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Is there a role for SARS-CoV-2 antigen testing in the post-containment strategy?
1Department of Virology, Amiens University Medical Center, Amiens, France.
Journal of Clinical Virology Plus
|March 9, 2022
Summary
Antigenic tests for SARS-CoV-2 show reduced sensitivity during periods of low virus circulation. Their performance declines significantly when PCR positivity rates drop, impacting public health strategies.
Area of Science:
- Virology
- Epidemiology
- Diagnostic testing
Background:
- Widespread deployment of SARS-CoV-2 antigenic tests during Europe's second epidemic wave provided real-world performance data.
- Concerns arose regarding the utility of these rapid tests during periods of low viral circulation.
Purpose of the Study:
- To evaluate the theoretical sensitivity of SARS-CoV-2 antigenic tests during periods of varying virus circulation.
- To assess the impact of declining PCR positivity rates on antigenic test performance.
Main Methods:
- Analysis of over 16,000 SARS-CoV-2 PCR results from a French region during early 2020.
- Extrapolation of theoretical antigenic test sensitivity based on PCR positivity rates and Ct levels.
Main Results:
- Antigenic test sensitivity was estimated between 70-80% when PCR positivity exceeded 1%.
- Sensitivity decreased below 70% as PCR positivity rates declined.
- A decrease in samples with low Ct levels correlated with reduced PCR positivity.
Conclusions:
- The effectiveness of SARS-CoV-2 antigenic tests is diminished during phases of low viral circulation.
- Limited test performance may compromise the efficacy of isolation, testing, and contact tracing efforts.
- Real-world performance data is crucial for optimizing diagnostic strategies.
