Author: Steinlin-Schopfer, Jacqueline; Barbani, Maria Teresa; Kamgang, Richard; Zwahlen, Martina; Suter-Riniker, Franziska; Dijkman, Ronald
Title: Evaluation of the Roche Antigen Rapid Test and a Cell Culture-Based Assay compared to rRT- PCR for the detection of SARS CoV-2: a contribution to the discussion about SARS CoV-2 diagnostic tests and contagiousness Cord-id: 2skb43f2 Document date: 2021_5_9
ID: 2skb43f2
Snippet: Background: The most sensitive method to detect SARS-CoV-2 relies on rRT-PCR; however, viral RNA can be detected weeks/months after clinical resolution. Since rRT-PCR cannot discern between non- and infectious virus, it is unclear whether the presence of viral RNA after recovery reflects infectious SARS-CoV-2. However, recent studies suggest a positive correlation between antigen rapid tests (Ag-RDT) and virus isolation that is more suited to assess contagiousness. Objectives: To assess the util
Document: Background: The most sensitive method to detect SARS-CoV-2 relies on rRT-PCR; however, viral RNA can be detected weeks/months after clinical resolution. Since rRT-PCR cannot discern between non- and infectious virus, it is unclear whether the presence of viral RNA after recovery reflects infectious SARS-CoV-2. However, recent studies suggest a positive correlation between antigen rapid tests (Ag-RDT) and virus isolation that is more suited to assess contagiousness. Objectives: To assess the utility of SARS CoV-2 diagnostic tests in different settings we evaluated the performance of Ag-RDT-based and a cell-culture-based SARS-CoV-2 assay in comparison to rRT-PCR. Study design: A total of 61 Nasopharyngeal-Swabs tested positive by cobas® SARS-CoV-2 rRT-PCR were in parallel evaluated with the Roche Ag-RDT and a cell culture-based assay to detect SARS-CoV-2. Results: SARS-CoV-2 was successfully isolated in 51/61 samples corresponding to 83.6%, which was 97.3% or 96.2% when considering samples with E-gene Ct-value <25 and <28, respectively. In comparison, the Ag-RDT showed an overall sensitivity of 85.2%, that increased to 100% and 96.2% using an E-gene Ct-value cut-off of <25 and <28, respectively. There was an overall good agreement between the commercial Ag-RDT and our in-house cell culture-based SARS-CoV-2 detection assay. However, SARS-CoV-2 could be isolated from two samples that tested negative by Ag-RDT. Conclusions: Our results support the use of the Roche Ag-RDT to detect SARS-CoV-2 exposure in large scale populations. However, it is recommended to use rRT-PCR, potentially in conjunction with cell culture-based SARS-CoV-2 assay, to support clinicians in making decisions regarding fragile patient groups.
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