Evaluation of six commercial SARS-CoV-2 rapid antigen tests in nasopharyngeal swabs: Better knowledge for better patient management?

• Published in: Journal of clinical virology 2021-10, Vol.143, p.104947-104947, Article 104947
• Main Authors: Andreani, Julien, Lupo, Julien, Germi, Raphaële, Laugier, Christel, Roccon, Marie, Larrat, Sylvie, Morand, Patrice, Nemoz, Benjamin
• Format: Article
• Language: English
• Subjects: COVID-19; Rapid antigen tests; RT-PCR; SARS-CoV-2
• ISSN: 1386-6532; 1873-5967
• DOI: 10.1016/j.jcv.2021.104947

•Antigen tests against SARS-Cov-2 could give rapid orientation diagnosis.•6 rapid antigen tests were compared with RT-PCR using 239 nasopharyngeal swabs.•Overall sensitivities and specificities varying depending antigenic tests.•Concordance range is included between 75,7% to 83,3%.•Sensitivity is greatly improved when considering highly infectious patients. Robust antigen point-of-care SARS-CoV-2 tests have been proposed as an efficient tool to address the COVID-19 pandemic. This requirement was raised after acknowledging the constraints that are brought by molecular biology. However, worldwide markets have been flooded with cheap and potentially underperforming lateral flow assays. Herein we retrospectively compared the overall performance of five qualitative rapid antigen SARS-CoV-2 assays and one quantitative automated test on 239 clinical swabs. While the overall sensitivity and specificity are relatively similar for all tests, concordance with molecular based methods varies, ranging from 75,7% to 83,3% among evaluated tests. Sensitivity is greatly improved when considering patients with higher viral excretion (Ct≤33), proving that antigen tests accurately distinguish infectious patients from viral shedding. These results should be taken into consideration by clinicians involved in patient triage and management, as well as by national authorities in public health strategies and for mass campaign approaches.