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A rapid, high-sensitivity SARS-CoV-2 nucleocapsid immunoassay to aid diagnosis of acute COVID-19 at the point of care
Paul K Drain; Madhavi Ampajwala; Christopher Chappel; Andre B Gvozden; Melanie Hoppers; Melody Wang; Robert Rosen; Stephen Young; Edward Zissman; Michalina Montano.
Afiliación
  • Paul K Drain; University of Washington
  • Madhavi Ampajwala; Village Health Partners
  • Christopher Chappel; Chappel Group
  • Andre B Gvozden; Gvozden Pediatrics
  • Melanie Hoppers; Clinical Research Solutions
  • Melody Wang; University of Washington
  • Robert Rosen; Ardmore Family Practice
  • Stephen Young; Tricore Reference Laboratories
  • Edward Zissman; Children's Research
  • Michalina Montano; University of Washington
Preprint en En | PREPRINT-MEDRXIV | ID: ppmedrxiv-20238410
ABSTRACT
BackgroundThe LumiraDx SARS-CoV-2 antigen test, which uses a high-sensitivity, microfluidic immunoassay to detect the nucleocapsid protein of SARS-CoV-2, was evaluated for diagnosing acute COVID-19 in adults and children across point-of-care settings. MethodsTwo paired anterior nasal swabs or two paired nasopharyngeal swabs were collected from each participant. Swabs were tested by the LumiraDx SARS-CoV-2 antigen test and compared with real-time PCR (rt-PCR; Roche cobas 6800 platform). Positive- and negative predictive values and likelihood ratios were calculated. Results stratified based on gender, age, duration of symptoms, and rt-PCR cycle threshold. ResultsOut of the 512 participants, aged 0-90 years, of this prospective validation study, 414 (81%) were symptomatic for COVID-19 and 123 (24%) swabs were positive for SARS-CoV-2 based on rt-PCR testing. Compared with rt-PCR, the 12-minute swab test had 97.6% sensitivity and 96.6% specificity within 12 days of symptom onset, representing the period of infectivity. All (100%) samples detected within 33 rt-PCR cycles were also identified using the antigen test. Results were consistent across age and gender. Despite being performed by minimally trained healthcare workers, the user error rate of the test system was 1%. ConclusionThe rapid high-sensitivity assay using nasopharyngeal or anterior nasal sampling may offer significant improvements for diagnosing acute SARS-CoV-2 infection in clinic- and community-based settings. SummaryA 12-minute nasal swab test detects 97.6% of COVID-19 infections, compared to gold standard real-time PCR testing, up to 12 days following symptom onset using a microfluidic immunoassay for SARS-CoV-2 nucleocapsid protein.
Licencia
cc_by_nc_nd
Texto completo: 1 Colección: 09-preprints Base de datos: PREPRINT-MEDRXIV Tipo de estudio: Diagnostic_studies / Experimental_studies / Observational_studies / Prognostic_studies Idioma: En Año: 2020 Tipo del documento: Preprint
Texto completo: 1 Colección: 09-preprints Base de datos: PREPRINT-MEDRXIV Tipo de estudio: Diagnostic_studies / Experimental_studies / Observational_studies / Prognostic_studies Idioma: En Año: 2020 Tipo del documento: Preprint