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In healthcare diagnostics, laboratory tests play a crucial role in identifying and diagnosing a wide range of medical conditions. However, interpreting test results is not always straightforward. An abnormal test result does not always confirm the presence of a disease, just as a normal result does not guarantee its absence. To assess the reliability of these diagnostic tools, healthcare practitioners rely on two key statistical indicators: sensitivity and specificity.
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Related Experiment Video

Updated: Jun 23, 2026

A Rapid, Multiplex Dual Reporter IgG and IgM SARS-CoV-2 Neutralization Assay for a Multiplexed Bead-Based Flow Analysis System
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Covid-19 antigen testing: better than we know? A test accuracy study.

Miroslav Homza1,2, Hana Zelena3,4, Jaroslav Janosek5

  • 1Hospital Karvina-Raj, Karvina, Czech Republic.

Infectious Diseases (London, England)
|May 14, 2021
PubMed
Summary
This summary is machine-generated.

Antigen tests for SARS-CoV-2 (COVID-19) missed fewer infectious patients than expected. When adjusted for virus viability, antigen test sensitivity and negative predictive value were high, indicating reliable identification of infectious individuals.

Keywords:
Covid-19SARS-CoV-2antigen testingsensitivityvirus sheddingvirus viability

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Area of Science:

  • Virology
  • Infectious Diseases
  • Diagnostic Testing

Background:

  • Antigen tests for SARS-CoV-2 are less sensitive than RT-PCR.
  • Many SARS-CoV-2 positive cases missed by antigen tests may not be infectious.

Purpose of the Study:

  • Evaluate the real-world performance of a SARS-CoV-2 antigen test.
  • Assess antigen test accuracy considering virus viability.

Main Methods:

  • Compared RT-PCR and a lateral flow antigen test in 494 asymptomatic/mildly symptomatic patients.
  • Used cell culture to determine virus viability for discordant results.
  • Calculated test parameters using RT-PCR and viability-adjusted RT-PCR as references.

Main Results:

  • Overall antigen test sensitivity was 76.2% and specificity 97.3% versus RT-PCR.
  • 36 of 39 patients missed by antigen test lacked viable virus.
  • Viability-adjusted sensitivity reached 97.7% with a 99.2% negative predictive value.

Conclusions:

  • Viability testing is crucial for evaluating antigen tests.
  • Validated antigen tests accurately identify infectious SARS-CoV-2 patients in high-throughput settings.
  • Antigen tests show high utility for disease control in asymptomatic/mildly symptomatic individuals.