UNIGE document Scientific Article
previous document  unige:157929  next document
add to browser collection
Title

Diagnostic accuracy of SARS-CoV-2 rapid antigen detection testing in symptomatic and asymptomatic children in the clinical setting

Authors
L'Huillier, Arnaud
show hidden authors show all authors [1 - 13]
Published in Journal of clinical microbiology. 2021, vol. 59, no. 9, e0099121
Abstract Antigen-based rapid diagnostic tests (RDTs) are used in children despite the lack of data. We evaluated the diagnostic performance of the Panbio-COVID-19 Ag Rapid Test Device (P-RDT) in children. Symptomatic and asymptomatic participants 0 to 16 years old had two nasopharyngeal swabs (NPS) for both reverse transcription-PCR (RT-PCR) and P-RDT. A total of 822 participants completed the study, of which 533 (64.9%) were symptomatic. Among the 119 (14.5%) RT-PCR-positive patients, the P-RDT sensitivity was 0.66 (95% confidence interval [CI] 0.57 to 0.74). Mean viral load (VL) was higher among P-RDT-positive patients than negative ones (P < 0.001). Sensitivity was 0.91 in specimens with VL of >1.0E6 IU/ml (95% CI 0.83 to 0.99) and decreased to 0.75 (95% CI 0.66 to 0.83) for specimens >1.0E3 IU/ml. Among symptomatic participants, the P-RDT displayed a sensitivity of 0.73 (95% CI 0.64 to 0.82), which peaked at 1.00 at 2 days post-onset of symptoms (DPOS) (95% CI 1.00 to 1.00), then decreased to 0.56 (95% CI 0.23 to 0.88) at 5 DPOS. There was a trend toward lower P-RDT sensitivity in symptomatic children <12 years (0.62 [95% CI 0.45 to 0.78]) versus ≥12 years (0.80 [95% CI 0.69 to 0.91]; P = 0.09). In asymptomatic participants, the P-RDT displayed a sensitivity of 0.43 (95% CI 0.26 to 0.61). Specificity was 1.00 in symptomatic and asymptomatic children (95% CI 0.99 to 1.00). The overall 73% and 43% sensitivities of P-RDT in symptomatic and asymptomatic children, respectively, was below the 80% cutoff recommended by the World Health Organization. We observed a correlation between VL and P-RDT sensitivity, as well as variation of sensitivity according to DPOS, a major determinant of VL. These data highlight the limitations of RDTs in children, with the potential exception in early symptomatic children ≥12yrs.
Keywords AdolescentAntigensViralCOVID-19COVID-19 Serological TestingChildChildPreschoolHumansInfantInfantNewbornSARS-CoV-2Sensitivity and Specificity
Identifiers
PMID: 34190574
Full text
Structures
Research groups Emerging viruses (993)
Etiologie des pneumonies et marqueurs inflammatoires chez l'enfant fébrile (183)
Groupe Laurent Kaiser (virologie clinique) (668)
Citation
(ISO format)
L'HUILLIER, Arnaud et al. Diagnostic accuracy of SARS-CoV-2 rapid antigen detection testing in symptomatic and asymptomatic children in the clinical setting. In: Journal of Clinical Microbiology, 2021, vol. 59, n° 9, p. e0099121. doi: 10.1128/JCM.00991-21 https://archive-ouverte.unige.ch/unige:157929

40 hits

0 download

Update

Deposited on : 2022-01-13

Export document
Format :
Citation style :