Implementing SARS-CoV-2 Rapid Antigen Testing in the Emergency Ward of a Swiss University Hospital: The INCREASE Study

Microorganisms

Reto Lienhard¹  Adrian Egli²  Maryline Foerster³  Pierre-Nicolas Carron³  Onya Opota⁴  Gilbert Greub⁴  René Brouillet⁴  Antony Croxatto⁴  Antonios Kritikos⁴  Giorgia Caruana⁴  Giuseppe Pantaleo⁵  Eleftheria Kampouri⁶  Laurence Senn⁶ 

[1] ADMed Microbiologie Laboratory, 2300 La Chaux-de-Fonds, Switzerland;Clinical Bacteriology and Mycology, University Hospital Basel, 4001 Basel, Switzerland;Emergency Department, Lausanne University Hospital, 1011 Lausanne, Switzerland;Institute of Microbiology, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland;Institute of immunology, University Hospital of Lausanne, 1011 Lausanne, Switzerland;Service of Hospital Preventive Medicine, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland;

关键词: SARS-CoV-2;    COVID-19 diagnostic testing;    rapid antigen test;    health plan implementation;    nucleocapsid protein;    emergency ward;   

DOI  :  10.3390/microorganisms9040798

来源: DOAJ

【 摘 要 】

Following the Swiss Federal Office of Public Health (FOPH) authorization of the rapid antigen test (RAT), we implemented the use of the RAT in the emergency ward of our university hospital for patients’ cohorting. RAT triaging in association with RT-PCR allowed us to promptly isolate positive patients and save resources. Among 532 patients, overall sensitivities were 48.3% for Exdia and 41.2% for Standard Q^®, Panbio^TM and BD Veritor™. All RATs exhibited specificity above 99%. Sensitivity increased to 74.6%, 66.2%, 66.2% and 64.8% for Exdia, Standard Q^®, Panbio^TM and BD Veritor™, respectively, for viral loads above 10⁵ copies/mL, to 100%, 97.8%, 96.6% and 95.6% for viral loads above 10⁶ copies/mL and 100% for viral loads above 10⁷ copies/mL. Sensitivity was significantly higher for patients with symptoms onset within four days (74.3%, 69.2%, 69.2% and 64%, respectively) versus patients with the evolution of symptoms longer than four days (36.8%, 21.1%, 21.1% and 23.7%, respectively). Among COVID-19 asymptomatic patients, sensitivity was 33%. All Immunoglobulin-A-positive patients resulted negative for RAT. The RAT might represent a useful resource in selected clinical settings as a complementary tool in RT-PCR for rapid patient triaging, but the lower sensitivity, especially in late presenters and COVID-19 asymptomatic subjects, must be taken into account.

【 授权许可】

Unknown