O. “SS Antonio e Biagio e C. Arrigo”, Via Venezia 16, 15121 Alessandria, Italy; (V.P.); (S.C.); (E.S.); (C.B.); (M.C.); (A.R.)
| | - Cristina Bara
- Microbiology and Virology Laboratory, A.O. “SS Antonio e Biagio e C. Arrigo”, Via Venezia 16, 15121 Alessandria, Italy; (V.P.); (S.C.); (E.S.); (C.B.); (M.C.); (A.R.)
| | - Marcella Cerrato
- Microbiology and Virology Laboratory, A.O. “SS Antonio e Biagio e C. Arrigo”, Via Venezia 16, 15121 Alessandria, Italy; (V.P.); (S.C.); (E.S.); (C.B.); (M.C.); (A.R.)
| | - Sabrina Sisinni
- Research and Innovation Department (DAIRI), A.O. “SS. Antonio e Biagio e C. Arrigo”, Via Venezia 16, 15121 Alessandria, Italy; (S.S.); (S.P.); (A.R.); (A.M.)
| | - Serena Penpa
- Research and Innovation Department (DAIRI), A.O. “SS. Antonio e Biagio e C. Arrigo”, Via Venezia 16, 15121 Alessandria, Italy; (S.S.); (S.P.); (A.R.); (A.M.)
| | - Annalisa Roveta
- Research and Innovation Department (DAIRI), A.O. “SS. Antonio e Biagio e C. Arrigo”, Via Venezia 16, 15121 Alessandria, Italy; (S.S.); (S.P.); (A.R.); (A.M.)
| | - Maria Gerbino
- Department of Science and Technological Innovation (DISIT), University of Eastern Piedmont, Viale Teresa Michel 11, 15121 Alessandria, Italy;
| | - Antonio Maconi
- Research and Innovation Department (DAIRI), A.O. “SS. Antonio e Biagio e C. Arrigo”, Via Venezia 16, 15121 Alessandria, Italy; (S.S.); (S.P.); (A.R.); (A.M.)
| | - Andrea Rocchetti
- Microbiology and Virology Laboratory, A.O. “SS Antonio e Biagio e C. Arrigo”, Via Venezia 16, 15121 Alessandria, Italy; (V.P.); (S.C.); (E.S.); (C.B.); (M.C.); (A.R.)
| |
Collapse
|
6
|
Wertenauer C, Pfeifer C, Roskos M, März W. Rapid antigen tests for SARS-CoV-2-a synopsis of the medical evidence. Diagn Microbiol Infect Dis 2023; 107:116027. [PMID: 37516068 DOI: 10.1016/j.diagmicrobio.2023.116027] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 06/26/2023] [Accepted: 07/11/2023] [Indexed: 07/31/2023]
Abstract
SARS-CoV-2, the causative agent of the COVID-19 pandemic, continues to influence health, economy, and stability worldwide. Diagnostic testing for SARS-CoV-2 is important to contain the COVID-19 pandemic. With the commercial availability of certified antigen (Ag) rapid diagnostic tests (RDTs), which can be used to identify an infection with SARS-CoV-2 an easy-to-use tool was introduced. Self-tests can offer advantages to complement professionally administered rapid antigen detection or nucleic acid amplification testing (NAAT). Compared to real-time polymerase chain reaction (RT-PCR), Ag-RDTs are cost inexpensive, do not need specialized laboratory equipment, facilitating high-throughput testing. However, Ag-RDT sensitivities are strongly dependent on the viral load within the specimen, which has limited their application in clinical settings so far. The methodical limitations of Ag-RDTs may produce false negative test results, particularly when specimens with low viral loads are examined. This may facilitate viral transmissions if protective measurements are lifted mistakenly.
Collapse
Affiliation(s)
- Christoph Wertenauer
- Medical Clinic V, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
| | | | | | - Winfried März
- Medical Clinic V, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; SYNLAB Academy, SYNLAB Holding Deutschland GmbH, Mannheim, Germany; Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| |
Collapse
|
7
|
Ortiz DA, Loeffelholz MJ. Practical Challenges of Point-of-Care Testing. Clin Lab Med 2023; 43:155-165. [PMID: 37169439 DOI: 10.1016/j.cll.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
The practical challenges of point-of-care testing (POCT) include analytical performance and quality compared with testing performed in a central laboratory and higher cost per test compared with laboratory-based tests. These challenges can be addressed with new test technology, consensus, and practice guidelines for the use of POCT, instituting a quality management system and data connectivity in the POCT setting, and studies that demonstrate evidence of clinical and economic value of POCT.
Collapse
Affiliation(s)
- Daniel A Ortiz
- Microbiology and Molecular Pathology, Department of Pathology, Oakland University William Beaumont School of Medicine, Beaumont Health, 3601 West 13 Mile Road, Royal Oak, MI 48073, USA
| | | |
Collapse
|
8
|
Karon BS, Donato LJ, Moyer AM, Wockenfus AM, Kelley BR, Majumdar R, Kipp BR, Yao JD. Evaluation of the analytical sensitivity of ACON and LumiraDx SARS-CoV-2 rapid antigen tests using samples with presumed Omicron variant. Diagn Microbiol Infect Dis 2023; 107:115977. [PMID: 37329875 PMCID: PMC10154058 DOI: 10.1016/j.diagmicrobio.2023.115977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 03/25/2023] [Accepted: 04/30/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Analytical sensitivity of 2 rapid antigen tests was evaluated for detection of presumed SARS-CoV-2 Omicron variants and earlier variants of concern. METHODS A total of 152 SARS-CoV-2 RNA positive samples (N and ORF1ab positive but S gene negative) were tested for SARS-CoV-2 antigen by ACON lateral flow and LumiraDx fluorescence immunoassays. Sensitivity within 3 viral load ranges was compared among these 152 samples and 194 similarly characterized samples collected prior to the circulation of the Delta variant (pre-Delta). RESULTS Antigen was detected in >95% of pre-Delta and presumed Omicron samples for both tests at viral loads >500,000 copies/mL, and 65 to 85% of samples with 50,000-500,000 copies/mL. At viral load <50,000 copies/mL, antigen tests showed better sensitivity in detecting pre-Delta compared to Omicron variants. LumiraDx was more sensitive than ACON at low viral load. CONCLUSIONS Antigen tests had decreased sensitivity for detecting presumed Omicron compared to pre-Delta variants at low viral load.
Collapse
Affiliation(s)
- Brad S Karon
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester MN 55905 USA.
| | - Leslie J Donato
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester MN 55905 USA
| | - Ann M Moyer
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester MN 55905 USA
| | - Amy M Wockenfus
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester MN 55905 USA
| | - Brandon R Kelley
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester MN 55905 USA
| | - Ramanath Majumdar
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester MN 55905 USA
| | - Benjamin R Kipp
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester MN 55905 USA
| | - Joseph D Yao
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester MN 55905 USA
| |
Collapse
|
9
|
Jang HJ, Zhuang W, Sui X, Ryu B, Huang X, Chen M, Cai X, Pu H, Beavis K, Huang J, Chen J. Rapid, Sensitive, Label-Free Electrical Detection of SARS-CoV-2 in Nasal Swab Samples. ACS Appl Mater Interfaces 2023; 15:15195-15202. [PMID: 36938607 PMCID: PMC10041344 DOI: 10.1021/acsami.3c00331] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 03/07/2023] [Indexed: 06/18/2023]
Abstract
Rapid diagnosis of coronavirus disease 2019 (COVID-19) is key for the long-term control of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) amid renewed threats of mutated SARS-CoV-2 around the world. Here, we report on an electrical label-free detection of SARS-CoV-2 in nasopharyngeal swab samples directly collected from outpatients or in saliva-relevant conditions by using a remote floating-gate field-effect transistor (RFGFET) with a 2-dimensional reduced graphene oxide (rGO) sensing membrane. RFGFET sensors demonstrate rapid detection (<5 min), a 90.6% accuracy from 8 nasal swab samples measured by 4 different devices for each sample, and a coefficient of variation (CV) < 6%. Also, RFGFET sensors display a limit of detection (LOD) of pseudo-SARS-CoV-2 that is 10 000-fold lower than enzyme-linked immunosorbent assays, with a comparable LOD to that of reverse transcription-polymerase chain reaction (RT-PCR) for patient samples. To achieve this, comprehensive systematic studies were performed regarding interactions between SARS-CoV-2 and spike proteins, neutralizing antibodies, and angiotensin-converting enzyme 2, as either a biomarker (detection target) or a sensing probe (receptor) functionalized on the rGO sensing membrane. Taken together, this work may have an immense effect on positioning FET bioelectronics for rapid SARS-CoV-2 diagnostics.
Collapse
Affiliation(s)
- Hyun-June Jang
- Pritzker
School of Molecular Engineering, University
of Chicago, Chicago, Illinois 60637, United States
- Chemical
Sciences and Engineering Division, Physical Sciences and Engineering
Directorate, Argonne National Laboratory, Lemont, Illinois 60439, United States
| | - Wen Zhuang
- Pritzker
School of Molecular Engineering, University
of Chicago, Chicago, Illinois 60637, United States
- Chemical
Sciences and Engineering Division, Physical Sciences and Engineering
Directorate, Argonne National Laboratory, Lemont, Illinois 60439, United States
| | - Xiaoyu Sui
- Pritzker
School of Molecular Engineering, University
of Chicago, Chicago, Illinois 60637, United States
- Chemical
Sciences and Engineering Division, Physical Sciences and Engineering
Directorate, Argonne National Laboratory, Lemont, Illinois 60439, United States
| | - Byunghoon Ryu
- Chemical
Sciences and Engineering Division, Physical Sciences and Engineering
Directorate, Argonne National Laboratory, Lemont, Illinois 60439, United States
| | - Xiaodan Huang
- Pritzker
School of Molecular Engineering, University
of Chicago, Chicago, Illinois 60637, United States
| | - Min Chen
- Pritzker
School of Molecular Engineering, University
of Chicago, Chicago, Illinois 60637, United States
| | - Xiaolei Cai
- Pritzker
School of Molecular Engineering, University
of Chicago, Chicago, Illinois 60637, United States
| | - Haihui Pu
- Pritzker
School of Molecular Engineering, University
of Chicago, Chicago, Illinois 60637, United States
- Chemical
Sciences and Engineering Division, Physical Sciences and Engineering
Directorate, Argonne National Laboratory, Lemont, Illinois 60439, United States
| | - Kathleen Beavis
- Department
of Pathology, University of Chicago, Chicago, Illinois 60637, United States
| | - Jun Huang
- Pritzker
School of Molecular Engineering, University
of Chicago, Chicago, Illinois 60637, United States
| | - Junhong Chen
- Pritzker
School of Molecular Engineering, University
of Chicago, Chicago, Illinois 60637, United States
- Chemical
Sciences and Engineering Division, Physical Sciences and Engineering
Directorate, Argonne National Laboratory, Lemont, Illinois 60439, United States
| |
Collapse
|
10
|
Chabi M, Vu B, Brosamer K, Smith M, Chavan D, Conrad JC, Willson RC, Kourentzi K. Smartphone-read phage lateral flow assay for point-of-care detection of infection. Analyst 2023; 148:839-848. [PMID: 36645184 PMCID: PMC10503656 DOI: 10.1039/d2an01499h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The COVID-19 pandemic has highlighted the urgent need for sensitive, affordable, and widely accessible testing at the point of care. Here we demonstrate a new, universal LFA platform technology using M13 phage conjugated with antibodies and HRP enzymes that offers high analytical sensitivity and excellent performance in a complex clinical matrix. We also report its complete integration into a sensitive chemiluminescence-based smartphone-readable lateral flow assay for the detection of SARS-CoV-2 nucleoprotein. We screened 84 anti-nucleoprotein monoclonal antibody pairs in phage LFA and identified an antibody pair that gave an LoD of 25 pg mL-1 nucleoprotein in nasal swab extract using a FluorChem gel documentation system and 100 pg mL-1 when the test was imaged and analyzed by an in-house-developed smartphone reader. The smartphone-read LFA signals for positive clinical samples tested (N = 15, with known Ct) were statistically different (p < 0.001) from signals for negative clinical samples (N = 11). The phage LFA technology combined with smartphone chemiluminescence imaging can enable the timely development of ultrasensitive, affordable point-of-care testing platforms for SARS-CoV-2 and beyond.
Collapse
Affiliation(s)
- Maede Chabi
- Department of Biomedical Engineering, University of Houston, Houston, Texas 77204, USA.
| | - Binh Vu
- Department of Chemical and Biomolecular Engineering, University of Houston, Houston, Texas 77204, USA.
| | - Kristen Brosamer
- Department of Biomedical Engineering, University of Houston, Houston, Texas 77204, USA.
| | - Maxwell Smith
- Department of Chemical and Biomolecular Engineering, University of Houston, Houston, Texas 77204, USA.
| | - Dimple Chavan
- Department of Biology and Biochemistry, University of Houston, Houston, Texas 77204, USA
| | - Jacinta C Conrad
- Department of Chemical and Biomolecular Engineering, University of Houston, Houston, Texas 77204, USA.
| | - Richard C Willson
- Department of Biomedical Engineering, University of Houston, Houston, Texas 77204, USA.
- Department of Chemical and Biomolecular Engineering, University of Houston, Houston, Texas 77204, USA.
- Department of Biology and Biochemistry, University of Houston, Houston, Texas 77204, USA
- Escuela de Medicina y Ciencias de Salud, Tecnológico de Monterrey, Monterrey, Nuevo León 64710, Mexico
| | - Katerina Kourentzi
- Department of Chemical and Biomolecular Engineering, University of Houston, Houston, Texas 77204, USA.
| |
Collapse
|
11
|
Chao TL, Lee WH, Hu HC, Lin YC, Ho SY, Chen HH, Chen CP, Tsai YM, Fang JT, Leong SM, Cheng YC, Peng M, Cheng SH, Cheng CY, Chang SY. Clinical assessment of SARS-CoV-2 infectivity by rapid antigen test compared with virus isolation. J Clin Virol Plus 2023; 3:100133. [PMID: 36594045 PMCID: PMC9798665 DOI: 10.1016/j.jcvp.2022.100133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 12/28/2022] [Indexed: 12/31/2022] Open
Abstract
Although real-time reverse transcriptase polymerase chain reaction (real-time RT-PCR) remains as a golden standard for detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, it can not be easily expanded to large-scaled screening during outbreaks, and the positive results do not necessarily correlate with infectious status of the identified subjects. In this study, the performance of Vstrip® RV2 COVID-19 Antigen Rapid Test (RAT) and its correlation with virus infectivity was examined by virus culture using 163 sequential respiratory specimens collected from 26 SARS-CoV-2 infected patients. When the presence of cytopathic effects (CPE) in cell culture was used as a reference method for virus infectivity, the sensitivity, specificity and accuracy of Vstrip® RV2 COVID-19 Antigen Rapid Test was 96.43%, 89.63%, and 90.8%, respectively. The highest Ct value was 27.7 for RdRp gene and 25.79 for E gene within CPE-positive samples, and the highest Ct value was 31.9 for RdRp gene and 29.1 for E gene within RAT positive samples. When the Ct values of specimens were below 25, the CPE and RAT results had high degree of consistency. We concluded that the RAT could be a great alternative method for determining the infectious potential of individuals with high viral load.
Collapse
Affiliation(s)
- Tai-Ling Chao
- Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taiwan,Genomics Research Center, Academia Sinica, Taipei, Taiwan
| | - Wen-Hau Lee
- Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taiwan
| | - Hui-Chun Hu
- Department of Nursing, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
| | - Yi-Chun Lin
- Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
| | - Shu-Yuan Ho
- Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Hui-Hou Chen
- Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Cheng-Pin Chen
- Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan,School of Clinical Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan
| | - Ya-Min Tsai
- Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taiwan
| | - Jun-Tung Fang
- Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taiwan
| | - Si-Man Leong
- Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taiwan
| | - Yu-Chen Cheng
- Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taiwan
| | - Mavis Peng
- Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taiwan
| | - Shu-Hsing Cheng
- Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan,School of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Chien-Yu Cheng
- Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan,Institute of Public Health, School of Medicine National Yang-Ming Chiao Tung University, Taipei, Taiwan,Corresponding authors
| | - Sui-Yuan Chang
- Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taiwan,Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan,Corresponding authors
| |
Collapse
|
12
|
Ang GY, Chan KG, Yean CY, Yu CY. Lateral Flow Immunoassays for SARS-CoV-2. Diagnostics (Basel) 2022; 12:diagnostics12112854. [PMID: 36428918 PMCID: PMC9689684 DOI: 10.3390/diagnostics12112854] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 11/09/2022] [Accepted: 11/16/2022] [Indexed: 11/19/2022] Open
Abstract
The continued circulation of SARS-CoV-2 virus in different parts of the world opens up the possibility for more virulent variants to evolve even as the coronavirus disease 2019 transitions from pandemic to endemic. Highly transmissible and virulent variants may seed new disruptive epidemic waves that can easily put the healthcare system under tremendous pressure. Despite various nucleic acid-based diagnostic tests that are now commercially available, the wide applications of these tests are largely hampered by specialized equipment requirements that may not be readily available, accessible and affordable in less developed countries or in low resource settings. Hence, the availability of lateral flow immunoassays (LFIs), which can serve as a diagnostic tool by detecting SARS-CoV-2 antigen or as a serological tool by measuring host immune response, is highly appealing. LFI is rapid, low cost, equipment-free, scalable for mass production and ideal for point-of-care settings. In this review, we first summarize the principle and assay format of these LFIs with emphasis on those that were granted emergency use authorization by the US Food and Drug Administration followed by discussion on the specimen type, marker selection and assay performance. We conclude with an overview of challenges and future perspective of LFI applications.
Collapse
Affiliation(s)
- Geik Yong Ang
- Faculty of Sports Science and Recreation, Universiti Teknologi MARA, Shah Alam 40450, Malaysia
- Correspondence: (G.Y.A.); (C.Y.Y.)
| | - Kok Gan Chan
- Division of Genetics and Molecular Biology, Institute of Biological Sciences, Faculty of Science, University of Malaya, Kuala Lumpur 50603, Malaysia
- International Genome Centre, Jiangsu University, Zhenjiang 212013, China
| | - Chan Yean Yean
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu 16150, Malaysia
| | - Choo Yee Yu
- Laboratory of Vaccine and Biomolecules, Institute of Bioscience, Universiti Putra Malaysia, Serdang 43400, Malaysia
- Correspondence: (G.Y.A.); (C.Y.Y.)
| |
Collapse
|
13
|
Konstantinus I, Chiwara D, Ndevaetela E, Ndarukwa-phiri V, Garus-oas N, Frans N, Ndumbu P, Shiningavamwe A, van Rooyen G, Schiceya F, Hlahla L, Namundjebo P, Ndozi-okia I, Chikuse F, Bantiewalu SH, Tjombonde K. Laboratory and field evaluation of the STANDARD Q and Panbio™ SARS-CoV-2 antigen rapid test in Namibia using nasopharyngeal samples. PLoS One 2022; 17:e0269329. [PMID: 36166414 PMCID: PMC9514621 DOI: 10.1371/journal.pone.0269329] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 05/18/2022] [Indexed: 11/23/2022] Open
Abstract
Background As new SARS-CoV-2 variants of concern emerge, there is a need to scale up testing to minimize transmission of the Coronavirus disease 2019 (COVID-19). Many countries especially those in the developing world continue to struggle with scaling up reverse transcriptase polymerase reaction (RT-PCR) to detect SARS-CoV-2 due to scarcity of resources. Alternatives such as antigen rapid diagnostics tests (Ag-RDTs) may provide a solution to enable countries scale up testing. Methods In this study, we evaluated the Panbio™ and STANDARD Q Ag-RDTs in the laboratory using 80 COVID-19 RT-PCR confirmed and 80 negative nasopharyngeal swabs. The STANDARD Q was further evaluated in the field on 112 symptomatic and 61 asymptomatic participants. Results For the laboratory evaluation, both tests had a sensitivity above 80% (Panbio™ = 86% vs STANDARD Q = 88%). The specificity of the Panbio™ was 100%, while that of the STANDARD Q was 99%. When evaluated in the field, the STANDARD Q maintained a high specificity of 99%, however the sensitivity was reduced to 56%. Conclusion Using Ag-RDTs in low resource settings will be helpful in scaling-up SARS-CoV-2 testing, however, negative results should be confirmed by RT-PCR where possible to rule out COVID-19 infection.
Collapse
|
14
|
Kosnik IG, Dermota U, Golle A, Cretnik TZ. Rapid antigen test for SARS-CoV-2: results of validation and use in real life. Future Virol 2022. [PMID: 36186521 PMCID: PMC9514382 DOI: 10.2217/fvl-2022-0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 09/12/2022] [Indexed: 11/24/2022]
Abstract
Aim: To verify a SARS-CoV-2 rapid antigen test (RAT) compared with PCR. Materials & methods: Validation of RAT included 2295 subjects. Next matching of RAT with the PCR was checked in 13,852 subjects referred to PCR after being positive in RAT. Results: Sensitivity and specificity of RAT were 77.38 and 99.10%, respectively. A 74.60% of RAT positive results were confirmed with PCR. Conclusion: The test met WHO susceptibility criteria in a group of symptomatic subjects. In terms of specificity, it met requirements in all subjects. The concordance of RAT with PCR in real life was in line with our verification data.
Collapse
Affiliation(s)
- Irena Grmek Kosnik
- National Laboratory for Health, Environment & Food, Prvomajska 2, 2000, Maribor, Slovenia
| | - Urska Dermota
- National Laboratory for Health, Environment & Food, Prvomajska 2, 2000, Maribor, Slovenia
| | - Andrej Golle
- National Laboratory for Health, Environment & Food, Prvomajska 2, 2000, Maribor, Slovenia
| | - Tjasa Zohar Cretnik
- National Laboratory for Health, Environment & Food, Prvomajska 2, 2000, Maribor, Slovenia
| |
Collapse
|
15
|
Chiba R, Miyakawa K, Aoki K, Morikawa TJ, Moriizumi Y, Degawa T, Arai Y, Segawa O, Tanaka K, Tajima H, Arai S, Yoshinaga H, Tsukada R, Tani A, Fuji H, Sato A, Ishii Y, Tateda K, Ryo A, Yoshimura T. Development of a Fully Automated Desktop Analyzer and Ultrahigh Sensitivity Digital Immunoassay for SARS-CoV-2 Nucleocapsid Antigen Detection. Biomedicines 2022; 10:biomedicines10092291. [PMID: 36140390 PMCID: PMC9496537 DOI: 10.3390/biomedicines10092291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/09/2022] [Accepted: 09/11/2022] [Indexed: 11/21/2022] Open
Abstract
Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak has had a significant impact on public health and the global economy. Several diagnostic tools are available for the detection of infectious diseases, with reverse transcription-polymerase chain reaction (RT-PCR) testing specifically recommended for viral RNA detection. However, this diagnostic method is costly, complex, and time-consuming. Although it does not have sufficient sensitivity, antigen detection by an immunoassay is an inexpensive and simpler alternative to RT-PCR. Here, we developed an ultrahigh sensitivity digital immunoassay (d-IA) for detecting SARS-CoV-2 nucleocapsid (N) protein as antigens using a fully automated desktop analyzer based on a digital enzyme-linked immunosorbent assay. Methods: We developed a fully automated d-IA desktop analyzer and measured the viral N protein as an antigen in nasopharyngeal (NP) swabs from patients with coronavirus disease. We studied nasopharyngeal swabs of 159 and 88 patients who were RT-PCR-negative and RT-PCR-positive, respectively. Results: The limit of detection of SARS-CoV-2 d-IA was 0.0043 pg/mL of N protein. The cutoff value was 0.029 pg/mL, with a negative RT-PCR distribution. The sensitivity of RT-PCR-positive specimens was estimated to be 94.3% (83/88). The assay time was 28 min. Conclusions: Our d-IA system, which includes a novel fully automated desktop analyzer, enabled detection of the SARS-CoV-2 N-protein with a comparable sensitivity to RT-PCR within 30 min. Thus, d-IA shows potential for SARS-CoV-2 detection across multiple diagnostic centers including small clinics, hospitals, airport quarantines, and clinical laboratories.
Collapse
Affiliation(s)
- Ryotaro Chiba
- Research and Development, Abbott Japan LLC, Matsudo 270-2214, Japan
| | - Kei Miyakawa
- Department of Microbiology, Yokohama City University School of Medicine, Yokohama 236-0004, Japan
| | - Kotaro Aoki
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo 143-8540, Japan
| | | | | | - Takuma Degawa
- Research and Development, Abbott Japan LLC, Matsudo 270-2214, Japan
| | - Yoshiyuki Arai
- Research and Development, Abbott Japan LLC, Matsudo 270-2214, Japan
| | - Osamu Segawa
- Precision System Science Co., Ltd., Matsudo 271-0064, Japan
| | - Kengo Tanaka
- Precision System Science Co., Ltd., Matsudo 271-0064, Japan
| | - Hideji Tajima
- Precision System Science Co., Ltd., Matsudo 271-0064, Japan
| | - Susumu Arai
- Sumitomo Bakelite Co., Ltd., Tokyo 140-0002, Japan
| | | | | | - Akira Tani
- Olympus Corporation, Hachioji 192-8507, Japan
| | | | | | - Yoshikazu Ishii
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo 143-8540, Japan
| | - Kazuhiro Tateda
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo 143-8540, Japan
| | - Akihide Ryo
- Department of Microbiology, Yokohama City University School of Medicine, Yokohama 236-0004, Japan
- Correspondence: (A.R.); (T.Y.)
| | - Toru Yoshimura
- Research and Development, Abbott Japan LLC, Matsudo 270-2214, Japan
- Correspondence: (A.R.); (T.Y.)
| |
Collapse
|
16
|
Favresse J, Bayart JL, David C, Gillot C, Wieërs G, Roussel G, Sondag G, Elsen M, Eucher C, Dogné JM, Douxfils J. Serum SARS-CoV-2 Antigens for the Determination of COVID-19 Severity. Viruses 2022; 14:v14081653. [PMID: 36016276 PMCID: PMC9415151 DOI: 10.3390/v14081653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/06/2022] [Accepted: 07/19/2022] [Indexed: 11/17/2022] Open
Abstract
The diagnostic of SARS-CoV-2 infection relies on reverse transcriptase polymerase chain reactions (RT-PCRs) performed on nasopharyngeal (NP) swabs. Nevertheless, false-negative results can be obtained with inadequate sampling procedures, making the use of other biological matrices worthy of investigation. This study aims to evaluate the kinetics of serum N antigens in severe and non-severe patients and compare the clinical performance of serum antigenic assays with NP RT-PCR. Ninety patients were included in the study and monitored for several days. Disease severity was determined according to the WHO clinical progression scale. Serum N antigen levels were measured with a chemiluminescent assay (CLIA) and the Single Molecular Array (Simoa) assay. Viremia thresholds for severity were determined and proposed. In severe patients, the peak antigen response was observed 7 days after the onset of symptoms, followed by a decline. No real peak response was observed in non-severe patients. Severity thresholds for the Simoa and the CLIA provided positive likelihood ratios of 30.0 and 10.9 for the timeframe between day 2 and day 14, respectively. Sensitive detection of N antigens in serum may thus provide a valuable new marker for COVID-19 diagnosis and evaluation of disease severity. When assessed during the first 2 weeks since the onset of symptoms, it may help in identifying patients at risk of developing severe COVID-19 to optimize better intensive care utilization.
Collapse
Affiliation(s)
- Julien Favresse
- Department of Laboratory Medicine, Clinique St-Luc Bouge, 5004 Namur, Belgium; (G.S.); (M.E.); (C.E.)
- Department of Pharmacy, Namur Research Institute for LIfe Sciences, University of Namur, 5000 Namur, Belgium; (C.G.); (J.-M.D.); (J.D.)
- Correspondence: ; Tel.: +32-81-20-91-44
| | - Jean-Louis Bayart
- Department of Laboratory Medicine, Clinique St-Pierre Ottignies, 1340 Ottignies-Louvain-la-Neuve, Belgium; (J.-L.B.); (G.R.)
| | | | - Constant Gillot
- Department of Pharmacy, Namur Research Institute for LIfe Sciences, University of Namur, 5000 Namur, Belgium; (C.G.); (J.-M.D.); (J.D.)
| | - Grégoire Wieërs
- Department of Internal Medicine, Clinique Saint-Pierre Ottignies, 1340 Ottignies-Louvain-la-Neuve, Belgium;
| | - Gatien Roussel
- Department of Laboratory Medicine, Clinique St-Pierre Ottignies, 1340 Ottignies-Louvain-la-Neuve, Belgium; (J.-L.B.); (G.R.)
| | - Guillaume Sondag
- Department of Laboratory Medicine, Clinique St-Luc Bouge, 5004 Namur, Belgium; (G.S.); (M.E.); (C.E.)
| | - Marc Elsen
- Department of Laboratory Medicine, Clinique St-Luc Bouge, 5004 Namur, Belgium; (G.S.); (M.E.); (C.E.)
| | - Christine Eucher
- Department of Laboratory Medicine, Clinique St-Luc Bouge, 5004 Namur, Belgium; (G.S.); (M.E.); (C.E.)
| | - Jean-Michel Dogné
- Department of Pharmacy, Namur Research Institute for LIfe Sciences, University of Namur, 5000 Namur, Belgium; (C.G.); (J.-M.D.); (J.D.)
| | - Jonathan Douxfils
- Department of Pharmacy, Namur Research Institute for LIfe Sciences, University of Namur, 5000 Namur, Belgium; (C.G.); (J.-M.D.); (J.D.)
- Qualiblood s.a., 5000 Namur, Belgium;
| |
Collapse
|
17
|
Dinnes J, Sharma P, Berhane S, van Wyk SS, Nyaaba N, Domen J, Taylor M, Cunningham J, Davenport C, Dittrich S, Emperador D, Hooft L, Leeflang MM, McInnes MD, Spijker R, Verbakel JY, Takwoingi Y, Taylor-Phillips S, Van den Bruel A, Deeks JJ. Rapid, point-of-care antigen tests for diagnosis of SARS-CoV-2 infection. Cochrane Database Syst Rev 2022; 7:CD013705. [PMID: 35866452 PMCID: PMC9305720 DOI: 10.1002/14651858.cd013705.pub3] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Accurate rapid diagnostic tests for SARS-CoV-2 infection would be a useful tool to help manage the COVID-19 pandemic. Testing strategies that use rapid antigen tests to detect current infection have the potential to increase access to testing, speed detection of infection, and inform clinical and public health management decisions to reduce transmission. This is the second update of this review, which was first published in 2020. OBJECTIVES To assess the diagnostic accuracy of rapid, point-of-care antigen tests for diagnosis of SARS-CoV-2 infection. We consider accuracy separately in symptomatic and asymptomatic population groups. Sources of heterogeneity investigated included setting and indication for testing, assay format, sample site, viral load, age, timing of test, and study design. SEARCH METHODS We searched the COVID-19 Open Access Project living evidence database from the University of Bern (which includes daily updates from PubMed and Embase and preprints from medRxiv and bioRxiv) on 08 March 2021. We included independent evaluations from national reference laboratories, FIND and the Diagnostics Global Health website. We did not apply language restrictions. SELECTION CRITERIA We included studies of people with either suspected SARS-CoV-2 infection, known SARS-CoV-2 infection or known absence of infection, or those who were being screened for infection. We included test accuracy studies of any design that evaluated commercially produced, rapid antigen tests. We included evaluations of single applications of a test (one test result reported per person) and evaluations of serial testing (repeated antigen testing over time). Reference standards for presence or absence of infection were any laboratory-based molecular test (primarily reverse transcription polymerase chain reaction (RT-PCR)) or pre-pandemic respiratory sample. DATA COLLECTION AND ANALYSIS We used standard screening procedures with three people. Two people independently carried out quality assessment (using the QUADAS-2 tool) and extracted study results. Other study characteristics were extracted by one review author and checked by a second. We present sensitivity and specificity with 95% confidence intervals (CIs) for each test, and pooled data using the bivariate model. We investigated heterogeneity by including indicator variables in the random-effects logistic regression models. We tabulated results by test manufacturer and compliance with manufacturer instructions for use and according to symptom status. MAIN RESULTS We included 155 study cohorts (described in 166 study reports, with 24 as preprints). The main results relate to 152 evaluations of single test applications including 100,462 unique samples (16,822 with confirmed SARS-CoV-2). Studies were mainly conducted in Europe (101/152, 66%), and evaluated 49 different commercial antigen assays. Only 23 studies compared two or more brands of test. Risk of bias was high because of participant selection (40, 26%); interpretation of the index test (6, 4%); weaknesses in the reference standard for absence of infection (119, 78%); and participant flow and timing 41 (27%). Characteristics of participants (45, 30%) and index test delivery (47, 31%) differed from the way in which and in whom the test was intended to be used. Nearly all studies (91%) used a single RT-PCR result to define presence or absence of infection. The 152 studies of single test applications reported 228 evaluations of antigen tests. Estimates of sensitivity varied considerably between studies, with consistently high specificities. Average sensitivity was higher in symptomatic (73.0%, 95% CI 69.3% to 76.4%; 109 evaluations; 50,574 samples, 11,662 cases) compared to asymptomatic participants (54.7%, 95% CI 47.7% to 61.6%; 50 evaluations; 40,956 samples, 2641 cases). Average sensitivity was higher in the first week after symptom onset (80.9%, 95% CI 76.9% to 84.4%; 30 evaluations, 2408 cases) than in the second week of symptoms (53.8%, 95% CI 48.0% to 59.6%; 40 evaluations, 1119 cases). For those who were asymptomatic at the time of testing, sensitivity was higher when an epidemiological exposure to SARS-CoV-2 was suspected (64.3%, 95% CI 54.6% to 73.0%; 16 evaluations; 7677 samples, 703 cases) compared to where COVID-19 testing was reported to be widely available to anyone on presentation for testing (49.6%, 95% CI 42.1% to 57.1%; 26 evaluations; 31,904 samples, 1758 cases). Average specificity was similarly high for symptomatic (99.1%) or asymptomatic (99.7%) participants. We observed a steady decline in summary sensitivities as measures of sample viral load decreased. Sensitivity varied between brands. When tests were used according to manufacturer instructions, average sensitivities by brand ranged from 34.3% to 91.3% in symptomatic participants (20 assays with eligible data) and from 28.6% to 77.8% for asymptomatic participants (12 assays). For symptomatic participants, summary sensitivities for seven assays were 80% or more (meeting acceptable criteria set by the World Health Organization (WHO)). The WHO acceptable performance criterion of 97% specificity was met by 17 of 20 assays when tests were used according to manufacturer instructions, 12 of which demonstrated specificities above 99%. For asymptomatic participants the sensitivities of only two assays approached but did not meet WHO acceptable performance standards in one study each; specificities for asymptomatic participants were in a similar range to those observed for symptomatic people. At 5% prevalence using summary data in symptomatic people during the first week after symptom onset, the positive predictive value (PPV) of 89% means that 1 in 10 positive results will be a false positive, and around 1 in 5 cases will be missed. At 0.5% prevalence using summary data for asymptomatic people, where testing was widely available and where epidemiological exposure to COVID-19 was suspected, resulting PPVs would be 38% to 52%, meaning that between 2 in 5 and 1 in 2 positive results will be false positives, and between 1 in 2 and 1 in 3 cases will be missed. AUTHORS' CONCLUSIONS Antigen tests vary in sensitivity. In people with signs and symptoms of COVID-19, sensitivities are highest in the first week of illness when viral loads are higher. Assays that meet appropriate performance standards, such as those set by WHO, could replace laboratory-based RT-PCR when immediate decisions about patient care must be made, or where RT-PCR cannot be delivered in a timely manner. However, they are more suitable for use as triage to RT-PCR testing. The variable sensitivity of antigen tests means that people who test negative may still be infected. Many commercially available rapid antigen tests have not been evaluated in independent validation studies. Evidence for testing in asymptomatic cohorts has increased, however sensitivity is lower and there is a paucity of evidence for testing in different settings. Questions remain about the use of antigen test-based repeat testing strategies. Further research is needed to evaluate the effectiveness of screening programmes at reducing transmission of infection, whether mass screening or targeted approaches including schools, healthcare setting and traveller screening.
Collapse
Affiliation(s)
- Jacqueline Dinnes
- Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK
| | - Pawana Sharma
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Sarah Berhane
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK
| | - Susanna S van Wyk
- Centre for Evidence-based Health Care, Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Nicholas Nyaaba
- Infectious Disease Unit, 37 Military Hospital, Cantonments, Ghana
| | - Julie Domen
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Melissa Taylor
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Jane Cunningham
- Global Malaria Programme, World Health Organization, Geneva, Switzerland
| | - Clare Davenport
- Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK
| | | | | | - Lotty Hooft
- Cochrane Netherlands, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Mariska Mg Leeflang
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | | | - René Spijker
- Cochrane Netherlands, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
- Medical Library, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health, Amsterdam, Netherlands
| | - Jan Y Verbakel
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Yemisi Takwoingi
- Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK
| | - Sian Taylor-Phillips
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Ann Van den Bruel
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Jonathan J Deeks
- Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK
| |
Collapse
|
18
|
Farhana A, Zahoor D, Wani S, Khan RA, Nasir R, Kanth F. Diagnostic utility and performance of rapid antigen test in SARS CoV- 2 in symptomatic and asymptomatic patients during the second pandemic wave in Kashmir, North India. Indian J Med Microbiol 2022:S0255-0857(22)00102-5. [PMID: 35787334 DOI: 10.1016/j.ijmmb.2022.06.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 06/09/2022] [Accepted: 06/16/2022] [Indexed: 11/29/2022]
Abstract
Purpose Real time reverse transcriptase PCR (rRT PCR) although gold standard test for the diagnosis of SARS CoV-2, carries disadvantages of a sophisticated set up, long time to results and centralized services. The rapid antigen tests (RAT) can be used as a primary screening tool with the advantages of rapid turnaround time and ease of use. The study was conducted to determine the performance of rapid antigen test (standard Q COVID 19 Ag) in comparison to rRT PCR in symptomatic patients and asymptomatic contacts and asymptomatic patients with no apparent contact history. Methods Nasopharyngeal swabs taken in duplicate from 1034 patients were collected over a 5 months period. These included 248 (23.98%) symptomatic, 386 (37.34%) asymptomatic contacts and 400 (38.68%) asymptomatic subjects who were routinely screened in pre-operative period, as a prerequisite for travel, or pregnant females. Both rRT PCR and RAT were performed as per manufacturers’ instructions. Performance of test in different subgroups of patients was evaluated. Performance of RAT test on basis of duration of illness and Ct values was also analyzed. Results In this study, 445 (43.04%) were rRT PCR positive, out of which 374 samples were RAT positive as well. 31 samples were RAT positive but PCR negative. The sensitivity, specificity, PPV and NPV of the rapid antigen test was 84.04%, 94.74%, 92.35% and 88.71% respectively. The negative predictive value of the test in asymptomatic patients without any significant contact history was 97.07%. Conclusions This study recommends the use of the antigen test as a method of diagnosis for SARS CoV-2. However a negative result with RAT in suspected patients and their contacts should be viewed with caution. This study also finds the utility of using RAT test in the community settings as a screening test in schools, colleges and mass gatherings.
Collapse
|
19
|
Tapari A, Braliou GG, Papaefthimiou M, Mavriki H, Kontou PI, Nikolopoulos GK, Bagos PG. Performance of Antigen Detection Tests for SARS-CoV-2: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2022; 12:1388. [PMID: 35741198 PMCID: PMC9221910 DOI: 10.3390/diagnostics12061388] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/20/2022] [Accepted: 05/24/2022] [Indexed: 11/16/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) initiated global health care challenges such as the necessity for new diagnostic tests. Diagnosis by real-time PCR remains the gold-standard method, yet economical and technical issues prohibit its use in points of care (POC) or for repetitive tests in populations. A lot of effort has been exerted in developing, using, and validating antigen-based tests (ATs). Since individual studies focus on few methodological aspects of ATs, a comparison of different tests is needed. Herein, we perform a systematic review and meta-analysis of data from articles in PubMed, medRxiv and bioRxiv. The bivariate method for meta-analysis of diagnostic tests pooling sensitivities and specificities was used. Most of the AT types for SARS-CoV-2 were lateral flow immunoassays (LFIA), fluorescence immunoassays (FIA), and chemiluminescence enzyme immunoassays (CLEIA). We identified 235 articles containing data from 220,049 individuals. All ATs using nasopharyngeal samples show better performance than those with throat saliva (72% compared to 40%). Moreover, the rapid methods LFIA and FIA show about 10% lower sensitivity compared to the laboratory-based CLEIA method (72% compared to 82%). In addition, rapid ATs show higher sensitivity in symptomatic patients compared to asymptomatic patients, suggesting that viral load is a crucial parameter for ATs performed in POCs. Finally, all methods perform with very high specificity, reaching around 99%. LFIA tests, though with moderate sensitivity, appear as the most attractive method for use in POCs and for performing seroprevalence studies.
Collapse
Affiliation(s)
- Anastasia Tapari
- Department of Computer Science and Biomedical Informatics, University of Thessaly, 35131 Lamia, Greece; (A.T.); (G.G.B.); (M.P.); (H.M.); (P.I.K.)
| | - Georgia G. Braliou
- Department of Computer Science and Biomedical Informatics, University of Thessaly, 35131 Lamia, Greece; (A.T.); (G.G.B.); (M.P.); (H.M.); (P.I.K.)
| | - Maria Papaefthimiou
- Department of Computer Science and Biomedical Informatics, University of Thessaly, 35131 Lamia, Greece; (A.T.); (G.G.B.); (M.P.); (H.M.); (P.I.K.)
| | - Helen Mavriki
- Department of Computer Science and Biomedical Informatics, University of Thessaly, 35131 Lamia, Greece; (A.T.); (G.G.B.); (M.P.); (H.M.); (P.I.K.)
| | - Panagiota I. Kontou
- Department of Computer Science and Biomedical Informatics, University of Thessaly, 35131 Lamia, Greece; (A.T.); (G.G.B.); (M.P.); (H.M.); (P.I.K.)
| | | | - Pantelis G. Bagos
- Department of Computer Science and Biomedical Informatics, University of Thessaly, 35131 Lamia, Greece; (A.T.); (G.G.B.); (M.P.); (H.M.); (P.I.K.)
| |
Collapse
|
20
|
Mak GCK, Lau SSY, Wong KKY, Lau CS, Ng KHL, Lam ETK, Chan RCW. Analytical sensitivity of the Rapid Antigen Test kits for detection of SARS-CoV-2 Omicron variant BA.2 sub-lineage. J Med Virol 2022; 94:5033-5037. [PMID: 35656593 PMCID: PMC9347738 DOI: 10.1002/jmv.27908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/03/2022] [Accepted: 05/31/2022] [Indexed: 12/02/2022]
Abstract
The severe acute respiratory syndrome coronavirus type 2 (SARS‐CoV‐2) Omicron was classified as a variant of concern in November 2021. The sublineage BA.2 spreads rapidly worldwide. Currently, there is a lack of data for the parallel comparison of Rapid Antigen Test (RAT) Kits to detect SARS‐CoV‐2 Omicron BA.2. We evaluated the analytical sensitivity of 12 RAT kits to detect Omicron BA.2 in the present study. Analytical sensitivity was determined by means of the limit of detection (LOD). We prepared a dilution set using a respiratory specimen collected from a COVID‐19 patient infected by Omicron BA.2. The reverse transcription‐polymerase chain reaction was used as a reference method. The LOD results showed that all 12 RAT kits had comparable analytical sensitivity to detect Omicron BA.2. The RAT kits selected in the current study may be used for the first‐line screening of the rapid spreading Omicron BA.2.
Collapse
Affiliation(s)
- Gannon C K Mak
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region
| | - Stephen S Y Lau
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region
| | - Kitty K Y Wong
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region
| | - C S Lau
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region
| | - Ken H L Ng
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region
| | - Edman T K Lam
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region
| | - Rickjason C W Chan
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region
| |
Collapse
|
21
|
Mak GCK, Lau SSY, Wong KKY, Lau CS, Lam ETK, Ng KHL, Chan RCW. Evaluation of Rapid Antigen Detection Kits for Detection of SARS-CoV-2 B.1.1.529. Dr Sulaiman Al Habib Med J 2022. [PMCID: PMC9153237 DOI: 10.1007/s44229-022-00009-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Abstract
Background
Currently, there is a lack of studies evaluating rapid antigen detection (RAD) kits to detect SARS-CoV-2 B.1.1.529.
Objective
To evaluate the analytical sensitivity of seven RAD kits to detect SARS-CoV-2 B.1.1.529.
Study design
The analytical sensitivity was determined by means of limit of detection (LOD). A dilution set using a respiratory specimen collected from a COVID-19 patient infected with SARS-CoV-2 B.1.1.529 was prepared. RT-PCR was used as a reference method.
Results
The LOD results showed that all seven RAD kits had comparable analytical sensitivity for detection of SARS-CoV-2 B.1.1.529.
Conclusions
The RAD kits selected in the current study may be used for first-line screening of the recently emerged SARS-CoV-2 B.1.1.529.
Collapse
Affiliation(s)
- Gannon C. K. Mak
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, 9/F, Public Health Laboratory Centre, 382 Nam Cheong Street, Shek Kip Mei, Kowloon, Hong Kong, Special Administrative Region China
| | - Stephen S. Y. Lau
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, 9/F, Public Health Laboratory Centre, 382 Nam Cheong Street, Shek Kip Mei, Kowloon, Hong Kong, Special Administrative Region China
| | - Kitty K. Y. Wong
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, 9/F, Public Health Laboratory Centre, 382 Nam Cheong Street, Shek Kip Mei, Kowloon, Hong Kong, Special Administrative Region China
| | - C. S. Lau
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, 9/F, Public Health Laboratory Centre, 382 Nam Cheong Street, Shek Kip Mei, Kowloon, Hong Kong, Special Administrative Region China
| | - Edman T. K. Lam
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, 9/F, Public Health Laboratory Centre, 382 Nam Cheong Street, Shek Kip Mei, Kowloon, Hong Kong, Special Administrative Region China
| | - Ken H. L. Ng
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, 9/F, Public Health Laboratory Centre, 382 Nam Cheong Street, Shek Kip Mei, Kowloon, Hong Kong, Special Administrative Region China
| | - Rickjason C. W. Chan
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, 9/F, Public Health Laboratory Centre, 382 Nam Cheong Street, Shek Kip Mei, Kowloon, Hong Kong, Special Administrative Region China
| |
Collapse
|
22
|
Piccinini E, Fenoy GE, Cantillo AL, Allegretto JA, Scotto J, Piccinini JM, Marmisollé WA, Azzaroni O. Biofunctionalization of Graphene-Based FET Sensors through Heterobifunctional Nanoscaffolds: Technology Validation toward Rapid COVID-19 Diagnostics and Monitoring. Adv Mater Interfaces 2022; 9:2102526. [PMID: 35538925 PMCID: PMC9073996 DOI: 10.1002/admi.202102526] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/04/2022] [Indexed: 05/09/2023]
Abstract
The biofunctionalization of graphene field-effect transistors (GFETs) through vinylsulfonated-polyethyleneimine nanoscaffold is presented for enhanced biosensing of severe acute respiratory-related coronavirus 2 (SARS-CoV-2) spike protein and human ferritin, two targets of great importance for the rapid diagnostic and monitoring of individuals with COVID-19. The heterobifunctional nanoscaffold enables covalent immobilization of binding proteins and antifouling polymers while the whole architecture is attached to graphene by multivalent π-π interactions. First, to optimize the sensing platform, concanavalin A is employed for glycoprotein detection. Then, monoclonal antibodies specific against SARS-CoV-2 spike protein and human ferritin are anchored, yielding biosensors with limit of detections of 0.74 and 0.23 nm, and apparent affinity constants ( K D G F E T ) of 6.7 and 8.8 nm, respectively. Both biosensing platforms show good specificity, fast time response, and wide dynamic range (0.1-100 nm). Moreover, SARS-CoV-2 spike protein is also detected in spiked nasopharyngeal swab samples. To rigorously validate this biosensing technology, the GFET response is matched with surface plasmon resonance measurements, exhibiting linear correlations (from 2 to 100 ng cm-2) and good agreement in terms of K D values. Finally, the performance of the biosensors fabricated through the nanoscaffold strategy is compared with those obtained through the widely employed monopyrene approach, showing enhanced sensitivity.
Collapse
Affiliation(s)
- Esteban Piccinini
- Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas (INIFTA)Departamento de Química, Facultad de Ciencias ExactasUniversidad Nacional de La Plata (UNLP)CONICET. 64 and 113Buenos Aires1900Argentina
| | - Gonzalo E. Fenoy
- Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas (INIFTA)Departamento de Química, Facultad de Ciencias ExactasUniversidad Nacional de La Plata (UNLP)CONICET. 64 and 113Buenos Aires1900Argentina
| | - Agustín L. Cantillo
- Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas (INIFTA)Departamento de Química, Facultad de Ciencias ExactasUniversidad Nacional de La Plata (UNLP)CONICET. 64 and 113Buenos Aires1900Argentina
- GISENS BIOTECHBuenos AiresC1414BPVArgentina
| | - Juan A. Allegretto
- Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas (INIFTA)Departamento de Química, Facultad de Ciencias ExactasUniversidad Nacional de La Plata (UNLP)CONICET. 64 and 113Buenos Aires1900Argentina
| | - Juliana Scotto
- Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas (INIFTA)Departamento de Química, Facultad de Ciencias ExactasUniversidad Nacional de La Plata (UNLP)CONICET. 64 and 113Buenos Aires1900Argentina
| | | | - Waldemar A. Marmisollé
- Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas (INIFTA)Departamento de Química, Facultad de Ciencias ExactasUniversidad Nacional de La Plata (UNLP)CONICET. 64 and 113Buenos Aires1900Argentina
| | - Omar Azzaroni
- Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas (INIFTA)Departamento de Química, Facultad de Ciencias ExactasUniversidad Nacional de La Plata (UNLP)CONICET. 64 and 113Buenos Aires1900Argentina
| |
Collapse
|
23
|
Pugh J, Wilkinson D, Savulescu J. Sense and sensitivity: can an inaccurate test be better than no test at all? J Med Ethics 2022; 48:329-333. [PMID: 33820853 PMCID: PMC9046741 DOI: 10.1136/medethics-2021-107234] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/11/2021] [Accepted: 03/17/2021] [Indexed: 06/12/2023]
Abstract
The UK government has put lateral flow antigen tests (LFATs) at the forefront of its strategy to scale-up testing in the coronavirus pandemic. However, evidence from a pilot trial using an LFAT to identify asymptomatic infections in the community suggested that the test missed over half of the positive cases in the tested population. This raises the question of whether it can be ethical to use an inaccurate test to guide public health measures. We begin by explicating different dimensions of test accuracy (sensitivity, specificity and predictive value), and why they matter morally, before highlighting key data from the Liverpool pilot. We argue that the poor sensitivity of the LFAT in this pilot trial suggests that there are important limitations to what we can expect these tests to achieve. A test with low sensitivity will provide false-negative results, and in doing so generate the risk of false assurance and its attendant moral costs. However, we also suggest that the deployment of an insensitive but specific test could identify many asymptomatic carriers of the virus who are currently being missed under existing arrangements. Having outlined ways in which the costs of false reassurance could potentially be mitigated, we conclude that the use of an insensitive LFAT in mass testing may be ethical if (1) it is used predominantly to identify positive cases, (2) it is a cost-effective method of achieving that goal and (3) if other public health tools can effectively prevent widespread false reassurance.
Collapse
Affiliation(s)
- Jonathan Pugh
- Faculty of Philosophy, University of Oxford, Oxford, UK
| | - Dominic Wilkinson
- Faculty of Philosophy, University of Oxford, Oxford, UK
- Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
- John Radcliffe Hospital, Oxford, UK3, Oxford, UK
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | | |
Collapse
|
24
|
Peronace C, Tallerico R, Colosimo M, Sacco V, Talarico R, De Fazio M, Pasceri F, Talotta I, Panduri G, Kim J, Cione E, Minchella P. Validation of GeneFinder COVID-19 Ag Plus Rapid Test and Its Potential Utility to Slowing Infection Waves: A Single-Center Laboratory Evaluation Study. Diagnostics (Basel) 2022; 12:1126. [PMID: 35626282 PMCID: PMC9140403 DOI: 10.3390/diagnostics12051126] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/21/2022] [Accepted: 04/28/2022] [Indexed: 11/16/2022] Open
Abstract
Diagnostic laboratory tools are essential to keep everyone safe and track newly emerging variants; on the other hand, “filter” screening tests recognizing positivity are valuable tools to avoid hectic laboratory work that, besides COVID-19, are also part of the routine. Therefore, complementary assays, such as rapid antigen tests (RATs), are essential in controlling and monitoring virus spread within the community, especially in the asymptomatic population. A subset of nasopharyngeal swab specimens resulted in SARS-CoV-2 positive and investigated for genomic characterization were used for RAT validation. RATs were performed immediately after sampling, following the manufacturer’s instructions (reading at 15 min). RT-PCRs were carried out within 24 h of specimens’ collection. Out of 603 patients, 145 (24.05%) tested positive by RT-PCR and RAT and 451 (74.79%) tested negative by both methods; discordant results (RT-PCR+/RAT− or RT-PCR−/RAT+) were obtained in 7 patients (1.16%). RATs’ overall specificity and sensitivity were 96.03% (95%CI: 91.55–98.53%) and 99.78% (95%CI: 98.77–99.99%), respectively, taking RT-PCR as the reference. Overall, RAT negative predictive value was 98.69% (95%CI 97.17–99.40%). The GeneFinder COVID-19 Ag Plus Rapid Test performed well as a screening test for early diagnosis of COVID-19, especially in asymptomatic subjects. The data suggested that patients with RT-PCR-proven COVID-19 testing negative by RAT are unlikely to be infectious. GeneFinder COVID-19 Ag Plus Rapid Test also works on variants of concern (VOC) delta and omicron BA.1 and BA.2.
Collapse
|
25
|
Mak GCK, Lau SSY, Wong KKY, Chow NLS, Lau CS, Lam ETK, Ng KHL, Chan RCW. Evaluation of rapid antigen detection kits for detection of SARS-CoV-2 B.1.617.2 virus. Future Virol 2022. [PMID: 35432576 PMCID: PMC9006337 DOI: 10.2217/fvl-2021-0229] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 03/14/2022] [Indexed: 11/21/2022]
Abstract
Aim: Currently, there is lack of data regarding rapid antigen detection (RAD) kits to detect SARS-CoV-2 B.1.617.2 virus. Objective: The purpose of this evaluation is to assess analytical sensitivity of 12 RAD kits against SARS-CoV-2 B.1.617.2. Study design: Analytical sensitivity was determined by limit of detection (LOD). A serial tenfold dilution set from a respiratory specimen collected from a COVID-19 patient infected by SARS-CoV-2 B.1.617.2 was used. RT-PCR was used as a reference method. Results: The LOD results showed that 11 and one RAD kits were 100- and 1000-fold less sensitive than RT-PCR respectively. Conclusion: The results showed that the RAD kits evaluated in this study may be used for first-line screening of the SARS-CoV-2 B.1.617.2 variant.
Collapse
Affiliation(s)
- Gannon CK Mak
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region, China
| | - Stephen SY Lau
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region, China
| | - Kitty KY Wong
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region, China
| | - Nancy LS Chow
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region, China
| | - Chi-Shan Lau
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region, China
| | - Edman TK Lam
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region, China
| | - Ken HL Ng
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region, China
| | - Rickjason CW Chan
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region, China
| |
Collapse
|
26
|
Wertenauer C, Brenner Michael G, Dressel A, Pfeifer C, Hauser U, Wieland E, Mayer C, Mutschmann C, Roskos M, Wertenauer HJ, Moissl AP, Lorkowski S, März W. Diagnostic Performance of Rapid Antigen Testing for SARS-CoV-2: The COVid-19 AntiGen (COVAG) study. Front Med (Lausanne) 2022; 9:774550. [PMID: 35386920 PMCID: PMC8979030 DOI: 10.3389/fmed.2022.774550] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 02/17/2022] [Indexed: 12/19/2022] Open
Abstract
Background Rapid diagnostic testing for SARS-Cov-2 antigens is used to combat the ongoing pandemic. In this study we aimed to compare two RDTs, the SD Biosensor Q SARS-CoV-2 Rapid Antigen Test (Roche) and the Panbio COVID-19 Ag Rapid Test (Abbott), against rRT-PCR. Methods We included 2,215 all-comers at a diagnostic center between February 1 and March 31, 2021. rRT-PCR-positive samples were examined for SARS-CoV-2 variants. Findings Three hundred and thirty eight participants (15%) were rRT-PCR-positive for SARS-CoV-2. The sensitivities of Roche-RDT and Abbott-RDT were 60.4 and 56.8% (P < 0.0001) and specificities 99.7% and 99.8% (P = 0.076). Sensitivity inversely correlated with rRT-PCR-Ct values. The RDTs had higher sensitivities in individuals referred by treating physicians (79.5%, 78.7%) than in those referred by health departments (49.5%, 44.3%) or tested for other reasons (50%, 45.8%), in persons without any comorbidities (74.4%, 71%) compared to those with comorbidities (38.2%, 34.4%), in individuals with COVID-19 symptoms (75.2%, 74.3%) compared to those without (31.9%, 23.3%), and in the absence of SARS-CoV-2 variants (87.7%, 84%) compared to Alpha variant carriers (77.1%, 72.3%). If 10,000 symptomatic individuals are tested of which 500 are truly positive, the RDTs would generate 38 false-positive and 124 false-negative results. If 10,000 asymptomatic individuals are tested, including 50 true positives, 18 false-positives and 34 false-negatives would be generated. Interpretation The sensitivities of the two RDTs for asymptomatic SARS-CoV-2 carriers are unsatisfactory. Their widespread use may not be effective in the ongoing SARS-CoV-2 pandemic. The virus genotype influences the sensitivity of the two RDTs. RDTs should be evaluated for different SARS-CoV-2 variants.
Collapse
Affiliation(s)
- Christoph Wertenauer
- Hausärzte am Schillerplatz, Stuttgart, Germany.,Medical Clinic V, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.,Faculty of Medicine, Riga Stradins University, Riga, Latvia.,SYNLAB Holding Deutschland GmbH, Augsburg, Germany
| | | | | | | | - Ulrike Hauser
- SYNLAB Medical Care Center Augsburg GmbH, Augsburg, Germany
| | - Eberhard Wieland
- SYNLAB Medical Care Center Leinfelden-Echterdingen GmbH, Leinfelden-Echterdingen, Germany
| | | | | | | | | | - Angela P Moissl
- Medical Clinic V, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.,Institute of Nutritional Sciences, Friedrich Schiller University Jena, Jena, Germany.,Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD) Halle-Jena-Leipzig, Jena, Germany
| | - Stefan Lorkowski
- Institute of Nutritional Sciences, Friedrich Schiller University Jena, Jena, Germany.,Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD) Halle-Jena-Leipzig, Jena, Germany
| | - Winfried März
- Medical Clinic V, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.,SYNLAB Academy, SYNLAB Holding Deutschland GmbH, Mannheim, Germany.,Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| |
Collapse
|
27
|
Cattelan AM, Sasset L, Zabeo F, Ferrari A, Rossi L, Mazzitelli M, Cocchio S, Baldo V. Rapid Antigen Test LumiraDx(TM) vs. Real Time Polymerase Chain Reaction for the Diagnosis of SARS-CoV-2 Infection: A Retrospective Cohort Study. Int J Environ Res Public Health 2022; 19. [PMID: 35409513 DOI: 10.3390/ijerph19073826] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/19/2022] [Accepted: 03/21/2022] [Indexed: 02/04/2023]
Abstract
Background: Real time reverse transcription polymerase chain reaction (real time RT-PCR) testing is the gold standard for the diagnosis of SARS-CoV-2 infections. However, to expand the testing capacity, new SARS-CoV-2 rapid antigen tests (Ag-RDTs) have been implemented. Ag-RDTs are more rapid, but less reliable in terms of sensitivity, and real-life data on their performance in comparison with the real time RT-PCR test are lacking. Methods: We aimed at assessing the diagnostic performance of the third-generation antigenic swab LumiraDx™ compared with real time RT-PCR in a retrospective cohort study at the Infectious Diseases Unit of Padua. All of the patients who were consecutively tested for SARS-CoV-2 in our centre (by both real time RT-PCR and Ag-RTD LumiraDxTM) from 19 January to 30 May 2021, were included. Cycle-threshold (Ct) values of positive real time RT-PCR were recorded as well as the number of days from symptoms’ onset to testing. Results: Among the 282 patients included, 80.9% (N = 228) tested positive to real time RT-PCR, and among these, 174 tested positive also to LumiraDx™. Compared with real time RT-PCR, which is considered as the gold standard for the assessment of the presence/absence of SARS-CoV-2 infection, LumiraDx™ showed an overall sensitivity of 76.3% and specificity of 94.4%. Sensitivity increased to 91% when testing was performed <10 days from symptoms’ onset, and to 95% when considering Ct < 25. Multivariable binomial logistic regression showed that false negative LumiraDx™ results were significantly associated with high Ct values, and with further testing from symptoms’ onset. Conclusions: The results of our study suggested that the LumiraDx™ SARS-CoV-2 antigen assay may be appropriate for the detection of SARS-CoV-2 infection, especially in its early phase when the test largely meets the performance requirements of the European Centre for Disease Prevention and Control (ECDC).
Collapse
|
28
|
Yen YF, Hu HY, Chen CC, Chu D, Lee YL. Clinical sensitivity of rapid antigen test during a COVID-19 outbreak in Taipei, May to June 2021. J Formos Med Assoc 2022; 121:1857-1863. [PMID: 35400582 PMCID: PMC8958153 DOI: 10.1016/j.jfma.2022.03.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/17/2022] [Accepted: 03/21/2022] [Indexed: 11/30/2022] Open
Abstract
Background/purpose This population-based study aimed to compare the accuracy of Rapid antigen detection (RAD) and reverse transcription-polymerase chain reaction (RT-PCR) assays for diagnosing individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the COVID-19 outbreak in Taipei, from May to June 2021. Methods In response to the outbreak of COVID-19 in mid-May 2021, Taipei City Hospital set up 12 citywide proactive community testing (PCT) stations for early identification of infected individuals from May 17 to June 20, 2021. Individuals with RAD positivity were isolated and later confirmed by RT-PCR. The c-statistic value was estimated to indicate the level of diagnostic accuracy of RAD tests. Results Of the 33,798 individuals who were evaluated for SARS-CoV-2 infection, 4.4% tested positive for RAD. There was a moderate concordance (kappa = 0.67) between the RAD tests and RT-PCR assay for identifying infectious individuals. The c-statistic value of the RAD test for the diagnosis of SARS-CoV-2 infection was 0.8. There was a positive linear trend between the accuracy of the RAD tests and the prevalence of SARS-CoV-2 infection in the study population (β = 0.04; p = .03). As the cycle threshold value decreased, the sensitivity rate of the RAD tests increased (p < .001). After implementation of the PCT program, the prevalence of COVID-19 decreased from 8.4% to 3.3% (p < .001). Conclusion Proactive community testing for SARS-CoV-2 infection using RAD tests could rapidly identify and quarantine the most infectious patients in the early phase of COVID-19 outbreak.
Collapse
Affiliation(s)
- Yung-Feng Yen
- Section of Infectious Diseases, Taipei City Hospital, Yangming Branch, Taipei, Taiwan; Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan; Department of Education and Research, Taipei City Hospital, Taipei, Taiwan; University of Taipei, Taipei, Taiwan
| | - Hsiao-Yun Hu
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Education and Research, Taipei City Hospital, Taipei, Taiwan; University of Taipei, Taipei, Taiwan
| | - Chu-Chieh Chen
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Dachen Chu
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan; University of Taipei, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Neurosurgery, Taipei City Hospital, Taipei, Taiwan
| | - Ya-Ling Lee
- University of Taipei, Taipei, Taiwan; Department of Dentistry, Taipei City Hospital, Taipei, Taiwan; Department of Dentistry, School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| |
Collapse
|
29
|
Patriquin G, LeBlanc JJ, Williams C, Hatchette TF, Ross J, Barrett L, Davidson R. Comparison between Nasal and Nasopharyngeal Swabs for SARS-CoV-2 Rapid Antigen Detection in an Asymptomatic Population, and Direct Confirmation by RT-PCR from the Residual Buffer. Microbiol Spectr 2022;:e0245521. [PMID: 35171010 DOI: 10.1128/spectrum.02455-21] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Containment measures employed during the COVID-19 pandemic included prompt recognition of cases, isolation, and contact tracing. Bilateral nasal (NA) swabs applied to a commercial antigen-based rapid diagnostic test (Ag-RDT) offer a simpler and more comfortable alternative to nasopharyngeal (NP) collection; however, little is known about the sensitivity of this method in an asymptomatic population. Participants in community-based asymptomatic testing sites were screened for SARS-CoV-2 using an Ag-RDT with NP sampling. Positive individuals returned for confirmatory molecular testing and consented to repeating the Ag-RDT using a bilateral NA swab for comparison. Residual test buffer (RTB) from Ag-RDTs was subjected to real-time reverse transcription-PCR (RT-PCR). Of 123,617 asymptomatic individuals, 197 NP Ag-RDT-positive participants were included, with 175 confirmed positive by RT-PCR. Of these cases, 154 were identified from the NA swab collection with Ag-RDT, with a sensitivity of 88.0% compared to the NP swab collection. Stratifying results by RT-PCR cycle threshold demonstrated that sensitivity of the nasal collection method varied based on the cycle threshold (CT) value of the paired RT-PCR sample. RT-PCR testing on the RTB from the Ag-RDT using NP and NA swab collections resulted in 100.0% and 98.7% sensitivity, respectively. NA swabs provide an adequate alternative to NP swab collection for use with Ag-RDT, with the recognition that the test is most sensitive in specimens with high viral loads. With the high sensitivity of RT-PCR testing on RTB from Ag-RDT, a more streamlined approach to confirmatory testing is possible without recollection or use of paired collections strategies. IMPORTANCE Nasal swabbing for SARS-CoV-2 (COVID-19) comes with many benefits but is slightly less sensitive than traditional nasopharyngeal swabbing; however, confirmatory lab-based testing could be performed directly from the residual buffer from either sample type.
Collapse
|
30
|
Gavurova B, Ivankova V, Rigelsky M, Caha Z, Mudarri T. Perception of COVID-19 Testing in the Entire Population. Front Public Health 2022; 10:757065. [PMID: 35223721 PMCID: PMC8877808 DOI: 10.3389/fpubh.2022.757065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 01/17/2022] [Indexed: 11/22/2022] Open
Abstract
In the Slovak Republic, a mass testing of the entire population was performed. Estimates show that this testing cost more than 400 million EUR and thousands of euros were paid for one positively identified case. Thus, it is possible to state a high cost for such a project, which has been criticized by many parties. On the other hand, from a public health point of view, mass testing has helped fight the pandemic. Both the health and economic perspectives are important in assessing the success of a pandemic strategy, but the social perspective is equally important. In fact, the situation is perceived from the position of public leaders who make decisions, but also from the position of the society that bears individual political decisions. It is not appropriate to forget about the society that is most affected by restrictions, testing, health status, but also the burden on the state budget. The objective of the presented research was to examine the perception of testing for coronavirus disease 2019 (COVID-19) in the Slovak population. Non-parametric difference tests and correspondence analysis were used for statistical processing. The research sample consisted of 806 respondents and data collection took place in February 2021. The main findings include significant differences in perceptions between the first and the last participation in testing in terms of gender, age, testing experience, and time aspect. The last participation in testing showed lower rates of positive aspects related to the internal motivation to test compared to the first participation. In contrast, external stimulation by government regulations related to restrictions in the absence of a negative result was higher in the last participation in testing. There were also differences between the first and the last test in the level of doubts about the accuracy of the test result, while a higher level was found at the last testing participation. It can be concluded that the frequency of testing and its requirements need to be approached very carefully over time, as it is likely that the positive perceptions may deteriorate. The recommendations include clear and timely government communication, trust building and health education.
Collapse
Affiliation(s)
- Beata Gavurova
- Institute of Earth Resources, Faculty of Mining, Ecology, Process Control and Geotechnologies, Technical University of Košice, Košice, Slovakia
- *Correspondence: Beata Gavurova
| | - Viera Ivankova
- Institute of Earth Resources, Faculty of Mining, Ecology, Process Control and Geotechnologies, Technical University of Košice, Košice, Slovakia
| | - Martin Rigelsky
- Department of Marketing and International Trade, Faculty of Management and Business, University of Prešov, Prešov, Slovakia
| | - Zdenek Caha
- Department of Human Resource Management, Faculty of Corporate Strategy, Institute of Technology and Business in České Budějovice, České Budějovice, Czechia
| | - Tawfik Mudarri
- Institute of Earth Resources, Faculty of Mining, Ecology, Process Control and Geotechnologies, Technical University of Košice, Košice, Slovakia
| |
Collapse
|
31
|
Alghounaim M, Bastaki H, Bin Essa F, Motlagh H, Al-Sabah S. The Performance of Two Rapid Antigen Tests During Population-Level Screening for SARS-CoV-2 Infection. Front Med (Lausanne) 2022; 8:797109. [PMID: 35004772 PMCID: PMC8733308 DOI: 10.3389/fmed.2021.797109] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 11/26/2021] [Indexed: 11/13/2022] Open
Abstract
Background: SARS-CoV-2 antigen assays offer a rapid mean to diagnose and isolate infected individuals. However, their utility in population-level screening is unknown. Objectives: The performance of two antigen tests in detecting SARS-CoV-2 was assessed among individuals randomly selected in the community. Study Design: A prospective study that performed head-to-head comparison of two SARS-CoV-2 antigen assays. Individuals were recruited during community SARS-CoV-2 screening over 10 working days. Demographic and clinical data were collected. Standard Q COVID-19 Ag test, a point-of-care chromatographic assay, was conducted immediately, and then the sample was transported to the virology laboratory to perform PCR and the LIAISON SARS-CoV-2 Ag chemiluminesence immunoassay. Results: respiratory samples from 991 individuals were collected, and 62 were positive by PCR. Inconclusive PCR results were observed in 19 samples and were excluded. The median age of participants was 40.2 years (IQR 32.3–47.8), and 932 (94%) were males. Most (77.4%) of infections were asymptomatic. The sensitivity and the specificity of the LIAISON assay were 43.3% (95%CI 30.6–56.8) and 99.9% (95%CI 99.3–100). The Standard Q assay had lower sensitivity (30.6%, 95%CI 19.6–43.7) but similar specificity (98.8%, 95%CI, 97.8–99.4). Similarly, the LIAISON assay had higher positive predictive value (96.3%, 95%CI 81–99.9% vs. 63.3%, 95%CI, 43.9–80.1%). Both assays performed better in symptomatic patients and among samples with a low-cycle threshold (Ct < 25). Conclusion: In our setting of random community surveillance, rapid antigen testing of nasopharyngeal swabs by either LIAISON SARS-CoV-2 Ag (DiaSorin) or Standard Q COVID-19 Ag (SD Biosensor) was less sensitive to detecting SARS-CoV-2 than the TaqPath COVID-19 RT-PCR.
Collapse
Affiliation(s)
- Mohammad Alghounaim
- Department of Pediatrics, Amiri Hospital, Ministry of Health, Kuwait City, Kuwait.,COVID-19 Research Team, Jaber Alahmad Hospital, Ministry of Health, Kuwait City, Kuwait
| | - Hamad Bastaki
- Department of Public Health, Ministry of Health, Kuwait City, Kuwait
| | - Farah Bin Essa
- Department of Public Health, Ministry of Health, Kuwait City, Kuwait
| | - Hoda Motlagh
- COVID-19 Research Team, Jaber Alahmad Hospital, Ministry of Health, Kuwait City, Kuwait
| | - Salman Al-Sabah
- COVID-19 Research Team, Jaber Alahmad Hospital, Ministry of Health, Kuwait City, Kuwait.,Department of Surgery, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| |
Collapse
|
32
|
Do T, Guran R, Adam V, Zitka O. Use of MALDI-TOF mass spectrometry for virus identification: a review. Analyst 2022; 147:3131-3154. [DOI: 10.1039/d2an00431c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The possibilities of virus identification, including SARS-CoV-2, by MALDI-TOF mass spectrometry are discussed in this review.
Collapse
Affiliation(s)
- Tomas Do
- Department of Chemistry and Biochemistry, Faculty of AgriSciences, Mendel University in Brno, Zemedelska 1, CZ-613 00 Brno, Czech Republic
| | - Roman Guran
- Department of Chemistry and Biochemistry, Faculty of AgriSciences, Mendel University in Brno, Zemedelska 1, CZ-613 00 Brno, Czech Republic
- Central European Institute of Technology, Brno University of Technology, Purkynova 656/123, CZ-612 00 Brno, Czech Republic
| | - Vojtech Adam
- Department of Chemistry and Biochemistry, Faculty of AgriSciences, Mendel University in Brno, Zemedelska 1, CZ-613 00 Brno, Czech Republic
- Central European Institute of Technology, Brno University of Technology, Purkynova 656/123, CZ-612 00 Brno, Czech Republic
| | - Ondrej Zitka
- Department of Chemistry and Biochemistry, Faculty of AgriSciences, Mendel University in Brno, Zemedelska 1, CZ-613 00 Brno, Czech Republic
- Central European Institute of Technology, Brno University of Technology, Purkynova 656/123, CZ-612 00 Brno, Czech Republic
| |
Collapse
|
33
|
Zhou Y, Zhang L, Xie YH, Wu J. Advancements in detection of SARS-CoV-2 infection for confronting COVID-19 pandemics. J Transl Med 2022; 102:4-13. [PMID: 34497366 PMCID: PMC8424153 DOI: 10.1038/s41374-021-00663-w] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 08/05/2021] [Accepted: 08/06/2021] [Indexed: 01/13/2023] Open
Abstract
As one of the major approaches in combating the COVID-19 pandemics, the availability of specific and reliable assays for the SARS-CoV-2 viral genome and its proteins is essential to identify the infection in suspected populations, make diagnoses in symptomatic or asymptomatic individuals, and determine clearance of the virus after the infection. For these purposes, use of the quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) for detection of the viral nucleic acid remains the most valuable in terms of its specificity, fast turn-around, high-throughput capacity, and reliability. It is critical to update the sequences of primers and probes to ensure the detection of newly emerged variants. Various assays for increased levels of IgG or IgM antibodies are available for detecting ongoing or past infection, vaccination responses, and persistence and for identifying high titers of neutralizing antibodies in recovered individuals. Viral genome sequencing is increasingly used for tracing infectious sources, monitoring mutations, and subtype classification and is less valuable in diagnosis because of its capacity and high cost. Nanopore target sequencing with portable options is available for a quick process for sequencing data. Emerging CRISPR-Cas-based assays, such as SHERLOCK and AIOD-CRISPR, for viral genome detection may offer options for prompt and point-of-care detection. Moreover, aptamer-based probes may be multifaceted for developing portable and high-throughput assays with fluorescent or chemiluminescent probes for viral proteins. In conclusion, assays are available for viral genome and protein detection, and the selection of specific assays depends on the purposes of prevention, diagnosis and pandemic control, or monitoring of vaccination efficacy.
Collapse
Affiliation(s)
- Yuan Zhou
- Department of Microbiology & Parasitology, MOE/NHC/CAMS Key Laboratory of Medical Molecular Virology, School of Basic Medical Sciences, Fudan University Shanghai Medical College, Shanghai, China
| | - Li Zhang
- Department of Microbiology & Parasitology, MOE/NHC/CAMS Key Laboratory of Medical Molecular Virology, School of Basic Medical Sciences, Fudan University Shanghai Medical College, Shanghai, China
| | - You-Hua Xie
- Department of Microbiology & Parasitology, MOE/NHC/CAMS Key Laboratory of Medical Molecular Virology, School of Basic Medical Sciences, Fudan University Shanghai Medical College, Shanghai, China.
- Shanghai Institutes of Infectious Disease and Biosecurity, Fudan University Shanghai Medical College, Shanghai, China.
| | - Jian Wu
- Department of Microbiology & Parasitology, MOE/NHC/CAMS Key Laboratory of Medical Molecular Virology, School of Basic Medical Sciences, Fudan University Shanghai Medical College, Shanghai, China.
- Department of Gastroenterology & Hepatology, Zhongshan Hospital of Fudan University, Shanghai, China.
- Shanghai Institute of Liver Diseases, Fudan University Shanghai Medical College, Shanghai, China.
| |
Collapse
|
34
|
Abstract
Respiratory tract infection is one of the most common diseases in human worldwide. Many viruses are implicated in these infections, including emerging viruses, such as the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Identification of the causative viral pathogens of respiratory tract infections is important to select a correct management of patients, choose an appropriate treatment, and avoid unnecessary antibiotics use. Different diagnostic approaches present variable performance in terms of accuracy, sensitivity, specificity, and time-to-result, that have to be acknowledged to be able to choose the right diagnostic test at the right time, in the right patient. This review describes currently available rapid diagnostic strategies and syndromic approaches for the detection of viruses commonly responsible for respiratory diseases.
Collapse
Affiliation(s)
- Luna Colagrossi
- Department of Laboratories, Bambino Gesù Children's Hospital, Rome, Italy
| | - Giordana Mattana
- Department of Laboratories, Bambino Gesù Children's Hospital, Rome, Italy
| | - Livia Piccioni
- Department of Laboratories, Bambino Gesù Children's Hospital, Rome, Italy
| | - Valeria Cento
- Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | | |
Collapse
|
35
|
Tariq M, Kim DM, Kim CM, Bang MS, Lee YM, Seo JW, Kim DY, Yun NR. Viable Severe Acute Respiratory Syndrome Coronavirus 2 Isolates Exhibit Higher Correlation With Rapid Antigen Assays Than Subgenomic RNA or Genomic RNA. Front Microbiol 2021; 12:718497. [PMID: 34867844 PMCID: PMC8633410 DOI: 10.3389/fmicb.2021.718497] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 10/11/2021] [Indexed: 12/23/2022] Open
Abstract
Background: Rapid identification and effective isolation are crucial for curbing the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). To meet this requirement, antigen-detection rapid diagnostic tests (Ag-RDTs) are essential. Methods: Between February 2020 and August 2020 we performed a cohort study of patients with confirmed COVID-19. The clinical performance of Ag rapid fluorescence immunoassay (FIA) and Ag Gold was evaluated and compared in parallel with genomic and subgenomic real-time reverse transcription-polymerase chain reaction (rRT-PCR) and cell culture-based assays. Results: In total, 150 samples were tested. Of these, 63 serial samples were obtained from 11 patients with SARS-CoV-2 and 87 from negative controls. Serial respiratory samples were obtained 2 days prior to symptom onset (-2) up to 25 days post-symptom onset. Overall, for rRT-PCR-positive samples (n = 51), the detection sensitivity of Ag rapid FIA and Ag Gold was 74.5% and 53.49%, respectively, with a specificity of 100%; however, for samples with low cycle threshold (Ct) values, Ag rapid FIA and Ag Gold exhibited a sensitivity of 82.61% (Ct ≤ 30, 5.6 log10RNA copies/mL) and 80% (Ct ≤ 25, 6.9 log10RNA copies/mL), respectively. Despite low analytical sensitivity, both Ag-RDTs detected 100% infection in cell culture-positive samples (n = 15) and were highly effective in distinguishing viable samples from those with subgenomic RNA (66.66%). For both Ag-RDTs, all samples that yielded discordant results (rRT-PCR + ve/Ag-RDT -ve) were also negative by culture. Conclusion: The data suggest that Ag-RDTs reliably detect viable SARS-CoV-2; thus, they may serve as an important tool for rapid detection of potentially infectious individuals.
Collapse
Affiliation(s)
- Misbah Tariq
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju, South Korea
| | - Dong-Min Kim
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju, South Korea
| | - Choon-Mee Kim
- Premedical Science, Chosun University College of Medicine, Gwangju, South Korea
| | - Mi-Seon Bang
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju, South Korea
| | - You Mi Lee
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju, South Korea
| | - Jun-Won Seo
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju, South Korea
| | - Da Young Kim
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju, South Korea
| | - Na Ra Yun
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju, South Korea
| |
Collapse
|
36
|
Buckley C, Wang CY, Chatfield MD, Bletchly C, Harris P, Whiley D. The impact of COVID-19 epidemic phase and changes in mean viral loads: implications for SARS-CoV-2 testing strategies. Diagn Microbiol Infect Dis 2021; 102:115598. [PMID: 34883385 PMCID: PMC8603442 DOI: 10.1016/j.diagmicrobio.2021.115598] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 11/07/2021] [Accepted: 11/14/2021] [Indexed: 12/11/2022]
Abstract
The sensitivity of SARS-CoV-2 diagnostic tests is inherently linked to viral load. We explored whether average viral loads changed at a population level in Queensland, Australia during the early phase of the pandemic. RT-PCR threshold cycle (CT) values, a crude marker for viral load, were compared for samples collected in February/March-2020 to those collected in April/May-2020, noting that the major public health interventions began in late-March 2020. Positive detections peaked mid-March, which coincided with the highest detection numbers and lowest CT values. However, this changed from April where the later CT samples (CT > 30) predominated. Overall, in February/March 29% (267/922) of samples had CT values >30 cycles compared to 88% (559/636) in April/May. Our study shows that SARS-CoV-2 viral loads in patients may vary at a population level over time. This needs considering when assessing suitability of diagnostic methods, particularly when methods in question are known to have reduced sensitivity.
Collapse
Affiliation(s)
- Cameron Buckley
- Faculty of Medicine, The University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia; Pathology Queensland Central Laboratory, Brisbane, Queensland, Australia
| | - Claire Yt Wang
- Pathology Queensland Central Laboratory, Brisbane, Queensland, Australia; Centre for Children's Health Research, Children's Health Queensland, Brisbane, Queensland, Australia
| | - Mark D Chatfield
- Faculty of Medicine, The University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Cheryl Bletchly
- Pathology Queensland Central Laboratory, Brisbane, Queensland, Australia
| | - Patrick Harris
- Faculty of Medicine, The University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia; Pathology Queensland Central Laboratory, Brisbane, Queensland, Australia
| | - David Whiley
- Faculty of Medicine, The University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia; Pathology Queensland Central Laboratory, Brisbane, Queensland, Australia.
| |
Collapse
|
37
|
Tripathy S, Supraja P, Mohanty S, Sai VM, Agrawal T, Chowdary CG, Taranikanti M, Bandaru R, Mudunuru AK, Tadi LJ, Suravaram S, Siddiqui IA, Maddur S, Guntuka RK, Singh R, Singh V, Singh SG. Artificial Intelligence-Based Portable Bioelectronics Platform for SARS-CoV-2 Diagnosis with Multi-nucleotide Probe Assay for Clinical Decisions. Anal Chem 2021; 93:14955-14965. [PMID: 34694783 DOI: 10.1021/acs.analchem.1c01650] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
In the context of the recent pandemic, the necessity of inexpensive and easily accessible rapid-test kits is well understood and need not be stressed further. In light of this, we report a multi-nucleotide probe-based diagnosis of SARS-CoV-2 using a bioelectronics platform, comprising low-cost chemiresistive biochips, a portable electronic readout, and an Android application for data acquisition with machine-learning-based decision making. The platform performs the desired diagnosis from standard nasopharyngeal and/or oral swabs (both on extracted and non-extracted RNA samples) without amplifying the viral load. Being a reverse transcription polymerase chain reaction-free hybridization assay, the proposed approach offers inexpensive, fast (time-to-result: ≤ 30 min), and early diagnosis, as opposed to most of the existing SARS-CoV-2 diagnosis protocols recommended by the WHO. For the extracted RNA samples, the assay accounts for 87 and 95.2% test accuracies, using a heuristic approach and a machine-learning-based classification method, respectively. In case of the non-extracted RNA samples, 95.6% decision accuracy is achieved using the heuristic approach, with the machine-learning-based best-fit model producing 100% accuracy. Furthermore, the availability of the handheld readout and the Android application-based simple user interface facilitates easy accessibility and portable applications. Besides, by eliminating viral RNA extraction from samples as a pre-requisite for specific detection, the proposed approach presents itself as an ideal candidate for point-of-care SARS-CoV-2 diagnosis.
Collapse
Affiliation(s)
- Suryasnata Tripathy
- Indian Institute of Technology Hyderabad, Kandi, Sangareddy, Telangana 502285, India
| | - Patta Supraja
- Indian Institute of Technology Hyderabad, Kandi, Sangareddy, Telangana 502285, India
| | - Swati Mohanty
- Indian Institute of Technology Hyderabad, Kandi, Sangareddy, Telangana 502285, India
| | - Vallepu Mohan Sai
- Indian Institute of Technology Hyderabad, Kandi, Sangareddy, Telangana 502285, India
| | - Tushant Agrawal
- Indian Institute of Technology Hyderabad, Kandi, Sangareddy, Telangana 502285, India
| | | | - Madhuri Taranikanti
- All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana 508126, India
| | - Rajiv Bandaru
- ESIC Medical College, S R Nagar, Hyderabad, Telangana 500038, India
| | | | - Lakshmi Jyothi Tadi
- All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana 508126, India.,ESIC Medical College, S R Nagar, Hyderabad, Telangana 500038, India
| | - Swathi Suravaram
- ESIC Medical College, S R Nagar, Hyderabad, Telangana 500038, India
| | | | - Srinivas Maddur
- ESIC Medical College, S R Nagar, Hyderabad, Telangana 500038, India
| | | | - Ranjana Singh
- Indian Institute of Technology Hyderabad, Kandi, Sangareddy, Telangana 502285, India
| | - Vikrant Singh
- School of Medicine, University of California, 1 Shields Avenue, Davis, California 95616, United States
| | - Shiv Govind Singh
- Indian Institute of Technology Hyderabad, Kandi, Sangareddy, Telangana 502285, India
| |
Collapse
|
38
|
Altawalah H, Alfouzan W, Al-Fadalah T, Ezzikouri S. Diagnostic Performance of Automated SARS-CoV-2 Antigen Assay in Nasal Swab during COVID-19 Vaccination Campaign. Diagnostics (Basel) 2021; 11:2110. [PMID: 34829457 PMCID: PMC8621910 DOI: 10.3390/diagnostics11112110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/05/2021] [Accepted: 11/11/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND To control the spread of the pandemic brought about by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, it is necessary to have an automated reliable diagnostic assay. To date, the RT-PCR (RT-qPCR) has been the recommended laboratory method to diagnose SARS-CoV-2 infection, but there is a need for more automated and reliable tests. The aim of this real-life study was to assess the diagnostic performance of DiaSorin's LIAISON SARS-CoV-2 antigen (Ag) chemiluminescence immunoassay in detecting SARS-CoV-2 in vaccinated and unvaccinated individuals. METHODS A prospective study was performed on 300 nasopharyngeal swabs randomly collected from 31 May to 6 July 2021. Nasopharyngeal samples were assayed with DiaSorin's LIAISON SARS-CoV-2 Ag and TaqPath™ COVID-19 multiplex RT-qPCR. RESULTS Of 300 participants, 150 had a RT-qPCR confirmed SARS-CoV-2 infection of whom 113 (75.33%) were also detected by the DiaSorin LIAISON SARS-CoV-2 Ag. Taking RT-qPCR as a reference, the sensitivity and specificity of the DiaSorin LIAISON SARS-CoV-2 Ag assay were evaluated as 75.33% (95% CI = 67.64-82) and 100% (95% CI = 97.57-100), respectively. When a viral load cut-off was applied for high viral load (median cycle threshold (Ct) < 18.57), the overall sensitivity was increased to 96.55% (95% CI = 88.09-99.58). Interestingly, median RT-qPCR Ct and SARS-CoV-2 Ag values were similar between fully vaccinated and unvaccinated subjects. CONCLUSIONS Automated, quantitative LIAISON SARS-CoV-2 Ag assay shows good performance to identify SARS-CoV-2-infected individuals with moderate to high viral loads. LIAISON SARS-CoV-2 Ag testing could be used as frontline testing for COVID-19 diagnosis and be more suitable for large utilization.
Collapse
Affiliation(s)
- Haya Altawalah
- Department of Microbiology, Faculty of Medicine, Kuwait University, Safat 24923, Kuwait;
- Virology Unit, Yacoub Behbehani Center, Sabah Hospital, Ministry of Health, Safat 24923, Kuwait
| | - Wadha Alfouzan
- Department of Microbiology, Faculty of Medicine, Kuwait University, Safat 24923, Kuwait;
- Laboratory Medicine, Farwania Hospital, Ministry of Health, Farwania 85000, Kuwait
| | - Talal Al-Fadalah
- Qualities and Accreditation Directorate, Ministry of Health, Safat 13001, Kuwait;
| | - Sayeh Ezzikouri
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, Casablanca 20250, Morocco
| |
Collapse
|
39
|
Scheiblauer H, Filomena A, Nitsche A, Puyskens A, Corman VM, Drosten C, Zwirglmaier K, Lange C, Emmerich P, Müller M, Knauer O, Nübling CM. Comparative sensitivity evaluation for 122 CE-marked rapid diagnostic tests for SARS-CoV-2 antigen, Germany, September 2020 to April 2021. Euro Surveill 2021; 26:2100441. [PMID: 34738515 PMCID: PMC8569926 DOI: 10.2807/1560-7917.es.2021.26.44.2100441] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 10/14/2021] [Indexed: 12/27/2022] Open
Abstract
IntroductionNumerous CE-marked SARS-CoV-2 antigen rapid diagnostic tests (Ag RDT) are offered in Europe, several of them with unconfirmed quality claims.AimWe performed an independent head-to-head evaluation of the sensitivity of SARS-CoV-2 Ag RDT offered in Germany.MethodsWe addressed the sensitivity of 122 Ag RDT in direct comparison using a common evaluation panel comprised of 50 specimens. Minimum sensitivity of 75% for panel specimens with a PCR quantification cycle (Cq) ≤ 25 was used to identify Ag RDT eligible for reimbursement in the German healthcare system.ResultsThe sensitivity of different SARS-CoV-2 Ag RDT varied over a wide range. The sensitivity limit of 75% for panel members with Cq ≤ 25 was met by 96 of the 122 tests evaluated; 26 tests exhibited lower sensitivity, few of which failed completely. Some RDT exhibited high sensitivity, e.g. 97.5 % for Cq < 30.ConclusionsThis comparative evaluation succeeded in distinguishing less sensitive from better performing Ag RDT. Most of the evaluated Ag RDT appeared to be suitable for fast identification of acute infections associated with high viral loads. Market access of SARS-CoV-2 Ag RDT should be based on minimal requirements for sensitivity and specificity.
Collapse
Affiliation(s)
- Heinrich Scheiblauer
- Testing Laboratory for In-vitro Diagnostic Medical Devices, Paul-Ehrlich-Institute, Langen, Germany
| | - Angela Filomena
- Testing Laboratory for In-vitro Diagnostic Medical Devices, Paul-Ehrlich-Institute, Langen, Germany
| | - Andreas Nitsche
- Robert Koch Institute, Highly Pathogenic Viruses, Centre for Biological Threats and Special Pathogens, WHO Reference Laboratory for SARS-CoV-2 and WHO Collaborating Centre for Emerging Infections and Biological Threats, Robert Koch Institute, Berlin, Germany
| | - Andreas Puyskens
- Robert Koch Institute, Highly Pathogenic Viruses, Centre for Biological Threats and Special Pathogens, WHO Reference Laboratory for SARS-CoV-2 and WHO Collaborating Centre for Emerging Infections and Biological Threats, Robert Koch Institute, Berlin, Germany
| | - Victor M Corman
- Charité - Universitätsmedizin Berlin, Institute of Virology and German Centre for Infection Research (DZIF), Associated Partner Site, Berlin, Germany
- Labor Berlin, Charité - Vivantes GmbH, Berlin, Germany
| | - Christian Drosten
- Charité - Universitätsmedizin Berlin, Institute of Virology and German Centre for Infection Research (DZIF), Associated Partner Site, Berlin, Germany
| | - Karin Zwirglmaier
- Bundeswehr Institute of Microbiology, and German Centre for Infection Research (DZIF), Partner Site, Munich, Germany
| | - Constanze Lange
- LADR Central Laboratory Dr. Kramer & Colleagues, Geesthacht, Germany
| | - Petra Emmerich
- Bernhard-Nocht Institute, Department of Virology, Hamburg, and Department of Tropical Medicine and Infectious Diseases, Center of Internal Medicine II, University of Rostock, Rostock, Germany
| | | | - Olivia Knauer
- Testing Laboratory for In-vitro Diagnostic Medical Devices, Paul-Ehrlich-Institute, Langen, Germany
| | - C Micha Nübling
- Testing Laboratory for In-vitro Diagnostic Medical Devices, Paul-Ehrlich-Institute, Langen, Germany
| |
Collapse
|
40
|
Aguilar-Shea AL, Vera-García M, Güerri-Fernández R. Rapid antigen tests for the detection of SARS-CoV-2: A narrative review. Aten Primaria 2021; 53:102127. [PMID: 34217106 PMCID: PMC8162716 DOI: 10.1016/j.aprim.2021.102127] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 04/27/2021] [Indexed: 02/03/2023] Open
Abstract
The rapid identificationand isolation of COVID-19 patients has become the cornerstone for the control of the recent outbreak. Real-time quantitative polymerase chain reaction is routinely used to confirm COVID-19 diagnosis and is considered the gold standard due to high sensitivity and specificity. Nevertheless, it usually takes several days and a relatively higher cost. Antigen tests based have emerged to cope with such disadvantages, by offering rapid results, an easy-to-use procedure, and low costs. The objective of the narrative review was to provide up-to-date data about CE-marked rapid antigen tests (RATs) for COVID-19. Given their large number, the study only focused on representative and widely used in Spain (Standard Q, Nadal, Panbio, CerTest, and Wondfo). RATs have become a very useful and validated tool for controlling the spread of COVID-19 allowing the rapid identification of active infection and isolation of positive patients. The present revision of the literature has demonstrated that sensitivity and specificity of all available RATs in Spain are high and accomplish European regulations and WHO recommendations.
Collapse
Affiliation(s)
- Antonio L Aguilar-Shea
- Centro de Salud Puerta de Madrid, Atención Primaria de Madrid, Spain; Hospital Clinical Multiprofesional COVID19 Unit, Avda del Ejército 61, 28802 Alcalá de Henares (Madrid), Spain.
| | - Mar Vera-García
- Centro Sanitario Sandoval, Calle de Sandoval, 7, 28010 Madrid, Spain; HIV/STD Unit, Hospital Clínico Universitario San Carlos, IdISSC, Calle del Profesor Martín Lagos, s/n, 28040 Madrid, Spain
| | - Robert Güerri-Fernández
- Hospital del Mar - Parc de Salut MAR, Paseo Marítimo de la Barceloneta, 25-29, 08003 Barcelona, Spain
| |
Collapse
|
41
|
Mak GCK, Lau SSY, Wong KKY, Chow NLS, Lau CS, Lam ETK, Chan RCW, Tsang DNC. Comparison of analytical sensitivity of the eight rapid antigen detection kits for detecting SARS-CoV-2 virus. J Clin Virol 2021; 144:104994. [PMID: 34626879 PMCID: PMC8486682 DOI: 10.1016/j.jcv.2021.104994] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 09/09/2021] [Accepted: 09/29/2021] [Indexed: 10/25/2022]
Affiliation(s)
- Gannon C K Mak
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region, China.
| | - Stephen S Y Lau
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region, China
| | - Kitty K Y Wong
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region, China
| | - Nancy L S Chow
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region, China
| | - C S Lau
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region, China
| | - Edman T K Lam
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region, China
| | - Rickjason C W Chan
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region, China
| | - Dominic N C Tsang
- Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region, China
| |
Collapse
|
42
|
Jo SJ, Shin SH, Kim J, Lee S, Lee J. Evaluation of the clinical performance of a magnetic force-assisted electrochemical immunoassay for the detection of SARS-CoV-2 antigens. PLoS One 2021; 16:e0258394. [PMID: 34618868 DOI: 10.1371/journal.pone.0258394] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 09/24/2021] [Indexed: 12/23/2022] Open
Abstract
Rapid antigen (Ag) tests for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) provide quick results, do not require specialized technical skills or infrastructure, and can be used as a point-of-care method to prevent the spread of coronavirus disease (COVID-19). The performance of a magnetic force-assisted electrochemical immunoassay-based test, namely the MARK-B COVID-19 Ag test (BBB, Sungnam, Republic of Korea), was evaluated using 170 nasopharyngeal swab specimens and compared to that of RT-PCR and commercial rapid Ag test (STANDARD Q COVID-19 Ag Test, SD Biosensor, Suwon-si, Republic of Korea). The overall sensitivity and specificity of the MARK-B test were 90.0% (95% CI 79.4%–96.2%) and 99.0% (95% CI 95.0%–99.9%), respectively, with a kappa coefficient of 0.908. The correlations between the electrical current values of MARK-B and the Ct values of RT-PCR were −0.898 (E gene, 95% CI −0.938 to −0.834) and −0.914 (RdRp gene, 95% CI −0.948 to −0.860), respectively. The limit of detection of the MARK-B was measured using the viral culture reference samples and found to be 1 x 102 pfu/mL. The magnetic force-assisted electrochemical immunoassay-based Ag test can be used to rapidly detect SARS-CoV-2 infections, and the corresponding fully automated portable device can provide easy readability and semi-quantitative results.
Collapse
|
43
|
Parvu V, Gary DS, Mann J, Lin YC, Mills D, Cooper L, Andrews JC, Manabe YC, Pekosz A, Cooper CK. Factors that Influence the Reported Sensitivity of Rapid Antigen Testing for SARS-CoV-2. Front Microbiol 2021; 12:714242. [PMID: 34675892 PMCID: PMC8524138 DOI: 10.3389/fmicb.2021.714242] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 08/18/2021] [Indexed: 12/19/2022] Open
Abstract
Tests that detect the presence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) antigen in clinical specimens from the upper respiratory tract can provide a rapid means of coronavirus disease 2019 (COVID-19) diagnosis and help identify individuals who may be infectious and should isolate to prevent SARS-CoV-2 transmission. This systematic review assesses the diagnostic accuracy of SARS-CoV-2 antigen detection in COVID-19 symptomatic and asymptomatic individuals compared to quantitative reverse transcription polymerase chain reaction (RT-qPCR) and summarizes antigen test sensitivity using meta-regression. In total, 83 studies were included that compared SARS-CoV-2 rapid antigen-based lateral flow testing (RALFT) to RT-qPCR for SARS-CoV-2. Generally, the quality of the evaluated studies was inconsistent; nevertheless, the overall sensitivity for RALFT was determined to be 75.0% (95% confidence interval: 71.0-78.0). Additionally, RALFT sensitivity was found to be higher for symptomatic vs. asymptomatic individuals and was higher for a symptomatic population within 7 days from symptom onset compared to a population with extended days of symptoms. Viral load was found to be the most important factor for determining SARS-CoV-2 antigen test sensitivity. Other design factors, such as specimen storage and anatomical collection type, also affect the performance of RALFT. RALFT and RT-qPCR testing both achieve high sensitivity when compared to SARS-CoV-2 viral culture.
Collapse
Affiliation(s)
- Valentin Parvu
- Becton, Dickinson and Company, BD Life Sciences–Integrated Diagnostic Solutions, Sparks, MD, United States
| | - Devin S. Gary
- Becton, Dickinson and Company, BD Life Sciences–Integrated Diagnostic Solutions, Sparks, MD, United States
| | - Joseph Mann
- Becton, Dickinson and Company, BD Life Sciences–Integrated Diagnostic Solutions, Sparks, MD, United States
| | - Yu-Chih Lin
- Becton, Dickinson and Company, BD Life Sciences–Integrated Diagnostic Solutions, Sparks, MD, United States
| | - Dorsey Mills
- Becton, Dickinson and Company, BD Life Sciences–Integrated Diagnostic Solutions, Sparks, MD, United States
| | - Lauren Cooper
- Becton, Dickinson and Company, BD Life Sciences–Integrated Diagnostic Solutions, Sparks, MD, United States
| | - Jeffrey C. Andrews
- Becton, Dickinson and Company, BD Life Sciences–Integrated Diagnostic Solutions, Sparks, MD, United States
| | - Yukari C. Manabe
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Andrew Pekosz
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Charles K. Cooper
- Becton, Dickinson and Company, BD Life Sciences–Integrated Diagnostic Solutions, Sparks, MD, United States
| |
Collapse
|
44
|
Abstract
Introduction: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection is a major pandemic and continuously emerging due to unclear prognosis and unavailability of reliable detection tools. Older adults are more susceptible to COVID-19 than children showing mature Angiotensin-Converting Enzyme 2 (ACE2), low concentration of immune targets, and comorbid conditions. Several detection platforms have been commercialized to date and more are in pipeline, however, the rate of false-positive results and rapid mutation of SARS-CoV-2 is increasing. Additionally, physiological, and geographical variations of affected individuals are also calling for diagnostic methods optimization.Areas Covered: Extensive information related to the optimization and usefulness of SARS-CoV-2 diagnostic methods based on sensitivity and specificity as definitive and feasible investigative tools is discussed. Moreover, an option of combining laboratory diagnostic methods to improve diagnostic strategies is also proposed and discussed in the comparative section of optimization studies.Expert Opinion: The review article explains the importance of optimization strategies for SARS-CoV-2 detection in children and older adults. There are advancements in COVID-19 detection including CRISPR-based, electrochemical, and optical-based sensing systems. However, the lack of sufficient studies on a comparative evaluation of standardized SARS-CoV-2 diagnostic methods among children and older adults, limit the authentication of commercialized kits.
Collapse
Affiliation(s)
- Nidhi Chauhan
- Amity Institute of Nanotechnology (AINT), Amity University Uttar Pradesh (AUUP), Noida, India
| | - Shringika Soni
- Amity Institute of Nanotechnology (AINT), Amity University Uttar Pradesh (AUUP), Noida, India
| | - Utkarsh Jain
- Amity Institute of Nanotechnology (AINT), Amity University Uttar Pradesh (AUUP), Noida, India
| |
Collapse
|
45
|
Graham M, Ballard SA, Pasricha S, Lin B, Hoang T, Stinear T, Druce J, Catton M, Sherry N, Williamson D, Howden BP. Use of emerging testing technologies and approaches for SARS-CoV-2: review of literature and global experience in an Australian context. Pathology 2021; 53:689-699. [PMID: 34425991 PMCID: PMC8352662 DOI: 10.1016/j.pathol.2021.08.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 07/12/2021] [Accepted: 08/03/2021] [Indexed: 11/26/2022]
Abstract
Emerging testing technologies for detection of SARS-CoV-2 include those that are rapid and can be used at point-of-care (POC), and those facilitating high throughput laboratory-based testing. Tests designed to be performed at POC (such as antigen tests and molecular assays) have the potential to expedite isolation of infectious patients and their contacts, but most are less sensitive than standard-of-care reverse transcription polymerase chain reaction (RT-PCR). Data on clinical performance of the majority of emerging assays are limited with most evaluations performed on contrived or stored laboratory samples. Further evaluations of these assays are required, particularly when performed at POC on symptomatic and asymptomatic patients and at various time-points after symptom onset. A few studies have so far shown several of these assays have high specificity. However, large prospective evaluations are needed to confirm specificity, particularly before the assays are implemented in low prevalence settings or asymptomatic populations. High throughput laboratory-based testing includes the use of new sample types (e.g., saliva to increase acceptability) or innovative uses of existing technology (e.g., sample pooling). Information detailing population-wide testing strategies for SARS-COV-2 is largely missing from peer-reviewed literature. Logistics and supply chains are key considerations in any plan to 'scale up' testing in the Australian context. The strategic use of novel assays will help strike the balance between achieving adequate test numbers without overwhelming laboratory capacity. To protect testing of high-risk populations, the aims of testing with respect to the phase of the pandemic must be considered.
Collapse
Affiliation(s)
- Maryza Graham
- Microbiological Diagnostic Unit, Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia; Department of Microbiology and Infectious Diseases, Monash Health, Clayton, Vic, Australia.
| | - Susan A Ballard
- Microbiological Diagnostic Unit, Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia
| | - Shivani Pasricha
- Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia
| | - Belinda Lin
- Microbiological Diagnostic Unit, Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia
| | - Tuyet Hoang
- Microbiological Diagnostic Unit, Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia; Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia
| | - Timothy Stinear
- Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia
| | - Julian Druce
- Victorian Infectious Diseases Reference Laboratory, Melbourne Health at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia
| | - Mike Catton
- Victorian Infectious Diseases Reference Laboratory, Melbourne Health at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia
| | - Norelle Sherry
- Microbiological Diagnostic Unit, Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia; Department of Microbiology, Royal Melbourne Hospital, Parkville, Vic, Australia
| | - Deborah Williamson
- Microbiological Diagnostic Unit, Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia; Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia; Department of Microbiology, Royal Melbourne Hospital, Parkville, Vic, Australia
| | - Benjamin P Howden
- Microbiological Diagnostic Unit, Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia; Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Vic, Australia
| |
Collapse
|
46
|
Mak GCK, Au SSM, Yeung MCW, Lau DMW, Lau KKS, Ng KHL, Lam ETK, Chan RCW, Fan CYM. Evaluation of rapid antigen detection test for individuals at risk of SARS-CoV-2 under quarantine. J Med Virol 2021; 94:819-820. [PMID: 34590737 DOI: 10.1002/jmv.27369] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 09/23/2021] [Accepted: 09/28/2021] [Indexed: 11/06/2022]
Affiliation(s)
- Gannon C K Mak
- All from Department of Health, Hong Kong Special Administrative Region
| | - Shermen S M Au
- All from Department of Health, Hong Kong Special Administrative Region
| | - Mick C W Yeung
- All from Department of Health, Hong Kong Special Administrative Region
| | - Dominic M W Lau
- All from Department of Health, Hong Kong Special Administrative Region
| | - Kinson K S Lau
- All from Department of Health, Hong Kong Special Administrative Region
| | - Ken H L Ng
- All from Department of Health, Hong Kong Special Administrative Region
| | - Edman T K Lam
- All from Department of Health, Hong Kong Special Administrative Region
| | | | - Cecilia Y M Fan
- All from Department of Health, Hong Kong Special Administrative Region
| |
Collapse
|
47
|
Kyritsi M, Vontas A, Voulgaridi I, Matziri A, Komnos A, Babalis D, Papadogoulas A, Oikonomou A, Mouchtouri VA, Speletas M, Hadjichristodoulou C. Rapid Test Ag 2019-nCoV (PROGNOSIS, BIOTECH, Larissa, Greece); Performance Evaluation in Hospital Setting with Real Time RT-PCR. Int J Environ Res Public Health 2021; 18:9151. [PMID: 34501741 DOI: 10.3390/ijerph18179151] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/25/2021] [Accepted: 08/27/2021] [Indexed: 12/26/2022]
Abstract
Introduction: Rapid antigen tests (RATs) are convenient for SARS-CoV-2 detection because they are simpler and faster than nucleic acid amplification tests (NAATs). This study aimed to assess the accuracy of a locally manufactured test; Rapid Test Ag 2019-nCoV (PROGNOSIS, BIOTECH, Larissa, Greece) in a clinical setting and during mass screening. Methods: Nasopharyngeal samples from 624 individuals were analyzed. The results of the rapid test were compared to real-time reverse-transcription quantitative polymerase chain reaction (RT-qPCR). At the end of the test’s procedure, positive test strips were scanned in an S-Flow reader in order to roughly estimate the antigen concentration. Results: The lower limit of detection of the test was 468.75 genome copies/mL. The PROGNOSIS rapid test displayed a sensitivity of 85.5% (141/165) (95%CI: 79.1–90.5) and a specificity of 99.8% (458/459) (95%CI: 98.8–100.0%). The general inter-rater agreement was 0.89 (95%CI: 85.1–93.3). The regression analysis between the S-flow reader measurements (viral antigen) and the viral load of the positive samples demonstrated a weak correlation (R2 = 0.288, p < 0.001). Conclusion: The Rapid Test Ag 2019-nCoV demonstrated sufficient sensitivity, excellent specificity and could be available to be used with low overall cost. Thus, it could be used as point of care test, but also for mass screening for rapid detection of infected persons (e.g., for travelers).
Collapse
|
48
|
Toropov N, Osborne E, Joshi LT, Davidson J, Morgan C, Page J, Pepperell J, Vollmer F. SARS-CoV-2 Tests: Bridging the Gap between Laboratory Sensors and Clinical Applications. ACS Sens 2021; 6:2815-2837. [PMID: 34392681 PMCID: PMC8386036 DOI: 10.1021/acssensors.1c00612] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 07/28/2021] [Indexed: 12/15/2022]
Abstract
This review covers emerging biosensors for SARS-CoV-2 detection together with a review of the biochemical and clinical assays that are in use in hospitals and clinical laboratories. We discuss the gap in bridging the current practice of testing laboratories with nucleic acid amplification methods, and the robustness of assays the laboratories seek, and what emerging SARS-CoV-2 sensors have currently addressed in the literature. Together with the established nucleic acid and biochemical tests, we review emerging technology and antibody tests to determine the effectiveness of vaccines on individuals.
Collapse
Affiliation(s)
- Nikita Toropov
- Living
Systems Institute, University of Exeter, Exeter EX4 4QD, United Kingdom
| | - Eleanor Osborne
- Living
Systems Institute, University of Exeter, Exeter EX4 4QD, United Kingdom
| | | | - James Davidson
- Somerset
Lung Centre, Musgrove Park Hospital, Parkfield Drive, Taunton TA1 5DA, United Kingdom
| | - Caitlin Morgan
- Somerset
Lung Centre, Musgrove Park Hospital, Parkfield Drive, Taunton TA1 5DA, United Kingdom
| | - Joseph Page
- Somerset
Lung Centre, Musgrove Park Hospital, Parkfield Drive, Taunton TA1 5DA, United Kingdom
| | - Justin Pepperell
- Somerset
Lung Centre, Musgrove Park Hospital, Parkfield Drive, Taunton TA1 5DA, United Kingdom
| | - Frank Vollmer
- Living
Systems Institute, University of Exeter, Exeter EX4 4QD, United Kingdom
| |
Collapse
|
49
|
Bohn MK, Lippi G, Horvath AR, Erasmus R, Grimmler M, Gramegna M, Mancini N, Mueller R, Rawlinson WD, Menezes ME, Patru MM, Rota F, Sethi S, Singh K, Yuen KY, Wang CB, Adeli K. IFCC interim guidelines on rapid point-of-care antigen testing for SARS-CoV-2 detection in asymptomatic and symptomatic individuals. Clin Chem Lab Med 2021; 59:1507-1515. [PMID: 33908222 DOI: 10.1515/cclm-2021-0455] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 04/16/2021] [Indexed: 12/16/2022]
Abstract
With an almost unremittent progression of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections all around the world, there is a compelling need to introduce rapid, reliable, and high-throughput testing to allow appropriate clinical management and/or timely isolation of infected individuals. Although nucleic acid amplification testing (NAAT) remains the gold standard for detecting and theoretically quantifying SARS-CoV-2 mRNA in various specimen types, antigen assays may be considered a suitable alternative, under specific circumstances. Rapid antigen tests are meant to detect viral antigen proteins in biological specimens (e.g. nasal, nasopharyngeal, saliva), to indicate current SARS-CoV-2 infection. The available assay methodology includes rapid chromatographic immunoassays, used at the point-of-care, which carries some advantages and drawbacks compared to more conventional, instrumentation-based, laboratory immunoassays. Therefore, this document by the International Federation for Clinical Chemistry and Laboratory Medicine (IFCC) Taskforce on COVID-19 aims to summarize available data on the performance of currently available SARS-CoV-2 antigen rapid detection tests (Ag-RDTs), providing interim guidance on clinical indications and target populations, assay selection, and evaluation, test interpretation and limitations, as well as on pre-analytical considerations. This document is hence mainly aimed to assist laboratory and regulated health professionals in selecting, validating, and implementing regulatory approved Ag-RDTs.
Collapse
Affiliation(s)
- Mary Kathryn Bohn
- Department of Paediatric Laboratory Medicine, CALIPER Program, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | | | - Andrea R Horvath
- Department of Clinical Chemistry, NSW Health Pathology, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Rajiv Erasmus
- Stellenbosch University, Cape Town, Western Cape, Republic of South Africa
| | | | | | | | | | - William D Rawlinson
- Department of Virology, NSW Health Pathology, Prince of Wales Hospital, Sydney, NSW, Australia
| | | | | | | | - Sunil Sethi
- National University Hospital, Singapore, Singapore
| | | | | | | | - Khosrow Adeli
- Department of Paediatric Laboratory Medicine, CALIPER Program, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | | |
Collapse
|
50
|
Khandker SS, Nik Hashim NHH, Deris ZZ, Shueb RH, Islam MA. Diagnostic Accuracy of Rapid Antigen Test Kits for Detecting SARS-CoV-2: A Systematic Review and Meta-Analysis of 17,171 Suspected COVID-19 Patients. J Clin Med 2021; 10:3493. [PMID: 34441789 DOI: 10.3390/jcm10163493] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/05/2021] [Accepted: 08/06/2021] [Indexed: 01/08/2023] Open
Abstract
Early diagnosis is still as crucial as the initial stage of the COVID-19 pandemic. As RT-PCR sometimes is not feasible in developing nations or rural areas, health professionals may use a rapid antigen test (RAT) to lessen the load of diagnosis. However, the efficacy of RAT is yet to be investigated thoroughly. Hence, we tried to evaluate the overall performance of RAT in SARS-CoV-2 diagnosis. Based on our PROSPERO registered protocol (CRD42021231432), we searched online databases (i.e., PubMed, Google Scholar, Scopus, and Web of Science) and analysed overall pooled specificity and sensitivity of RAT along with study quality, publication bias, heterogeneity and more. The overall pooled specificity and sensitivity of RAT were detected as 99.4% (95% CI: 99.1–99.8; I2 = 90%) and 68.4% (95% CI: 60.8–75.9; I2 = 98%), respectively. In subgroup analyses, nasopharyngeal specimens and symptomatic patient’s samples were more sensitive in RAT, while cycle threshold (Ct) values were found to have an inverse relationship with sensitivity. In the European and American populations, RAT showed better performance. Although the sensitivity of RAT is yet to be improved, it could still be an alternative in places with poor laboratory set up. Nevertheless, the negative samples of RAT can be re-tested using RT-PCR to reduce false negative results.
Collapse
|