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Detection of Antibody versus Antigen, Optimal Option of Different Serological Assays Based Tests for COVID-19
Haiyan Fu1, Lin Sun1, Jingwei Zhu2
1Department of Clinical Laboratory, Yantaishan Hospital, Yantai 264001, Shandong Province, PR China.
Insights
Rapid antigen tests demonstrate superior diagnostic efficacy for COVID-19 compared to antibody tests, offering higher sensitivity and specificity. This finding aids in selecting reliable diagnostic methods for Corona Virus Disease 2019.
Area of Science:
- Medical Diagnostics
- Infectious Disease Research
- Biomarker Analysis
Background:
- Assessing the diagnostic performance of antigen and antibody tests for COVID-19.
- Comparing the sensitivity, specificity, and diagnostic odds ratio between antibody and antigen tests for Corona Virus Disease 2019 (COVID-19).
Purpose of the Study:
- To compare the diagnostic efficacy of antigen versus antibody tests for COVID-19.
- To provide insights for selecting rapid and reliable diagnostic methods for COVID-19.
Main Methods:
- Systematic review and meta-analysis of 25 studies published before September 1st, 2022.
- Data pooling and analysis using STATA software.
- Utilized Forrest plots and combined receiver operating characteristic (ROC) curves to assess diagnostic accuracy.
Main Results:
- Overall sensitivity was 0.68 and specificity was 0.99. The area under the curve (AUC) was 0.98, and the diagnostic odds ratio (DOR) was 299.54.
- Subgroup analysis showed antigen tests had higher sensitivity (0.77) and comparable specificity (0.99) versus antibody tests (sensitivity 0.59, specificity 0.98).
- Antigen tests demonstrated higher AUC and DOR, indicating superior diagnostic performance.
Conclusions:
- Rapid antigen testing exhibits better diagnostic efficacy, lower heterogeneity, and less publication bias compared to antibody testing for COVID-19.
- The findings suggest that antigen tests are a more reliable and efficient option for COVID-19 diagnosis.
- This study informs strategies for choosing rapid and dependable testing methods for Corona Virus Disease 2019.
Background:
In this study, the diagnostic efficacy of antigen test and antibody test were assessed. Additionally, the difference of sensitivity, specificity, and diagnostic odds ratio were compared concerning efficacy of antibody test versus antigen test for Corona Virus Disease 2019 (COVID-19) diagnosis.
Methods:
Online databases were searched for full-text publications and STATA software was used for data pooling and analysis before Sep 1st, 2022. Forrest plot was used to show the pooled sensitivity, specificity and diagnostic odds ratio. Combined receiver operating characteristic (ROC) curve was used to show the area of under curve of complex data.
Results:
Overall, 25 studies were included. The sensitivity (0.68, 95% CI: 0.53-0.80) and specificity (0.99, 95% CI: 0.98-0.99) in antibody or antigen was calculated. The time point of test lead to heterogeneity. The area under curve (AUC) was 0.98 (95% CI: 0.96-0.99), and the diagnostic odds ratio (DOR) was 299.54 (95% CI: 135.61-661.64). Subgroup analysis indicated antibody test with sensitivity (0.59, 95% CI: 0.44-0.73) and specificity (0.98, 95% CI: 0.95-0.99) and antigen test with sensitivity of 0.77 (95% CI: 0.53-0.91) and specificity of 0.99 (95% CI: 0.98-1.00). Higher AUC and DOR were proved in antigen test.
Conclusion:
The present study compared the efficacy of antibody test versus antigen test for COVID-19 diagnosis. Better diagnostic efficacy, lower heterogeneity, and less publication bias of rapid antigen testing was suggested in this study. This study would help us to make better strategy about choosing rapid and reliable testing method in diagnosis of the COVID-19 disease.
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