Evaluation of the accuracy, ease of use and limit of detection of novel, rapid, antigen-detecting point-of-care diagnostics for SARS-CoV-2

<h3>Abstract</h3> <h3>Background</h3> <p>Reliable point-of-care (POC) diagnostics not requiring laboratory infrastructure could be a game changer in the COVID-19 pandemic, particularly in the Global South. We assessed performance, limit of detection and ease-of-use of t...

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Hauptverfasser: Krüger, Lisa (VerfasserIn) , Gaeddert, Mary (VerfasserIn) , Köppel, Lisa (VerfasserIn) , Brümmer, Lukas E. (VerfasserIn) , Gottschalk, Claudius (VerfasserIn) , Barreto Miranda, Isabel (VerfasserIn) , Schnitzler, Paul (VerfasserIn) , Kräusslich, Hans-Georg (VerfasserIn) , Lindner, Andreas (VerfasserIn) , Nikolai, Olga (VerfasserIn) , Mockenhaupt, Frank Peter (VerfasserIn) , Seybold, Joachim (VerfasserIn) , Corman, Victor Max (VerfasserIn) , Drosten, Christian (VerfasserIn) , Pollock, Nira (VerfasserIn) , Cubas-Atienzar, A. I. (VerfasserIn) , Kontogianni, K. (VerfasserIn) , Collins, A. (VerfasserIn) , Wright, A. H. (VerfasserIn) , Knorr, Britta (VerfasserIn) , Welker, Andreas (VerfasserIn) , Vos, Margaretha de (VerfasserIn) , Sacks, Jilian A. (VerfasserIn) , Adams, E. R. (VerfasserIn) , Denkinger, Claudia M. (VerfasserIn)
Dokumenttyp: Article (Journal) Kapitel/Artikel
Sprache:Englisch
Veröffentlicht: October 4, 2020
Ausgabe:Preprint
In: medRxiv
Year: 2020, Pages: 1-22
DOI:10.1101/2020.10.01.20203836
Online-Zugang:Verlag, kostenfrei, Volltext: https://doi.org/10.1101/2020.10.01.20203836
Verlag, kostenfrei, Volltext: https://www.medrxiv.org/content/10.1101/2020.10.01.20203836v1
Volltext
Verfasserangaben:L.J. Krüger, M. Gaeddert, L. Köppel, L.E. Brümmer, C. Gottschalk, I.B. Miranda, P. Schnitzler, H.G. Kräusslich, A.K. Lindner, O. Nikolai, F.P. Mockenhaupt, J. Seybold, V.M. Corman, C. Drosten, N.R. Pollock, A.I. Cubas-Atienzar, K. Kontogianni, A. Collins, A.H. Wright, B. Knorr, A. Welker, M. de Vos, J.A. Sacks, E.R. Adams, C.M. Denkinger, for the study team

MARC

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520 |a <h3>Abstract</h3> <h3>Background</h3> <p>Reliable point-of-care (POC) diagnostics not requiring laboratory infrastructure could be a game changer in the COVID-19 pandemic, particularly in the Global South. We assessed performance, limit of detection and ease-of-use of three antigen-detecting, rapid POC tests (Ag-RDT) for <i>SARS-CoV-2</i>.</p><h3>Methods</h3> <p>This prospective, multi-centre diagnostic accuracy study recruited participants suspected to have <i>SARS-CoV-2</i> in Germany and the UK. Paired nasopharyngeal swabs (NP) or NP and/or oropharyngeal swabs (OP) were collected from participants (one for clinical RT-PCR and one for Ag-RDT). Performance of each of three Ag-RDTs was compared to RT-PCR overall, and according to predefined subcategories e.g. cycle threshold (CT)-value, days from symptoms onset, etc. In addition, limited verification of the analytical limit-of-detection (LOD) was determined. To understand the usability a System Usability Scale (SUS) questionnaire and ease-of-use (EoU) assessment were performed.</p><h3>Results</h3> <p>Between April 17<sup>th</sup> and August 25<sup>th</sup>, 2020, 2417 participants were enrolled, with 70 (3.0%) testing positive by RT-PCR. The best-performing test (SD Biosensor, Inc. STANDARD Q) was 76×6% (95% Confidence Interval (CI) 62×8-86×4) sensitive and 99×3% (CI 98×6-99×6) specific. A sub-analysis showed all samples with RT-PCR CT-values <25 were detectable by STANDARD Q. The test was considered easy-to-use (SUS 86/100) and suitable for POC. Bioeasy and Coris showed specificity of 93×1% (CI 91×0%-94×8%) and 95×8% (CI 93×4%-97×4%), respectively, not meeting the predefined target of ≥98%.</p><h3>Conclusion</h3> <p>There is large variability in performance of Ag-RDT with SD Biosensor showing promise. Given the usability at POC, this test is likely to have impact despite imperfect sensitivity; however further research and modelling are needed.</p> 
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