Clinical practice of rapid antigen tests for SARS-CoV-2 Omicron variant: A single-center study in China

• Published in: Virologica Sinica Vol. 37; no. 6; pp. 842 - 849
• Main Authors: Chen, Mengyuan, Xu, Jiaqin, Ying, Lingjun, Cai, Miaoguo, Tung, Tao-Hsin, Zhou, Kai, Zheng, Yufen, Bi, Xiaojie, Wang, Jing, Tu, Xi, Shen, Bo, Lv, Dongqing
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.12.2022; The Authors. Publishing services by Elsevier B.V. on behalf of KeAi Communications Co. Ltd
• Subjects: China; COVID-19; COVID-19 progression evaluation; Disease Progression; Dynamic zero-COVID policy; Humans; Omicron variant; Rapid antigen tests (RATs); SARS-CoV-2; China; Omicron variant; SARS-CoV-2; Rapid antigen tests (RATs); Dynamic zero-COVID policy; COVID-19 progression evaluation
• ISSN: 1995-820X; 1674-0769; 1995-820X
• DOI: 10.1016/j.virs.2022.08.008

Responding to the fast-spreading SARS-CoV-2 Omicron variant, to improve screening efficiency, rapid antigen tests (RATs) were first added as a supplementary detection method in China in mid-March, 2022. What and how big a role RATs should play need to be supported by clinical data. Here, RAT performance and relevant factors in comparison with nucleic acid amplification tests (NAATs) were assessed in Omicron-infected inpatients. From the NAAT results, nasopharyngeal swabs (NPs) performed better than oropharyngeal swabs (OPs). RATs tested on NAAT positive NPs performed better than those with OP-positive samples. The RAT positivity rate was strongly associated with high levels of N and OFR1ab genes, especially in NPs where patients also had significantly longer hospital stays and shorter days from symptom onset to RAT testing. Self-performed RATs had a detection accuracy that was comparable to professionally performed RATs when the subjects were well guided. The antigen negative rate of the studied patients was 100% at discharge. These findings suggest that, in addition to a supplementary detection role, RATs can be an important strategy for evaluating the disease progression of Omicron-infected inpatients. This study provides important clinical data to support better rules regarding RATs under China's COVID-19 prevention and control policy. •Disease progression time and gene level in nasopharynx were relevant factors on RAT.•Accuracy rate of self-performed RATs was comparable to professionally-performed RAT.•RATs may be an important strategy for COVID-19 progression evaluation.