Rebecca L Smith1,2,3, Laura L Gibson4, Pamela P Martinez1,5,6, Ruian Ke7, Agha Mirza8, Madison Conte8, Nicholas Gallagher9, Abigail Conte10, Leyi Wang11, Richard Fredrickson11, Darci C Edmonson1, Melinda E Baughman1, Karen K Chiu1, Hannah Choi1, Tor W Jensen1,12, Kevin R Scardina1, Shannon Bradley1, Stacy L Gloss1, Crystal Reinhart1, Jagadeesh Yedetore1, Alyssa N Owens13, John Broach14,15, Bruce Barton16,17, Peter Lazar16, Darcy Henness18, Todd Young18, Alastair Dunnett18, Matthew L Robinson8, Heba H Mostafa9, Andrew Pekosz10, Yukari C Manabe8, William J Heetderks19, David D McManus20, Christopher B Brooke1,5. 1. Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA. 2. Department of Pathobiology, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA. 3. Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA. 4. Division of Infectious Diseases and Immunology, Departments of Medicine and Pediatrics, University of Massachusetts Medical School, Worcester, Massachusetts, USA. 5. Department of Microbiology, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA. 6. Department of Statistics, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA. 7. T-6, Theoretical Biology and Biophysics, Los Alamos National Laboratory, Los Alamos, New Mexico, USA. 8. Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA. 9. Division of Medical Microbiology, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. 10. W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. 11. Veterinary Diagnostic Laboratory, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA. 12. Cancer Center at Illinois, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA. 13. Center for Clinical and Translational Research, University of Massachusetts Medical School, Worcester, Massachusetts, USA. 14. UMass Memorial Medical Center, Worcester, Massachusetts, USA. 15. Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA. 16. Division of Biostatistics and Health Services Research, University of Massachusetts Medical School, Worcester, Massachusetts, USA. 17. Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA. 18. Carle Foundation Hospital, Urbana, Illinois, USA. 19. National Institute for Biomedical Imaging and Bioengineering, Bethesda, Maryland, USA. 20. Division of Cardiology, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
Abstract
BACKGROUND: Serial screening is critical for restricting spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by facilitating timely identification of infected individuals to interrupt transmission. Variation in sensitivity of different diagnostic tests at different stages of infection has not been well documented. METHODS: In a longitudinal study of 43 adults newly infected with SARS-CoV-2, all provided daily saliva and nasal swabs for quantitative reverse transcription polymerase chain reaction (RT-qPCR), Quidel SARS Sofia antigen fluorescent immunoassay (FIA), and live virus culture. RESULTS: Both RT-qPCR and Quidel SARS Sofia antigen FIA peaked in sensitivity during the period in which live virus was detected in nasal swabs, but sensitivity of RT-qPCR tests rose more rapidly prior to this period. We also found that serial testing multiple times per week increases the sensitivity of antigen tests. CONCLUSIONS: RT-qPCR tests are more effective than antigen tests at identifying infected individuals prior to or early during the infectious period and thus for minimizing forward transmission (given timely results reporting). All tests showed >98% sensitivity for identifying infected individuals if used at least every 3 days. Daily screening using antigen tests can achieve approximately 90% sensitivity for identifying infected individuals while they are viral culture positive.
BACKGROUND: Serial screening is critical for restricting spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by facilitating timely identification of infected individuals to interrupt transmission. Variation in sensitivity of different diagnostic tests at different stages of infection has not been well documented. METHODS: In a longitudinal study of 43 adults newly infected with SARS-CoV-2, all provided daily saliva and nasal swabs for quantitative reverse transcription polymerase chain reaction (RT-qPCR), Quidel SARS Sofia antigen fluorescent immunoassay (FIA), and live virus culture. RESULTS: Both RT-qPCR and Quidel SARS Sofia antigen FIA peaked in sensitivity during the period in which live virus was detected in nasal swabs, but sensitivity of RT-qPCR tests rose more rapidly prior to this period. We also found that serial testing multiple times per week increases the sensitivity of antigen tests. CONCLUSIONS: RT-qPCR tests are more effective than antigen tests at identifying infected individuals prior to or early during the infectious period and thus for minimizing forward transmission (given timely results reporting). All tests showed >98% sensitivity for identifying infected individuals if used at least every 3 days. Daily screening using antigen tests can achieve approximately 90% sensitivity for identifying infected individuals while they are viral culture positive.
Authors: Stefan Flasche; Sebastian Funk; Martin Pavelka; Kevin Van-Zandvoort; Sam Abbott; Katharine Sherratt; Marek Majdan; Pavol Jarčuška; Marek Krajčí Journal: Science Date: 2021-03-23 Impact factor: 47.728
Authors: Gage K Moreno; Katarina M Braun; Ian W Pray; Hannah E Segaloff; Ailam Lim; Keith Poulsen; Jonathan Meiman; James Borcher; Ryan P Westergaard; Michael K Moll; Thomas C Friedrich; David H O'Connor Journal: Clin Infect Dis Date: 2021-07-15 Impact factor: 9.079
Authors: Lauren M Kucirka; Stephen A Lauer; Oliver Laeyendecker; Denali Boon; Justin Lessler Journal: Ann Intern Med Date: 2020-05-13 Impact factor: 25.391
Authors: A E Jääskeläinen; M J Ahava; P Jokela; L Szirovicza; S Pohjala; O Vapalahti; M Lappalainen; J Hepojoki; S Kurkela Journal: J Clin Virol Date: 2021-03-05 Impact factor: 3.168
Authors: Ian W Pray; Laura Ford; Devlin Cole; Christine Lee; John Paul Bigouette; Glen R Abedi; Dena Bushman; Miranda J Delahoy; Dustin Currie; Blake Cherney; Marie Kirby; Geroncio Fajardo; Motria Caudill; Kimberly Langolf; Juliana Kahrs; Patrick Kelly; Collin Pitts; Ailam Lim; Nicole Aulik; Azaibi Tamin; Jennifer L Harcourt; Krista Queen; Jing Zhang; Brett Whitaker; Hannah Browne; Magdalena Medrzycki; Patricia Shewmaker; Jennifer Folster; Bettina Bankamp; Michael D Bowen; Natalie J Thornburg; Kimberly Goffard; Brandi Limbago; Allen Bateman; Jacqueline E Tate; Douglas Gieryn; Hannah L Kirking; Ryan Westergaard; Marie Killerby Journal: MMWR Morb Mortal Wkly Rep Date: 2021-01-01 Impact factor: 35.301
Authors: Andrew William Byrne; David McEvoy; Aine B Collins; Kevin Hunt; Miriam Casey; Ann Barber; Francis Butler; John Griffin; Elizabeth A Lane; Conor McAloon; Kirsty O'Brien; Patrick Wall; Kieran A Walsh; Simon J More Journal: BMJ Open Date: 2020-08-05 Impact factor: 2.692
Authors: Daniel B Larremore; Bryan Wilder; Evan Lester; Soraya Shehata; James M Burke; James A Hay; Milind Tambe; Michael J Mina; Roy Parker Journal: Sci Adv Date: 2021-01-01 Impact factor: 14.136
Authors: Jacqueline Dinnes; Pawana Sharma; Sarah Berhane; Susanna S van Wyk; Nicholas Nyaaba; Julie Domen; Melissa Taylor; Jane Cunningham; Clare Davenport; Sabine Dittrich; Devy Emperador; Lotty Hooft; Mariska Mg Leeflang; Matthew Df McInnes; René Spijker; Jan Y Verbakel; Yemisi Takwoingi; Sian Taylor-Phillips; Ann Van den Bruel; Jonathan J Deeks Journal: Cochrane Database Syst Rev Date: 2022-07-22
Authors: Apurv Soni; Carly Herbert; Andreas Filippaios; John Broach; Andres Colubri; Nisha Fahey; Kelsey Woods; Janvi Nanavati; Colton Wright; Taylor Orwig; Karen Gilliam; Vik Kheterpal; Thejas Suvarna; Chris Nowak; Summer Schrader; Honghuang Lin; Laurel O'Connor; Caitlin Pretz; Didem Ayturk; Elizabeth Orvek; Julie Flahive; Peter Lazar; Qiming Shi; Chad Achenbach; Robert Murphy; Matthew Robinson; Laura Gibson; Pamela Stamegna; Nathaniel Hafer; Katherine Luzuriaga; Bruce Barton; William Heetderks; Yukari C Manabe; David McManus Journal: Ann Intern Med Date: 2022-10-11 Impact factor: 51.598
Authors: Victoria T Chu; Noah G Schwartz; Marisa A P Donnelly; Meagan R Chuey; Raymond Soto; Anna R Yousaf; Emily N Schmitt-Matzen; Sadia Sleweon; Jasmine Ruffin; Natalie Thornburg; Jennifer L Harcourt; Azaibi Tamin; Gimin Kim; Jennifer M Folster; Laura J Hughes; Suxiang Tong; Ginger Stringer; Bernadette A Albanese; Sarah E Totten; Meghan M Hudziec; Shannon R Matzinger; Elizabeth A Dietrich; Sarah W Sheldon; Sarah Stous; Eric C McDonald; Brett Austin; Mark E Beatty; J Erin Staples; Marie E Killerby; Christopher H Hsu; Jacqueline E Tate; Hannah L Kirking; Almea Matanock Journal: JAMA Intern Med Date: 2022-07-01 Impact factor: 44.409
Authors: Chad R Wells; Abhishek Pandey; Seyed M Moghadas; Burton H Singer; Gary Krieger; Richard J L Heron; David E Turner; Justin P Abshire; Kimberly M Phillips; A Michael Donoghue; Alison P Galvani; Jeffrey P Townsend Journal: Commun Med (Lond) Date: 2022-07-09
Authors: Anastasia Tapari; Georgia G Braliou; Maria Papaefthimiou; Helen Mavriki; Panagiota I Kontou; Georgios K Nikolopoulos; Pantelis G Bagos Journal: Diagnostics (Basel) Date: 2022-06-04
Authors: Matthew L Robinson; Agha Mirza; Nicholas Gallagher; Alec Boudreau; Lydia Garcia Jacinto; Tong Yu; Julie Norton; Chun Huai Luo; Abigail Conte; Ruifeng Zhou; Kim Kafka; Justin Hardick; David D McManus; Laura L Gibson; Andrew Pekosz; Heba H Mostafa; Yukari C Manabe Journal: J Clin Microbiol Date: 2022-06-22 Impact factor: 11.677
Authors: Chad J Achenbach; Matthew Caputo; Claudia Hawkins; Lauren C Balmert; Chao Qi; Joseph Odorisio; Etienne Dembele; Alema Jackson; Hiba Abbas; Jennifer K Frediani; Joshua M Levy; Paulina A Rebolledo; Russell R Kempker; Annette M Esper; Wilbur A Lam; Greg S Martin; Robert L Murphy Journal: PLoS One Date: 2022-06-16 Impact factor: 3.752
Authors: Ngoc Anh Thi Nguyen; Hoai Thi Bui; Quynh Thi-Huong Pham; Ly Thi Thao Hoang; Hung Xuan Ta; Timo Heikkinen; Duyet Van Le; Trang Dinh Van; Nam Quoc Ngo; Phuong Thi Hong Huynh; Trang Thi Huyen Tran; Hoan Quoc Phan; Luong Van Hoang; H Rogier van Doorn; Diep Thi Ngoc Nguyen; Tam Thi Nguyen; Nam Sy Vo; Cuong Viet Vo; Sau Khac Trinh; Tai The Pham; Quang Duc Le; Phan Van Le; Son Thai Nguyen; Loan Thi Tran; Toan Dinh Vu; Quynh Anh Vu Nguyen; Nguyet Thi Trieu; Thuy Thi Le; Ung Dinh Nguyen; Jakob Steman; Tho Huu Ho Journal: Clin Chim Acta Date: 2022-04-29 Impact factor: 6.314