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Krüger LJ, Lindner AK, Gaeddert M, Tobian F, Klein J, Steinke S, Lainati F, Schnitzler P, Nikolai O, Mockenhaupt FP, Seybold J, Corman VM, Jones TC, Pollock NR, Knorr B, Welker A, Weber S, Sethurarnan N, Swaminathan J, Solomon H, Padmanaban A, Thirunarayan M, L P, de Vos M, Ongarello S, Sacks JA, Escadafal C, Denkinger CM. A Multicenter Clinical Diagnostic Accuracy Study of SureStatus, an Affordable, WHO Emergency Use-Listed, Rapid, Point-Of-Care Antigen-Detecting Diagnostic Test for SARS-CoV-2. Microbiol Spectr 2022; 10:e0122922. [PMID: 36066256 PMCID: PMC9604065 DOI: 10.1128/spectrum.01229-22] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 08/04/2022] [Indexed: 12/30/2022] Open
Abstract
Access to reverse transcription-PCR (RT-PCR) testing, the gold standard for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection, is limited throughout the world, due to restricted resources, available infrastructure, and high costs. Antigen-detecting rapid diagnostic tests (Ag-RDTs) overcome some of these barriers, but independent clinical validations in settings of intended use are scarce. To inform the World Health Organization's (WHO) emergency use listing (EUL) procedure and ensure affordable, high-quality Ag-RDTs, we assessed the performance and ease of use of the SureStatus for SARS-CoV-2. For this prospective, multicenter diagnostic accuracy study, we recruited unvaccinated participants with presumed SARS-CoV-2 infection in India and Germany from December 2020 to March 2021, when the Alpha (B.1.1.7) variant was predominantly circulating. Paired swabs were performed for (i) routine clinical RT-PCR testing (sampling was either nasopharyngeal [NP] or combined NP and oropharyngeal [NP/OP]) and (ii) Ag-RDT (sampling was NP). Performance of the Ag-RDT was compared to RT-PCR overall and by predefined subgroups, e.g., cycle threshold (CT) value, symptoms, and days from symptom onset. To understand the usability, a system usability scale (SUS) questionnaire and ease-of-use (EoU) assessment were performed. A total of 1,119 participants were included in the analysis, of whom 205 (18.3%) were RT-PCR positive. SureStatus detected 169 out of 205 RT-PCR-positive participants, reporting a sensitivity of 82.4% (95% confidence interval [CI]: 76.6% to 87.1%) and a specificity of 98.5% (95% CI: 97.4% to 99.1%). In the first 7 days post-symptom onset, the sensitivity was 90.7% (95% CI: 83.5% to 94.9%), when CT values were low and viral loads were high. The test was characterized as easy to use (SUS, 85/100) and considered suitable for point-of-care settings, although quality concerns were raised due to visibly contaminated packaging of swabs included in the test kits. The SureStatus diagnostic test can be considered a reliable test during the first week of SARS-CoV-2 infection, with high sensitivity in combination with excellent usability. IMPORTANCE Our manufacturer-independent, prospective diagnostic accuracy study assessed clinical performance in participants presumed to have a SARS-CoV-2 infection at three study sites in two countries. We assessed the accuracy overall and in predefined subgroups (CT values and symptom duration). SureStatus performed with high sensitivity. Its sensitivity was particularly high in the first 3 days after symptom onset and when CT values were low (i.e., the viral load was high). The system usability and ease-of-use assessment complements the accuracy assessment of the test and highlights critical factors to facilitate the widespread use of SureStatus in point-of-care settings. The high sensitivity demonstrated by the evaluated Ag-RDT within the first days of symptoms, when most transmission occurs, supports the role of Ag-RDTs for public health-relevant screening. Evidence from this study was used to inform the World Health Organization Emergency Use Listing procedure.
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Affiliation(s)
- Lisa J. Krüger
- Division of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Andreas K. Lindner
- Charité—Universitätsmedizin Berlin, Institute of Tropical Medicine and International Health, Berlin, Germany
| | - Mary Gaeddert
- Division of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Frank Tobian
- Division of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Julian Klein
- Division of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Salome Steinke
- Division of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Federica Lainati
- Division of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Paul Schnitzler
- Virology, Heidelberg University Hospital, Heidelberg, Germany
| | - Olga Nikolai
- Charité—Universitätsmedizin Berlin, Institute of Tropical Medicine and International Health, Berlin, Germany
| | - Frank P. Mockenhaupt
- Charité—Universitätsmedizin Berlin, Institute of Tropical Medicine and International Health, Berlin, Germany
| | - Joachim Seybold
- Charité—Universitätsmedizin Berlin, Medical Directorate, Berlin, Germany
| | - Victor M. Corman
- Charité—Universitätsmedizin Berlin, Institute of Virology, Berlin, Germany
- German Center for Infection Research (DZIF), Charité Partner Site, Berlin, Germany
| | - Terry C. Jones
- Charité—Universitätsmedizin Berlin, Institute of Virology, Berlin, Germany
- German Center for Infection Research (DZIF), Charité Partner Site, Berlin, Germany
- Center for Pathogen Evolution, Department of Zoology, University of Cambridge, Cambridge, United Kingdom
| | - Nira R. Pollock
- Department of Laboratory Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Britta Knorr
- Department of Public Health Rhein Neckar Region, Heidelberg, Germany
| | - Andreas Welker
- Department of Public Health Rhein Neckar Region, Heidelberg, Germany
| | | | | | | | | | | | | | - Prabakaran L
- Foundation of Innovative New Diagnostics (FIND), New Delhi, India
| | - Margaretha de Vos
- Foundation of Innovative New Diagnostics (FIND), Campus Biotech, Geneva, Switzerland
| | - Stefano Ongarello
- Foundation of Innovative New Diagnostics (FIND), Campus Biotech, Geneva, Switzerland
| | - Jilian A. Sacks
- Foundation of Innovative New Diagnostics (FIND), Campus Biotech, Geneva, Switzerland
| | - Camille Escadafal
- Foundation of Innovative New Diagnostics (FIND), Campus Biotech, Geneva, Switzerland
| | - Claudia M. Denkinger
- Division of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany
- German Center for Infection Research (DZIF), Heidelberg University Hospital Partner Site, Heidelberg, Germany
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Krüger LJ, Tanuri A, Lindner AK, Gaeddert M, Köppel L, Tobian F, Brümmer LE, Klein JAF, Lainati F, Schnitzler P, Nikolai O, Mockenhaupt FP, Seybold J, Corman VM, Jones TC, Drosten C, Gottschalk C, Weber SF, Weber S, Ferreira OC, Mariani D, Dos Santos Nascimento ER, Pereira Pinto Castineiras TM, Galliez RM, Faffe DS, Leitão IDC, Dos Santos Rodrigues C, Frauches TS, Nocchi KJCV, Feitosa NM, Ribeiro SS, Pollock NR, Knorr B, Welker A, de Vos M, Sacks J, Ongarello S, Denkinger CM. Accuracy and ease-of-use of seven point-of-care SARS-CoV-2 antigen-detecting tests: A multi-centre clinical evaluation. EBioMedicine 2022; 75:103774. [PMID: 34959134 PMCID: PMC8702380 DOI: 10.1016/j.ebiom.2021.103774] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/02/2021] [Accepted: 12/09/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Antigen-detecting rapid diagnostic tests (Ag-RDTs) for SARS-CoV-2 are important diagnostic tools. We assessed clinical performance and ease-of-use of seven Ag-RDTs in a prospective, manufacturer-independent, multi-centre cross-sectional diagnostic accuracy study to inform global decision makers. METHODS Unvaccinated participants suspected of a first SARS-CoV-2 infection were recruited at six sites (Germany, Brazil). Ag-RDTs were evaluated sequentially, with collection of paired swabs for routine reverse transcription polymerase chain reaction (RT-PCR) testing and Ag-RDT testing. Performance was compared to RT-PCR overall and in sub-group analyses (viral load, symptoms, symptoms duration). To understandusability a System Usability Scale (SUS) questionnaire and ease-of-use (EoU) assessment were performed. FINDINGS 7471 participants were included in the analysis. Sensitivities across Ag-RDTs ranged from 70·4%-90·1%, specificities were above 97·2% for all Ag-RDTs but one (93·1%).Ag-RDTs, Mologic, Bionote, Standard Q, showed diagnostic accuracy in line with WHO targets (> 80% sensitivity, > 97% specificity). All tests showed high sensitivity in the first three days after symptom onset (≥87·1%) and in individuals with viral loads≥ 6 log10SARS-CoV2 RNA copies/mL (≥ 88·7%). Usability varied, with Rapigen, Bionote and Standard Q reaching very good scores; 90, 88 and 84/100, respectively. INTERPRETATION Variability in test performance is partially explained by variable viral loads in population evaluated over the course of the pandemic. All Ag-RDTs reach high sensitivity early in the disease and in individuals with high viral loads, supporting their role in identifying transmission relevant infections. For easy-to-use tests, performance shown will likely be maintained in routine implementation. FUNDING Ministry of Science, Research and Arts, State of Baden-Wuerttemberg, Germany, internal funds from Heidelberg University Hospital, University Hospital Charité - Universitätsmedizin Berlin, UK Department of International Development, WHO, Unitaid.
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Affiliation(s)
- Lisa J Krüger
- Division of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 324, Heidelberg 69120, Germany
| | - Amilcar Tanuri
- Laboratório de Virologia Molecular, Instituto de Biologia - Departamento de Genética, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Cidade Universitária, Rio de Janeiro, RJ 21941-902, Brazil
| | - Andreas K Lindner
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Tropical Medicine and International Health, Augustenburger Pl. 1, Berlin 13353, Germany
| | - Mary Gaeddert
- Division of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 324, Heidelberg 69120, Germany
| | - Lisa Köppel
- Division of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 324, Heidelberg 69120, Germany
| | - Frank Tobian
- Division of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 324, Heidelberg 69120, Germany
| | - Lukas E Brümmer
- Division of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 324, Heidelberg 69120, Germany
| | - Julian A F Klein
- Division of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 324, Heidelberg 69120, Germany
| | - Federica Lainati
- Division of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 324, Heidelberg 69120, Germany
| | - Paul Schnitzler
- Virology, Heidelberg University Hospital, Im Neuenheimer Feld 324, Heidelberg 69120, Germany
| | - Olga Nikolai
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Tropical Medicine and International Health, Augustenburger Pl. 1, Berlin 13353, Germany
| | - Frank P Mockenhaupt
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Tropical Medicine and International Health, Augustenburger Pl. 1, Berlin 13353, Germany
| | - Joachim Seybold
- Medical Directorate, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Pl. 1, Berlin 13353, Germany
| | - Victor M Corman
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Virology, Rahel-Hirsch-Weg 3, Berlin 10117, Germany; German Centre for Infection Research (DZIF), Partner Site Charité, Charitépl. 1, Berlin 10117, Germany
| | - Terence C Jones
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Virology, Rahel-Hirsch-Weg 3, Berlin 10117, Germany; German Centre for Infection Research (DZIF), Partner Site Charité, Charitépl. 1, Berlin 10117, Germany; Centre for Pathogen Evolution, Department of Zoology, University of Cambridge, Downing Street, Cambridge CB2 3EJ, UK
| | - Christian Drosten
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Virology, Rahel-Hirsch-Weg 3, Berlin 10117, Germany; German Centre for Infection Research (DZIF), Partner Site Charité, Charitépl. 1, Berlin 10117, Germany
| | - Claudius Gottschalk
- Division of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 324, Heidelberg 69120, Germany
| | - Stefan F Weber
- Division of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 324, Heidelberg 69120, Germany
| | - Stephan Weber
- Acomed Statistik, Fockestraße 57, Leipzig 04275, Germany
| | - Orlando C Ferreira
- Laboratório de Virologia Molecular, Instituto de Biologia - Departamento de Genética, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Cidade Universitária, Rio de Janeiro, RJ 21941-902, Brazil
| | - Diana Mariani
- Laboratório de Virologia Molecular, Instituto de Biologia - Departamento de Genética, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Cidade Universitária, Rio de Janeiro, RJ 21941-902, Brazil
| | - Erika Ramos Dos Santos Nascimento
- Laboratório de Virologia Molecular, Instituto de Biologia - Departamento de Genética, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Cidade Universitária, Rio de Janeiro, RJ 21941-902, Brazil
| | - Terezinha M Pereira Pinto Castineiras
- Departamento de Doenças Infecciosas e Parasitárias, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Cidade Universitária, Rio de Janeiro, RJ 21941-902, Brazil
| | - Rafael Mello Galliez
- Departamento de Doenças Infecciosas e Parasitárias, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Cidade Universitária, Rio de Janeiro, RJ 21941-902, Brazil
| | - Debora Souza Faffe
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Cidade Universitária, Rio de Janeiro, RJ 21941-902, Brazil
| | - Isabela de Carvalho Leitão
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Cidade Universitária, Rio de Janeiro, RJ 21941-902, Brazil
| | - Claudia Dos Santos Rodrigues
- Serviço de Atendimento Especializado / Centro de Testagem e Aconselhamento, Avenida Roberto Silveira, 46 - 3° Andar, Maricá, Brazil
| | - Thiago Silva Frauches
- Laboratório Central Dr. Francisco Rímolo Neto, R. Álvares de Castro, n° 346, Maricá, RJ 24900-880, Brazil
| | | | - Natalia Martins Feitosa
- Instituto de Biodiversidade e Sustantabilidade NUPEM, Universidade Federal do Rio de Janeiro, Campus Macaé, Av. São José Barreto, 764 - São José do Barreto, Macaé, RJ 27965-045, Brazil
| | - Sabrina Santana Ribeiro
- Secretaria Municipal de Saúde de Guapimirim, Rua Pastor Francisco Antônio Rosa - S/N, Guapimirim, RJ 25946-253, Brazil
| | - Nira R Pollock
- Department of Laboratory Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, United States
| | - Britta Knorr
- Department Public Health Rhein Neckar Region, Kurfürsten-Anlage 38-40, Heidelberg 69115, Germany
| | - Andreas Welker
- Department Public Health Rhein Neckar Region, Kurfürsten-Anlage 38-40, Heidelberg 69115, Germany
| | - Margaretha de Vos
- FIND, Campus Biotech, Building B, Level 0, Chemin des Mines 9, Geneva 1202, Switzerland
| | - JilianA Sacks
- FIND, Campus Biotech, Building B, Level 0, Chemin des Mines 9, Geneva 1202, Switzerland
| | - Stefano Ongarello
- FIND, Campus Biotech, Building B, Level 0, Chemin des Mines 9, Geneva 1202, Switzerland
| | - Claudia M Denkinger
- Division of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 324, Heidelberg 69120, Germany; German Centre for Infection Research (DZIF), Partner Site Heidelberg University Hospital, Im Neuenheimer Feld 672, Heidelberg 69120, Germany.
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Herrmann Y, Lainati F, Castro MDM, Mwamba CP, Kumwenda M, Muyoyeta M, Broger T, Heinrich N, Olbrich L, Corbett EL, McMahon SA, Engel N, Denkinger CM. User perspectives and preferences on a novel TB LAM diagnostic (Fujifilm SILVAMP TB LAM)-a qualitative study in Malawi and Zambia. PLOS Glob Public Health 2022; 2:e0000672. [PMID: 36962216 PMCID: PMC10021253 DOI: 10.1371/journal.pgph.0000672] [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] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 05/30/2022] [Indexed: 11/18/2022]
Abstract
Widely available tuberculosis (TB) diagnostics use sputum samples. However, many patients, particularly children and patients living with HIV (PLHIV), struggle to provide sputum. Urine diagnostics are a promising approach to circumvent this challenge while delivering reliable and timely diagnosis. This qualitative study in two high TB/HIV burden countries assesses values and preferences of end-users, along with potential barriers for the implementation of the novel Fujifilm SILVAMP TB-LAM (FujiLAM, Fujifilm, Japan) urine test. Between September 2020 and March 2021, we conducted 42 semi-structured interviews with patients, health care providers (HCPs) and decision makers (DMs) (e.g., in national TB programs) in Malawi and Zambia. Interviews were transcribed verbatim and analyzed using a framework approach supported by NVIVO. Findings aligned with the pre-existing Health Equity Implementation Framework, which guided the presentation of results. The ease and convenience of urine-based testing was described as empowering among patients and HCPs who lamented the difficulty of sputum collection, however HCPs expressed concerns that a shift in agency to the patient may affect clinic workflows (e.g., due to less control over collection). Implementation facilitators, such as shorter turnaround times, were welcomed by operators and patients alike. The decentralization of diagnostics was considered possible with FujiLAM by HCPs and DMs due to low infrastructure requirements. Finally, our findings support efforts for eliminating the CD4 count as an eligibility criterion for LAM testing, to facilitate implementation and benefit a wider range of patients. Our study identified barriers and facilitators relevant to scale-up of urine LAM tests in Malawi and Zambia. FujiLAM could positively impact health equity, as it would particularly benefit patient groups currently underserved by existing TB diagnostics. Participants view the approach as a viable, acceptable, and likely sustainable option in low- and middle-income countries, though adaptations may be required to current health care processes for deployment. Trial registration: German Clinical Trials Register, DRKS00021003. URL: https://www.drks.de/drks_web/setLocale_EN.do.
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Affiliation(s)
- Yannis Herrmann
- Division of Clinical Infectious Disease and Tropical Medicine, Centre for Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Federica Lainati
- Division of Clinical Infectious Disease and Tropical Medicine, Centre for Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - María Del Mar Castro
- Division of Clinical Infectious Disease and Tropical Medicine, Centre for Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Chanda P Mwamba
- Centre for Infectious Disease Research in Zambia, Social & Behavioural Science Group, Lusaka, Zambia
| | - Moses Kumwenda
- Malawi-Liverpool-Wellcome Clinical Research Programme (MLW), Public Health Group, Blantyre, Malawi
| | - Monde Muyoyeta
- Centre for Infectious Disease Research in Zambia, Tuberculosis Department, Lusaka, Zambia
| | - Tobias Broger
- Division of Clinical Infectious Disease and Tropical Medicine, Centre for Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Norbert Heinrich
- Division for Infectious Diseases, LMU Hospital, Munich, Germany
- German Centre for Infection Research (DZIF), Partner Site Munich, Munich, Germany
| | - Laura Olbrich
- Division for Infectious Diseases, LMU Hospital, Munich, Germany
- German Centre for Infection Research (DZIF), Partner Site Munich, Munich, Germany
| | - Elizabeth L Corbett
- London School of Hygiene and Tropical Medicine, Infectious and Tropical Diseases, London, United Kingdom
| | - Shannon A McMahon
- Heidelberg University Hospital, Heidelberg Institute of Global Health, Heidelberg, Germany
- International Health Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Nora Engel
- Maastricht University, Department of Health, Ethics & Society, Research School for Public Health and Primary Care, Maastricht, The Netherlands
| | - Claudia M Denkinger
- Division of Clinical Infectious Disease and Tropical Medicine, Centre for Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
- German Centre for Infection Research (DZIF), Partner Site Heidelberg University Hospital, Heidelberg, Germany
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Nikolai O, Rohardt C, Tobian F, Junge A, Corman VM, Jones TC, Gaeddert M, Lainati F, Sacks JA, Seybold J, Mockenhaupt FP, Denkinger CM, Lindner AK. Anterior nasal versus nasal mid-turbinate sampling for a SARS-CoV-2 antigen-detecting rapid test: does localisation or professional collection matter? Infect Dis (Lond) 2021; 53:947-952. [PMID: 34445926 PMCID: PMC8425459 DOI: 10.1080/23744235.2021.1969426] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 07/01/2021] [Accepted: 08/12/2021] [Indexed: 11/02/2022] Open
Abstract
INTRODUCTION Most SARS-CoV-2 antigen-detecting rapid diagnostic tests require nasopharyngeal sampling, which is frequently perceived as uncomfortable and requires healthcare professionals, thus limiting scale-up. Nasal sampling could enable self-sampling and increase acceptability. The term nasal sampling is often not used uniformly and sampling protocols differ. METHODS This manufacturer-independent, prospective diagnostic accuracy study, compared professional anterior nasal and nasal mid-turbinate sampling for a WHO-listed SARS-CoV-2 antigen-detecting rapid diagnostic test. The second group of participants collected a nasal mid-turbinate sample themselves and underwent a professional nasopharyngeal swab for comparison. The reference standard was real-time polymerase chain reaction (RT-PCR) using combined oro-/nasopharyngeal sampling. Individuals with high suspicion of SARS-CoV-2 infection were tested. Sensitivity, specificity, and percent agreement were calculated. Self-sampling was observed without intervention. Feasibility was evaluated by observer and participant questionnaires. RESULTS Among 132 symptomatic adults, both professional anterior nasal and nasal mid-turbinate sampling yielded a sensitivity of 86.1% (31/36 RT-PCR positives detected; 95%CI: 71.3-93.9) and a specificity of 100.0% (95%CI: 95.7-100). The positive percent agreement was 100% (95%CI: 89.0-100). Among 96 additional adults, self nasal mid-turbinate and professional nasopharyngeal sampling yielded an identical sensitivity of 91.2% (31/34; 95%CI 77.0-97.0). Specificity was 98.4% (95%CI: 91.4-99.9) with nasal mid-turbinate and 100.0% (95%CI: 94.2-100) with nasopharyngeal sampling. The positive percent agreement was 96.8% (95%CI: 83.8-99.8). Most participants (85.3%) considered self-sampling as easy to perform. CONCLUSION Professional anterior nasal and nasal mid-turbinate sampling are of equivalent accuracy for an antigen-detecting rapid diagnostic test in ambulatory symptomatic adults. Participants were able to reliably perform nasal mid-turbinate sampling themselves, following written and illustrated instructions. Nasal self-sampling will facilitate scaling of SARS-CoV-2 antigen testing.
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Affiliation(s)
- Olga Nikolai
- Charité – Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Tropical Medicine and International Health, Berlin, Germany
| | - Chiara Rohardt
- Charité – Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Tropical Medicine and International Health, Berlin, Germany
| | - Frank Tobian
- Division of Clinical Tropical Medicine, Center of Infectious Diseases, Heidelberg University Hospital, Germany
| | - Andrea Junge
- Charité – Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Tropical Medicine and International Health, Berlin, Germany
| | - Victor M. Corman
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Virology, Berlin, Germany
- partner site Charité, German Centre for Infection Research (DZIF), Berlin, Germany
| | - Terry C. Jones
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Virology, Berlin, Germany
- partner site Charité, German Centre for Infection Research (DZIF), Berlin, Germany
- Centre for Pathogen Evolution, Department of Zoology, University of Cambridge, Cambridge, UK
| | - Mary Gaeddert
- Division of Clinical Tropical Medicine, Center of Infectious Diseases, Heidelberg University Hospital, Germany
| | - Federica Lainati
- Division of Clinical Tropical Medicine, Center of Infectious Diseases, Heidelberg University Hospital, Germany
| | - Jilian A. Sacks
- Foundation for Innovative New Diagnostics, Geneva, Switzerland
| | - Joachim Seybold
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Medical Directorate, Berlin, Germany
| | - Frank P. Mockenhaupt
- Charité – Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Tropical Medicine and International Health, Berlin, Germany
| | - Claudia M. Denkinger
- Division of Clinical Tropical Medicine, Center of Infectious Diseases, Heidelberg University Hospital, Germany
- German Centre for Infection Research (DZIF) partner site Heidelberg, Heidelberg, Germany
| | - Andreas K. Lindner
- Charité – Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Tropical Medicine and International Health, Berlin, Germany
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Klein JAF, Krüger LJ, Tobian F, Gaeddert M, Lainati F, Schnitzler P, Lindner AK, Nikolai O, Knorr B, Welker A, de Vos M, Sacks JA, Escadafal C, Denkinger CM. Head-to-head performance comparison of self-collected nasal versus professional-collected nasopharyngeal swab for a WHO-listed SARS-CoV-2 antigen-detecting rapid diagnostic test. Med Microbiol Immunol 2021; 210:181-186. [PMID: 34028625 PMCID: PMC8142294 DOI: 10.1007/s00430-021-00710-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/05/2021] [Indexed: 01/25/2023]
Abstract
In 2020, the World Health Organization (WHO) recommended two SARS-CoV-2 lateral flow antigen-detecting rapid diagnostics tests (Ag-RDTs), both initially with nasopharyngeal (NP) sample collection. Independent head-to-head studies are necessary for SARS-CoV-2 Ag-RDT nasal sampling to demonstrate comparability of performance with nasopharyngeal (NP) sampling. We conducted a head-to-head comparison study of a supervised, self-collected nasal mid-turbinate (NMT) swab and a professional-collected NP swab, using the Panbio™ Ag-RDT (distributed by Abbott). We calculated positive and negative percent agreement between the sampling methods as well as sensitivity and specificity for both sampling techniques compared to the reference standard reverse transcription polymerase chain reaction (RT-PCR). A SARS-CoV-2 infection could be diagnosed by RT-PCR in 45 of 290 participants (15.5%). Comparing the NMT and NP sampling the positive percent agreement of the Ag-RDT was 88.1% (37/42 PCR positives detected; CI 75.0-94.8%). The negative percent agreement was 98.8% (245/248; CI 96.5-99.6%). The overall sensitivity of Panbio with NMT sampling was 84.4% (38/45; CI 71.2-92.3%) and 88.9% (40/45; CI 76.5-95.5%) with NP sampling. Specificity was 99.2% (243/245; CI 97.1-99.8%) for both, NP and NMT sampling. The sensitivity of the Panbio test in participants with high viral load (> 7 log10 SARS-CoV-2 RNA copies/mL) was 96.3% (CI 81.7-99.8%) for both, NMT and NP sampling. For the Panbio supervised NMT self-sampling yields comparable results to NP sampling. This suggests that nasal self-sampling could be used for to enable scaled-up population testing.Clinical Trial DRKS00021220.
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Affiliation(s)
- Julian A F Klein
- Division of Clinical Tropical Medicine, Centre of Infectious Diseases, Heidelberg University Hospital, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany
| | - Lisa J Krüger
- Division of Clinical Tropical Medicine, Centre of Infectious Diseases, Heidelberg University Hospital, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany
| | - Frank Tobian
- Division of Clinical Tropical Medicine, Centre of Infectious Diseases, Heidelberg University Hospital, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany
| | - Mary Gaeddert
- Division of Clinical Tropical Medicine, Centre of Infectious Diseases, Heidelberg University Hospital, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany
| | - Federica Lainati
- Division of Clinical Tropical Medicine, Centre of Infectious Diseases, Heidelberg University Hospital, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany
| | - Paul Schnitzler
- Department of Virology, Centre of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Andreas K Lindner
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Tropical Medicine and International Health, Berlin, Germany
| | - Olga Nikolai
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Tropical Medicine and International Health, Berlin, Germany
| | - B Knorr
- Local Health Authority of Heidelberg and Rhein-Neckar-Region, Heidelberg, Germany
| | - A Welker
- Local Health Authority of Heidelberg and Rhein-Neckar-Region, Heidelberg, Germany
| | | | - Jilian A Sacks
- Foundation for Innovative New Diagnostics, Geneva, Switzerland
| | | | - Claudia M Denkinger
- Division of Clinical Tropical Medicine, Centre of Infectious Diseases, Heidelberg University Hospital, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany.
- German Centre for Infection Research (DZIF), 69120, Heidelberg, Germany.
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6
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Lindner AK, Nikolai O, Rohardt C, Kausch F, Wintel M, Gertler M, Burock S, Hörig M, Bernhard J, Tobian F, Gaeddert M, Lainati F, Corman VM, Jones TC, Sacks JA, Seybold J, Denkinger CM, Mockenhaupt FP. Diagnostic accuracy and feasibility of patient self-testing with a SARS-CoV-2 antigen-detecting rapid test. J Clin Virol 2021; 141:104874. [PMID: 34144452 PMCID: PMC8163726 DOI: 10.1016/j.jcv.2021.104874] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [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: 03/26/2021] [Revised: 05/20/2021] [Accepted: 05/22/2021] [Indexed: 01/02/2023]
Abstract
Background Considering the possibility of nasal self-sampling and the ease of use in performing SARS-CoV-2 antigen-detecting rapid diagnostic tests (Ag-RDTs), self-testing is a feasible option. Objective The goal of this study was a head-to-head comparison of diagnostic accuracy of patient self-testing with professional testing using a SARS-CoV-2 Ag-RDT. Study design We performed a manufacturer-independent, prospective diagnostic accuracy study of nasal mid-turbinate self-sampling and self-testing with symptomatic adults using a WHO-listed SARS-CoV-2 Ag-RDT. Procedures were observed without intervention. For comparison, Ag-RDTs with nasopharyngeal sampling were professionally performed. Estimates of agreement, sensitivity, and specificity relative to RT-PCR on a combined oro-/nasopharyngeal sample were calculated. Feasibility was evaluated by observer and participant questionnaires. Results Among 146 symptomatic adults, 40 (27.4%) were RT-PCR-positive for SARS-CoV-2. Sensitivity with self-testing was 82.5% (33/40; 95% CI 68.1–91.3), and 85.0% (34/40; 95% CI 70.9–92.9) with professional testing. At high viral load (≥7.0 log10 SARS-CoV-2 RNA copies/ml), sensitivity was 96.6% (28/29; 95% CI 82.8–99.8) for both self- and professional testing. Deviations in sampling and testing were observed in 25 out of the 40 PCR-positives. Most participants (80.9%) considered the Ag-RDT as easy to perform. Conclusion Laypersons suspected for SARS-CoV-2 infection were able to reliably perform the Ag-RDT and test themselves. Procedural errors might be reduced by refinement of the instructions for use or the product design/procedures. Self-testing allows more wide-spread and frequent testing. Paired with the appropriate information of the public about the benefits and risks, self-testing may have significant impact on the pandemic.
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Affiliation(s)
- Andreas K Lindner
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Institute of Tropical Medicine and International Health, Am Augustenburger Platz 1, 13353 Berlin, Germany.
| | - Olga Nikolai
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Institute of Tropical Medicine and International Health, Am Augustenburger Platz 1, 13353 Berlin, Germany
| | - Chiara Rohardt
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Institute of Tropical Medicine and International Health, Am Augustenburger Platz 1, 13353 Berlin, Germany
| | - Franka Kausch
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Institute of Tropical Medicine and International Health, Am Augustenburger Platz 1, 13353 Berlin, Germany
| | - Mia Wintel
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Institute of Tropical Medicine and International Health, Am Augustenburger Platz 1, 13353 Berlin, Germany
| | - Maximilian Gertler
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Institute of Tropical Medicine and International Health, Am Augustenburger Platz 1, 13353 Berlin, Germany
| | - Susen Burock
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Charité Comprehensive Cancer Center, Charitéplatz 1, 10117 Berlin, Germany
| | - Merle Hörig
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Institute of Tropical Medicine and International Health, Am Augustenburger Platz 1, 13353 Berlin, Germany
| | - Julian Bernhard
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Institute of Tropical Medicine and International Health, Am Augustenburger Platz 1, 13353 Berlin, Germany
| | - Frank Tobian
- Division of Clinical Tropical Medicine, Center of Infectious Diseases, Heidelberg University Hospital, Im Neuenheimer Feld 672, 69120 Heidelberg, Germany
| | - Mary Gaeddert
- Division of Clinical Tropical Medicine, Center of Infectious Diseases, Heidelberg University Hospital, Im Neuenheimer Feld 672, 69120 Heidelberg, Germany
| | - Federica Lainati
- Division of Clinical Tropical Medicine, Center of Infectious Diseases, Heidelberg University Hospital, Im Neuenheimer Feld 672, 69120 Heidelberg, Germany
| | - Victor M Corman
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Institute of Virology, Charitéplatz 1, 10117 Berlin, Germany; German Centre for Infection Research (DZIF), partner site Charité, Charitéplatz 1, 10117 Berlin, Germany
| | - Terry C Jones
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Institute of Virology, Charitéplatz 1, 10117 Berlin, Germany; German Centre for Infection Research (DZIF), partner site Charité, Charitéplatz 1, 10117 Berlin, Germany; Centre for Pathogen Evolution, Department of Zoology, University of Cambridge, Downing St., Cambridge, CB2 3EJ, UK
| | - Jilian A Sacks
- Foundation for Innovative New Diagnostics, Chemin des Mines 9, 1202 Geneva, Switzerland
| | - Joachim Seybold
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Medical Directorate, Charitéplatz 1, 10117 Berlin, Germany
| | - Claudia M Denkinger
- Division of Clinical Tropical Medicine, Center of Infectious Diseases, Heidelberg University Hospital, Im Neuenheimer Feld 672, 69120 Heidelberg, Germany; German Centre for Infection Research (DZIF), partner site Heidelberg, Im Neuenheimer Feld 672, 69120 Heidelberg, Germany
| | - Frank P Mockenhaupt
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Institute of Tropical Medicine and International Health, Am Augustenburger Platz 1, 13353 Berlin, Germany
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7
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Krüger LJ, Gaeddert M, Tobian F, Lainati F, Gottschalk C, Klein JAF, Schnitzler P, Kräusslich HG, Nikolai O, Lindner AK, Mockenhaupt FP, Seybold J, Corman VM, Drosten C, Pollock NR, Knorr B, Welker A, de Vos M, Sacks JA, Denkinger CM. The Abbott PanBio WHO emergency use listed, rapid, antigen-detecting point-of-care diagnostic test for SARS-CoV-2-Evaluation of the accuracy and ease-of-use. PLoS One 2021; 16:e0247918. [PMID: 34043631 PMCID: PMC8158996 DOI: 10.1371/journal.pone.0247918] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [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: 12/23/2020] [Accepted: 02/16/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Diagnostics are essential for controlling the pandemic. Identifying a reliable and fast diagnostic device is needed for effective testing. We assessed performance and ease-of-use of the Abbott PanBio antigen-detecting rapid diagnostic test (Ag-RDT). METHODS This prospective, multi-centre diagnostic accuracy study enrolled at two sites in Germany. Following routine testing with reverse-transcriptase polymerase chain reaction (RT-PCR), a second study-exclusive swab was performed for Ag-RDT testing. Routine swabs were nasopharyngeal (NP) or combined NP/oropharyngeal (OP) whereas the study-exclusive swabs were NP. To evaluate performance, sensitivity and specificity were assessed overall and in predefined sub-analyses accordingly to cycle-threshold values, days after symptom onset, disease severity and study site. Additionally, an ease-of-use assessment (EoU) and System Usability Scale (SUS) were performed. RESULTS 1108 participants were enrolled between Sept 28 and Oct 30, 2020. Of these, 106 (9.6%) were PCR-positive. The Abbott PanBio detected 92/106 PCR-positive participants with a sensitivity of 86.8% (95% CI: 79.0% - 92.0%) and a specificity of 99.9% (95% CI: 99.4%-100%). The sub-analyses indicated that sensitivity was 95.8% in Ct-values <25 and within the first seven days from symptom onset. The test was characterized as easy to use (SUS: 86/100) and considered suitable for point-of-care settings. CONCLUSION The Abbott PanBio Ag-RDT performs well for SARS-CoV-2 testing in this large manufacturer independent study, confirming its WHO recommendation for Emergency Use in settings with limited resources.
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Affiliation(s)
- Lisa J Krüger
- Division of Clinical Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Mary Gaeddert
- Division of Clinical Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Frank Tobian
- Division of Clinical Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Federica Lainati
- Division of Clinical Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Claudius Gottschalk
- Division of Clinical Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Julian A F Klein
- Division of Clinical Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Paul Schnitzler
- Virology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Olga Nikolai
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Tropical Medicine and International Health, Berlin, Germany
| | - Andreas K Lindner
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Tropical Medicine and International Health, Berlin, Germany
| | - Frank P Mockenhaupt
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Tropical Medicine and International Health, Berlin, Germany
| | - Joachim Seybold
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Medical Directorate, Berlin, Germany
| | - Victor M Corman
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Virology, Berlin, Germany
- German Centre for Infection Research (DZIF), Partner Site Charité, Berlin, Germany
| | - Christian Drosten
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Virology, Berlin, Germany
- German Centre for Infection Research (DZIF), Partner Site Charité, Berlin, Germany
| | - Nira R Pollock
- Department of Laboratory Medicine, Boston Children's Hospital, Boston, Massachusetts, United States of America
| | - Britta Knorr
- Department of Public Health Rhein Neckar Region, Heidelberg, Germany
| | - Andreas Welker
- Department of Public Health Rhein Neckar Region, Heidelberg, Germany
| | | | - Jilian A Sacks
- Foundation for Innovative New Diagnostics, Geneva, Switzerland
| | - Claudia M Denkinger
- Division of Clinical Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany
- German Centre for Infection Research (DZIF), Partner Site Heidelberg University Hospital, Heidelberg, Germany
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8
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Lindner AK, Nikolai O, Rohardt C, Burock S, Hülso C, Bölke A, Gertler M, Krüger LJ, Gaeddert M, Tobian F, Lainati F, Seybold J, Jones TC, Hofmann J, Sacks JA, Mockenhaupt FP, Denkinger CM. Head-to-head comparison of SARS-CoV-2 antigen-detecting rapid test with professional-collected nasal versus nasopharyngeal swab. Eur Respir J 2021; 57:2004430. [PMID: 33574072 PMCID: PMC7877326 DOI: 10.1183/13993003.04430-2020] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 01/24/2021] [Indexed: 12/23/2022]
Abstract
Antigen-detecting rapid diagnostic tests (Ag-RDTs) are likely to play a substantial role in innovative testing strategies for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1, 2]. Currently, most Ag-RDTs require nasopharyngeal (NP) sampling performed by qualified healthcare professionals. Nasal sampling would enable scaling of antigen testing strategies. The term nasal sampling is often not used uniformly, but can be differentiated as either anterior nasal sampling (entire absorbent tip of the swab, usually 1 to 1.5 cm, inserted into nostril), and nasal mid-turbinate (as described below) [3]. Professional nasal sampling is a reliable alternative to nasopharyngeal sampling when using a WHO-listed SARS-CoV-2 antigen-detecting rapid test. This less invasive method needs less training to facilitate rapid scaling of testing strategies. https://bit.ly/3pEVlUL
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Affiliation(s)
- Andreas K. Lindner
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Tropical Medicine and International Health, Berlin, Germany
- Authors contributed equally
| | - Olga Nikolai
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Tropical Medicine and International Health, Berlin, Germany
- Authors contributed equally
| | - Chiara Rohardt
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Tropical Medicine and International Health, Berlin, Germany
| | - Susen Burock
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charité Comprehensive Cancer Center, Berlin, Germany
| | - Claudia Hülso
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Tropical Medicine and International Health, Berlin, Germany
| | - Alisa Bölke
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Tropical Medicine and International Health, Berlin, Germany
| | - Maximilian Gertler
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Tropical Medicine and International Health, Berlin, Germany
| | - Lisa J. Krüger
- Division of Clinical Tropical Medicine, Center of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Mary Gaeddert
- Division of Clinical Tropical Medicine, Center of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Frank Tobian
- Division of Clinical Tropical Medicine, Center of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Federica Lainati
- Division of Clinical Tropical Medicine, Center of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Joachim Seybold
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Medical Directorate, Berlin, Germany
| | - Terry C. Jones
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Virology, Berlin, Germany
- German Centre for Infection Research (DZIF), partner site Charité, Berlin, Germany
- Centre for Pathogen Evolution, Dept of Zoology, University of Cambridge, Cambridge, UK
| | - Jörg Hofmann
- Labor Berlin – Charité Vivantes GmbH, Berlin, Germany
| | - Jilian A. Sacks
- Foundation for Innovative New Diagnostics, Geneva, Switzerland
| | - Frank P. Mockenhaupt
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Tropical Medicine and International Health, Berlin, Germany
- Authors contributed equally
| | - Claudia M. Denkinger
- Division of Clinical Tropical Medicine, Center of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
- German Centre for Infection Research (DZIF), partner site Heidelberg, Heidelberg, Germany
- Authors contributed equally
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9
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Lindner AK, Nikolai O, Kausch F, Wintel M, Hommes F, Gertler M, Krüger LJ, Gaeddert M, Tobian F, Lainati F, Köppel L, Seybold J, Corman VM, Drosten C, Hofmann J, Sacks JA, Mockenhaupt FP, Denkinger CM. Head-to-head comparison of SARS-CoV-2 antigen-detecting rapid test with self-collected nasal swab versus professional-collected nasopharyngeal swab. Eur Respir J 2021; 57:13993003.03961-2020. [PMID: 33303544 PMCID: PMC7736752 DOI: 10.1183/13993003.03961-2020] [Citation(s) in RCA: 100] [Impact Index Per Article: 33.3] [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: 10/26/2020] [Accepted: 11/24/2020] [Indexed: 01/22/2023]
Abstract
A number of antigen-detecting rapid diagnostic tests (Ag-RDTs) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are now commercially available and can result in rapid decisions on patient care, isolation and contact tracing at the point of care [1]. Two Ag-RDTs using nasopharyngeal (NP) swab samples meet World Health Organization (WHO) targets and are now approved through the WHO Emergency Use Listing procedure [2–4]. Supervised nasal self-sampling is a reliable alternative to professional nasopharyngeal sampling using a WHO-listed SARS-CoV-2 antigen-detecting rapid test. Self-sampling and potentially patient self-testing may be a future use case.https://bit.ly/3mup0hS
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Affiliation(s)
- Andreas K Lindner
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt - Universität zu Berlin, and Berlin Institute of Health, Institute of Tropical Medicine and International Health, Berlin, Germany.,Authors contributed equally
| | - Olga Nikolai
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt - Universität zu Berlin, and Berlin Institute of Health, Institute of Tropical Medicine and International Health, Berlin, Germany.,Authors contributed equally
| | - Franka Kausch
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt - Universität zu Berlin, and Berlin Institute of Health, Institute of Tropical Medicine and International Health, Berlin, Germany
| | - Mia Wintel
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt - Universität zu Berlin, and Berlin Institute of Health, Institute of Tropical Medicine and International Health, Berlin, Germany
| | - Franziska Hommes
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt - Universität zu Berlin, and Berlin Institute of Health, Institute of Tropical Medicine and International Health, Berlin, Germany
| | - Maximilian Gertler
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt - Universität zu Berlin, and Berlin Institute of Health, Institute of Tropical Medicine and International Health, Berlin, Germany
| | - Lisa J Krüger
- Division of Clinical Tropical Medicine, Center of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Mary Gaeddert
- Division of Clinical Tropical Medicine, Center of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Frank Tobian
- Division of Clinical Tropical Medicine, Center of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Federica Lainati
- Division of Clinical Tropical Medicine, Center of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Lisa Köppel
- Division of Clinical Tropical Medicine, Center of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Joachim Seybold
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt - Universität zu Berlin, and Berlin Institute of Health, Medical Directorate, Berlin, Germany
| | - Victor M Corman
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt - Universität zu Berlin, and Berlin Institute of Health, Institute of Virology, Berlin, Germany.,German Centre for Infection Research (DZIF), Berlin, Germany
| | - Christian Drosten
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt - Universität zu Berlin, and Berlin Institute of Health, Institute of Virology, Berlin, Germany.,German Centre for Infection Research (DZIF), Berlin, Germany
| | - Jörg Hofmann
- Labor Berlin - Charité Vivantes GmbH, Berlin, Germany
| | - Jilian A Sacks
- Foundation for Innovative New Diagnostics, Geneva, Switzerland
| | - Frank P Mockenhaupt
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt - Universität zu Berlin, and Berlin Institute of Health, Institute of Tropical Medicine and International Health, Berlin, Germany.,Authors contributed equally
| | - Claudia M Denkinger
- Division of Clinical Tropical Medicine, Center of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany .,Authors contributed equally
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