Please use this identifier to cite or link to this item: 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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