1
|
Thell R, Kallab V, Weinhappel W, Mueckstein W, Heschl L, Heschl M, Korsatko S, Toedling F, Blaschke A, Herzog T, Klicpera A, Koeller C, Haugk M, Kreil A, Spiel A, Kreuzer P, Krause R, Sebesta C, Winkler S, Laky B, Szell M. Evaluation of a novel, rapid antigen detection test for the diagnosis of SARS-CoV-2. PLoS One 2021; 16:e0259527. [PMID: 34843505 PMCID: PMC8629250 DOI: 10.1371/journal.pone.0259527] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 10/20/2021] [Indexed: 11/18/2022] Open
Abstract
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease 2019 (COVID-19) is currently finally determined in laboratory settings by real-time reverse-transcription polymerase-chain-reaction (rt-PCR). However, simple testing with immediately available results are crucial to gain control over COVID-19. The aim was to evaluate such a point-of-care antigen rapid test (AG-rt) device in its performance compared to laboratory-based rt-PCR testing in COVID-19 suspected, symptomatic patients. Methods For this prospective study, two specimens each of 541 symptomatic female (54.7%) and male (45.3%) patients aged between 18 and 95 years tested at five emergency departments (ED, n = 296) and four primary healthcare centres (PHC, n = 245), were compared, using AG-rt (positive/negative/invalid) and rt-PCR (positive/negative and cycle threshold, Ct) to diagnose SARS-CoV-2. Diagnostic accuracy, sensitivity, specificity, positive predictive values (PPV), negative predictive value (NPV), and likelihood ratios (LR+/-) of the AG-rt were assessed. Results Differences between ED and PHC were detected regarding gender, age, symptoms, disease prevalence, and diagnostic performance. Overall, 174 (32.2%) were tested positive on AG-rt and 213 (39.4%) on rt-PCR. AG correctly classified 91.7% of all rt-PCR positive cases with a sensitivity of 80.3%, specificity of 99.1%, PPV of 98.3, NPV of 88.6%, LR(+) of 87.8, and LR(-) of 0.20. The highest sensitivities and specificities of AG-rt were detected in PHC (sensitivity: 84.4%, specificity: 100.0%), when using Ct of 30 as cut-off (sensitivity: 92.5%, specificity: 97.8%), and when symptom onset was within the first three days (sensitivity: 82.9%, specificity: 99.6%). Conclusions The highest sensitivity was detected with a high viral load. Our findings suggest that AG-rt are comparable to rt-PCR to diagnose SARS-CoV-2 in COVID-19 suspected symptomatic patients presenting both at emergency departments and primary health care centres.
Collapse
Affiliation(s)
- Rainer Thell
- Wiener Gesundheitsverbund, Vienna, Australia
- Department of Internal Medicine 2, Emergency Department, Klinik Donaustadt, Vienna, Austria
- * E-mail: (RT); (MS)
| | - Verena Kallab
- Wiener Gesundheitsverbund, Vienna, Australia
- Department of Internal Medicine 2, Emergency Department, Klinik Donaustadt, Vienna, Austria
| | | | | | - Lukas Heschl
- Primary Health Care Centre Landarztteam, Oed, Austria
| | | | | | - Franz Toedling
- Primary Health Care Centre Praxis Dr Toedling, Probstdorf, Austria
| | - Amelie Blaschke
- Wiener Gesundheitsverbund, Vienna, Australia
- Department of Internal Medicine 2, Emergency Department, Klinik Donaustadt, Vienna, Austria
| | - Theresa Herzog
- Wiener Gesundheitsverbund, Vienna, Australia
- Department of Internal Medicine 2, Emergency Department, Klinik Donaustadt, Vienna, Austria
| | - Anna Klicpera
- Wiener Gesundheitsverbund, Vienna, Australia
- Department of Internal Medicine 2, Emergency Department, Klinik Donaustadt, Vienna, Austria
| | - Clara Koeller
- Emergency Department, Klinik Hietzing, Vienna, Austria
- Semmelweis University Budapest, Hungary
| | - Moritz Haugk
- Wiener Gesundheitsverbund, Vienna, Australia
- Emergency Department, Klinik Hietzing, Vienna, Austria
| | - Anna Kreil
- Wiener Gesundheitsverbund, Vienna, Australia
- Emergency Department, Klinik Landstrasse, Vienna, Austria
| | - Alexander Spiel
- Wiener Gesundheitsverbund, Vienna, Australia
- Emergency Department, Klinik Ottakring, Vienna, Austria
| | - Philipp Kreuzer
- Emergency Department, Univ. Clinic of Internal Medicine, Medical University Graz, Graz, Austria
| | - Robert Krause
- Univ. Clinic of Internal Medicine, Section of Infectiology and Tropical Medicine, Medical University Graz, Graz, Austria
| | - Christian Sebesta
- Wiener Gesundheitsverbund, Vienna, Australia
- Department of Internal Medicine 2, Emergency Department, Klinik Donaustadt, Vienna, Austria
| | - Stefan Winkler
- Department of Infectiology and Tropical Medicine, University Clinic of Internal Medicine I, Medical University Vienna, Austria
| | - Brenda Laky
- MedSciCare, Vienna, Austria
- Competence Centre Clinical Research, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Marton Szell
- Wiener Gesundheitsverbund, Vienna, Australia
- Department of Internal Medicine 2, Emergency Department, Klinik Donaustadt, Vienna, Austria
- * E-mail: (RT); (MS)
| |
Collapse
|