Longitudinal Assessment of Diagnostic Test Performance over the Course of Acute SARS-CoV-2 Infection

Rebecca L. Smith; Laura L. Gibson; Pamela P. Martinez; Ruian Ke; Agha Mirza; Madison Conte; Nicholas Gallagher; Abigail Conte; Leyi Wang; Richard Fredrickson; Darci C. Edmonson; Melinda E. Baughman; Karen K. Chiu; Hannah Choi; Tor W. Jensen; Kevin R. Scardina; Shannon Bradley; Stacy L. Gloss; Crystal Reinhart; Jagadeesh Yedetore; Alyssa N. Owens; John Broach; Bruce Barton; Peter Lazar; Darcy Henness; Todd Young; Alastair Dunnett; Matthew L. Robinson; Heba H. Mostafa; Andrew Pekosz; Yukari C. Manabe; William J. Heetderks; David D. McManus; Christopher B. Brooke

doi:10.1093/infdis/jiab337

Longitudinal Assessment of Diagnostic Test Performance over the Course of Acute SARS-CoV-2 Infection

Rebecca L. Smith, Laura L. Gibson, Pamela P. Martinez, Ruian Ke, Agha Mirza, Madison Conte, Nicholas Gallagher, Abigail Conte, Leyi Wang, Richard Fredrickson, Darci C. Edmonson, Melinda E. Baughman, Karen K. Chiu, Hannah Choi, Tor W. Jensen, Kevin R. Scardina, Shannon Bradley, Stacy L. Gloss, Crystal Reinhart, Jagadeesh YedetoreAlyssa N. Owens, John Broach, Bruce Barton, Peter Lazar, Darcy Henness, Todd Young, Alastair Dunnett, Matthew L. Robinson, Heba H. Mostafa, Andrew Pekosz, Yukari C. Manabe, William J. Heetderks, David D. McManus, Christopher B. Brooke

Research output: Contribution to journal › Article › peer-review

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.

Original language	English (US)
Pages (from-to)	976-982
Number of pages	7
Journal	Journal of Infectious Diseases
Volume	224
Issue number	6
DOIs	https://doi.org/10.1093/infdis/jiab337
State	Published - Sep 15 2021

Keywords

RT-qPCR testing
SARS-CoV-2
antigen testing
diagnostic testing
test sensitivity

ASJC Scopus subject areas

General Medicine

Access to Document

10.1093/infdis/jiab337

Cite this

Smith, R. L., Gibson, L. L., Martinez, P. P., Ke, R., Mirza, A., Conte, M., Gallagher, N., Conte, A., Wang, L., Fredrickson, R., Edmonson, D. C., Baughman, M. E., Chiu, K. K., Choi, H., Jensen, T. W., Scardina, K. R., Bradley, S., Gloss, S. L., Reinhart, C., ... Brooke, C. B. (2021). Longitudinal Assessment of Diagnostic Test Performance over the Course of Acute SARS-CoV-2 Infection. Journal of Infectious Diseases, 224(6), 976-982. https://doi.org/10.1093/infdis/jiab337

Smith, RL, Gibson, LL, Martinez, PP, Ke, R, Mirza, A, Conte, M, Gallagher, N, Conte, A, Wang, L, Fredrickson, R, Edmonson, DC, Baughman, ME, Chiu, KK, Choi, H, Jensen, TW, Scardina, KR, Bradley, S, Gloss, SL, Reinhart, C, Yedetore, J, Owens, AN, Broach, J, Barton, B, Lazar, P, Henness, D, Young, T, Dunnett, A, Robinson, ML , Mostafa, HH , Pekosz, A , Manabe, YC, Heetderks, WJ, McManus, DD & Brooke, CB 2021, 'Longitudinal Assessment of Diagnostic Test Performance over the Course of Acute SARS-CoV-2 Infection', Journal of Infectious Diseases, vol. 224, no. 6, pp. 976-982. https://doi.org/10.1093/infdis/jiab337

@article{48537c5984a64bdfb8fc59d3cf70af38,

title = "Longitudinal Assessment of Diagnostic Test Performance over the Course of Acute SARS-CoV-2 Infection",

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.",

keywords = "RT-qPCR testing, SARS-CoV-2, antigen testing, diagnostic testing, test sensitivity",

author = "Smith, {Rebecca L.} and Gibson, {Laura L.} and Martinez, {Pamela P.} and Ruian Ke and Agha Mirza and Madison Conte and Nicholas Gallagher and Abigail Conte and Leyi Wang and Richard Fredrickson and Edmonson, {Darci C.} and Baughman, {Melinda E.} and Chiu, {Karen K.} and Hannah Choi and Jensen, {Tor W.} and Scardina, {Kevin R.} and Shannon Bradley and Gloss, {Stacy L.} and Crystal Reinhart and Jagadeesh Yedetore and Owens, {Alyssa N.} and John Broach and Bruce Barton and Peter Lazar and Darcy Henness and Todd Young and Alastair Dunnett and Robinson, {Matthew L.} and Mostafa, {Heba H.} and Andrew Pekosz and Manabe, {Yukari C.} and Heetderks, {William J.} and McManus, {David D.} and Brooke, {Christopher B.}",

year = "2021",

month = sep,

day = "15",

doi = "10.1093/infdis/jiab337",

language = "English (US)",

volume = "224",

pages = "976--982",

journal = "Journal of Infectious Diseases",

issn = "0022-1899",

publisher = "Oxford University Press",

number = "6",

}

TY - JOUR

T1 - Longitudinal Assessment of Diagnostic Test Performance over the Course of Acute SARS-CoV-2 Infection

AU - Smith, Rebecca L.

AU - Gibson, Laura L.

AU - Martinez, Pamela P.

AU - Ke, Ruian

AU - Mirza, Agha

AU - Conte, Madison

AU - Gallagher, Nicholas

AU - Conte, Abigail

AU - Wang, Leyi

AU - Fredrickson, Richard

AU - Edmonson, Darci C.

AU - Baughman, Melinda E.

AU - Chiu, Karen K.

AU - Choi, Hannah

AU - Jensen, Tor W.

AU - Scardina, Kevin R.

AU - Bradley, Shannon

AU - Gloss, Stacy L.

AU - Reinhart, Crystal

AU - Yedetore, Jagadeesh

AU - Owens, Alyssa N.

AU - Broach, John

AU - Barton, Bruce

AU - Lazar, Peter

AU - Henness, Darcy

AU - Young, Todd

AU - Dunnett, Alastair

AU - Robinson, Matthew L.

AU - Mostafa, Heba H.

AU - Pekosz, Andrew

AU - Manabe, Yukari C.

AU - Heetderks, William J.

AU - McManus, David D.

AU - Brooke, Christopher B.

PY - 2021/9/15

Y1 - 2021/9/15

N2 - 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.

AB - 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.

KW - RT-qPCR testing

KW - SARS-CoV-2

KW - antigen testing

KW - diagnostic testing

KW - test sensitivity

UR - http://www.scopus.com/inward/record.url?scp=85116490155&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85116490155&partnerID=8YFLogxK

U2 - 10.1093/infdis/jiab337

DO - 10.1093/infdis/jiab337

M3 - Article

C2 - 34191025

AN - SCOPUS:85116490155

SN - 0022-1899

VL - 224

SP - 976

EP - 982

JO - Journal of Infectious Diseases

JF - Journal of Infectious Diseases

IS - 6

ER -

Longitudinal Assessment of Diagnostic Test Performance over the Course of Acute SARS-CoV-2 Infection

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this