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http://conacyt.repositorioinstitucional.mx/jspui/handle/1000/7071
Diagnostic performance and clinical implications of rapid SARS-CoV-2 antigen testing in Mexico using real-world nationwide COVID-19 registry data | |
OMAR YAXMEHEN BELLO CHAVOLLA Neftali Eduardo Antonio Villa Luisa Fernández Chirino Enrique Cañedo Guerra Carlos Fermín Martínez Alejandro Márquez Salinas Arsenio Vargas Vázquez Jessica Paola Bahena López | |
Acceso Abierto | |
Atribución-NoComercial | |
https://doi.org/10.1101/2021.01.02.21249141 | |
https://www.medrxiv.org/content/10.1101/2021.01.02.21249141v1 | |
BACKGROUND SARS-CoV-2 testing capacity is important to monitor epidemic dynamics. Given difficulties of large-scale RT-PCR implementation, rapid antigen tests (Rapid Ag-T) have been proposed as alternatives in settings such as Mexico. OBJECTIVES To evaluate diagnostic performance of Rapid Ag-T for SARS-CoV-2 infection and its associated clinical implications compared to RT-PCR testing in Mexico. METHODS We analyzed data from the COVID-19 registry of the Mexican General Directorate of Epidemiology up to December 31st, 2020 (n=3,374,165) and cases with both RT-PCR and Rapid Ag-T (n=18,446). We evaluated diagnostic performance using accuracy measures and assessed time-dependent changes in AUROC. We also explored test discordances as predictors of hospitalization, intubation, severe COVID-19 and mortality. RESULTS Rapid Ag-T is primarily used in Mexico City. Rapid Ag-T have low sensitivity 37.6% (95%CI 36.6-38.7), high specificity 95.4% (95%CI 95.1-95.8) and acceptable positive 86.1% (95%CI 85.0-86.6) and negative predictive values 67.2% (95%CI 66.2-69.2). Rapid Ag-T has optimal diagnostic performance up to days 7-10 after symptom, and its performance is modified by testing location, comorbidity, and age. RT-PCR(-) / Rapid Ag-T(+) cases had higher risk of adverse COVID-19 outcomes and were older, RT-PCR(+)/ Rapid Ag-T(-) cases had slightly higher risk or adverse outcomes and ≥7 days from symptom onset. Cases detected with rapid Ag-T were younger, without comorbidities, and milder COVID-19 course. CONCLUSIONS Rapid Ag-T could be used as an alternative to RT-PCR for large scale SARS-CoV-2 testing in Mexico. Interpretation of Rapid Ag-T results should be done with caution to minimize the risk associated with false negative results. | |
medRxiv and bioRxiv | |
04-01-2021 | |
Preimpreso | |
www.medrxiv.org | |
Inglés | |
Epidemia COVID-19 | |
Público en general | |
VIRUS RESPIRATORIOS | |
Versión publicada | |
publishedVersion - Versión publicada | |
Appears in Collections: | Artículos científicos |
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