Nasopharyngeal Panbio COVID-19 Antigen Performed at Point-of-Care Has a High Sensitivity in Symptomatic and Asymptomatic Patients With Higher Risk for Transmission and Older Age
Por:
Masia, M, Fernandez-Gonzalez, M, Sanchez, M, Carvajal, M, Garcia, J, Gonzalo-Jimenez, N, de la Tabla, V, Agullo, V, Candela I, Guijarro, J, Gutierrez, J, de Gregorio, C and Gutierrez, F
Publicada:
1 mar 2021
Ahead of Print:
1 feb 2021
Resumen:
Background. Performance of point-of-care tests in different clinical scenarios and on different samples remains undetermined. We comprehensively evaluated the performance of the nasopharyngeal Panbio COVID-19 Ag Rapid Test Device.
Methods. This is a prospective study that includes consecutive patients attending 3 primary care centers (PCCs) and an emergency department. The antigen test was performed at point-of-care in nasopharyngeal and nasal swabs and in saliva. Positive percent agreement (PPA) and negative percent agreement (NPA) were calculated with the reverse-transcription polymerase chain reaction (RT-PCR) assay as reference standard.
Results. Of 913 patients included, 296 (32.3%) were asymptomatic and 690 (75.6%) came from the PCC. Nasopharyngeal swabs were collected from 913 patients, nasal swabs were collected from 659 patients, and saliva was collected from 611 patients. The RT-PCR was positive in 196 (21.5%) nasopharyngeal samples (NPS). Overall, PPA (95% CI) in NPS was 60.5% (53.3-67.4), and it was lower in nasal swabs (44.7%) and saliva (23.1%). Test performance in NPS was largely dependent on the cycle threshold (Ct) in RT-PCR, with PPA of 94% for Ct <= 25 and 80% for Ct <30. In symptomatic patients, the PPA was 95% for Ct <= 25, 85% for Ct <30, and 89% for the symptom triad of fever, cough, and malaise. Performance was also dependent on age, with a PPA of 100% in symptomatic patients >50 years with Ct <25. In asymptomatic patients, the PPA was 86% for Ct <25. In all cases, NPA was 100%.
Conclusions. The nasopharyngeal Panbio COVID-19 Ag test performed at point-of-care has a good sensitivity in symptomatic patients with Ct <30 and older age. The test was useful to identify asymptomatic patients with lower Ct values.
Filiaciones:
:
Hosp Gen Univ Elche, Infect Dis Unit, Alicante, Spain
Univ Miguel Hernandez, Clin Med Dept, Alacant, Spain
:
Hosp Gen Univ Elche, Infect Dis Unit, Alicante, Spain
Sanchez, M:
Generalitat Valenciana, Dept 20th Hlth Author, Conselleria Sanitat, Alicante, Spain
:
Hosp Gen Univ Elche, Infect Dis Unit, Alicante, Spain
:
Hosp Gen Univ Elche, Infect Dis Unit, Alicante, Spain
:
Hosp Gen Univ Elche, Microbiol Serv, Alicante, Spain
:
Hosp Univ San Juan, Microbiol Serv, Alicante, Spain
:
Hosp Gen Univ Elche, Infect Dis Unit, Alicante, Spain
Candela I:
Santa Pola Primary Care Ctr, Alicante, Spain
Guijarro, J:
Altabix Primary Care Ctr, Alicante, Spain
:
Hosp Gen Univ Elche, Emergency Dept, Alicante, Spain
de Gregorio, C:
Generalitat Valenciana, Dept 20th Hlth Author, Conselleria Sanitat, Alicante, Spain
:
Hosp Gen Univ Elche, Infect Dis Unit, Alicante, Spain
Univ Miguel Hernandez, Clin Med Dept, Alacant, Spain
gold, Green Published, Green Submitted
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