Comparing the diagnostic accuracy of rapid antigen detection tests to real time polymerase chain reaction in the diagnosis of SARS-CoV-2 infection: A systematic review and meta-analysis
- Authors
- Lee, Jonghoo; Song, Jae-Uk; Shim, Sung Ryul
- Issue Date
- Nov-2021
- Publisher
- Elsevier BV
- Keywords
- SARS-CoV-2; COVID-19 testing; Diagnosis; Point-of-care testing; Antigens
- Citation
- Journal of Clinical Virology, v.144
- Indexed
- SCIE
SCOPUS
- Journal Title
- Journal of Clinical Virology
- Volume
- 144
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/54587
- DOI
- 10.1016/j.jcv.2021.104985
- ISSN
- 1386-6532
1873-5967
- Abstract
- Background: Timely and accurate diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is crucial to reduce the risk of viral transmission. We investigated the diagnostic accuracy of rapid antigen detection tests (RADTs) in the diagnosis of SARS-CoV-2 infection. Methods: A systematic literature search was performed using Pubmed, Embase, and the Cochrane Central Register. The sensitivity, specificity, diagnostic odds ratio (DOR), and a hierarchical summary receiver-operating characteristic curve (HSROC) of RADTs were pooled using meta-analysis. We used commercial and laboratory-developed reverse transcriptase-polymerase chain reaction (RT-PCR) as reference standards. Results: We identified 24 studies comprising 14,188 patients. The overall pooled sensitivity, specificity, and DOR of RADTs for diagnosis of SARS-CoV-2 were 0.68 (95%CI, 0.59 - 0.76), 0.99 (95%CI, 0.99 - 1.00), and 426.70 (95% CI, 168.37 - 1081.65), respectively. RADTs and RT-PCR had moderate agreement with an estimated pooled Cohen's kappa statistic of 0.75 (95%CI, 0.74-0.77), and area under the HSROC of 0.98 (95%CI, 0.96 - 0.99). The pooled sensitivity of RADTs was significantly increased in subjects with viral load of Ct-value <25 or in those within 5 days after symptom onset than it was in subjects with lower viral loads or longer symptom duration. Conclusions: The overall sensitivity of RADTs was inferior to that of the RT-PCR assay. The RADTs were more sensitive for samples of Ct-value < 25 and might be suitable for subjects in the community within 5 days of symptom onset.
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Collections - 3. Graduate School > Graduate School of Public Health > 1. Journal Articles
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