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Longitudinal Assessment of Diagnostic Test Performance Over the Course of Acute SARS-CoV-2 Infection
Rebecca L Smith1,2,3, Laura L Gibson4, Pamela P Martinez1,5,6
1Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA.
The Journal of Infectious Diseases
|June 30, 2021
Summary
Serial screening for SARS-CoV-2 is crucial. Quantitative RT-qPCR offers higher sensitivity for early detection compared to antigen tests, aiding transmission control.
Area of Science:
- Infectious Diseases
- Virology
- Diagnostic Testing
Background:
- Serial screening for SARS-CoV-2 is vital for controlling transmission.
- Understanding diagnostic test sensitivity across infection stages is limited.
Purpose of the Study:
- To compare the sensitivity of different SARS-CoV-2 diagnostic tests.
- To evaluate test performance at various stages of infection.
Main Methods:
- Longitudinal study of 43 adults with recent SARS-CoV-2 infection.
- Daily collection of saliva and nasal swabs.
- Testing using RT-qPCR, antigen immunoassay (FIA), and viral culture.
Main Results:
- Both RT-qPCR and antigen FIA sensitivity peaked when live virus was present.
- RT-qPCR showed higher sensitivity earlier in the infection.
- Serial antigen testing significantly improved sensitivity.
Conclusions:
- RT-qPCR is more effective for early detection and minimizing transmission.
- All tested methods achieved >98% sensitivity when used every 3 days.
- Daily antigen screening offers ~90% sensitivity during viral culture positivity.
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