Rapid screening for severe acute respiratory syndrome coronavirus 2 infection with a combined point-of-care antigen test and an immunoglobulin G antibody test

Rapid screening and diagnosis of coronavirus disease 2019 in the emergency department is important for controlling infections. When polymerase chain reaction tests cannot be rapidly performed, rapid antigen testing is often used, albeit with insufficient sensitivity. Therefore, we evaluated the diag...

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Bibliographic Details
Published in:PloS one 2022-02, Vol.17 (2), p.e0263327-e0263327
Main Authors: Mori, Kosuke, Imaki, Shohei, Ohyama, Yutaro, Satoh, Kosuke, Abe, Takeru, Takeuchi, Ichiro
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Analysis
Antibodies
Antigen-antibody reactions
Antigens
Biology and Life Sciences
Coronaviruses
COVID-19
COVID-19 - diagnosis
COVID-19 Serological Testing - methods
COVID-19 Testing - methods
Diagnostic systems
Disease transmission
Emergency medical care
Emergency medical services
Female
Hospitals
Humans
IgG antibody
Immune system
Immunoglobulin G
Immunoglobulin G - analysis
Immunoglobulins
Infection control
Infections
Laboratories
Male
Masks
Medicine and Health Sciences
Methods
Middle Aged
Nosocomial infections
Patients
Point-of-Care Testing
Polymerase chain reaction
Research and Analysis Methods
Retrospective Studies
Reverse transcription
Sensitivity analysis
Sensitivity and Specificity
Severe acute respiratory syndrome
Severe acute respiratory syndrome coronavirus 2
Statistical analysis
Testing
Viral diseases
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Summary:Rapid screening and diagnosis of coronavirus disease 2019 in the emergency department is important for controlling infections. When polymerase chain reaction tests cannot be rapidly performed, rapid antigen testing is often used, albeit with insufficient sensitivity. Therefore, we evaluated the diagnostic accuracy of combining rapid antigen and antibody test results. This was a retrospective review of patients who visited our emergency department between February and May 2021 and underwent rapid antigen, immunoglobulin G antibody, and reverse transcription-polymerase chain reaction tests. The study included 1,070 patients, of whom 56 (5.2%) tested positive on reverse transcription-polymerase chain reaction. The sensitivity, specificity, and area under the curve of rapid antigen testing were 73.7%, 100.0%, and 0.87, respectively. The combined rapid antigen and antibody test result had improved diagnostic accuracy, with 91.2% sensitivity, 97.9% specificity, and an area under the curve of 0.95. The results of the rapid antigen and antibody tests could be combined as a reliable alternative to reverse transcription-polymerase chain reaction.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0263327