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2020 ; 26
(8
): 1094.e7-1094.e10
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
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English Wikipedia
Comparison of diagnostic accuracies of rapid serological tests and ELISA to
molecular diagnostics in patients with suspected coronavirus disease 2019
presenting to the hospital
#MMPMID32502646
Ong DSY
; de Man SJ
; Lindeboom FA
; Koeleman JGM
Clin Microbiol Infect
2020[Aug]; 26
(8
): 1094.e7-1094.e10
PMID32502646
show ga
OBJECTIVES: To assess the diagnostic performance of rapid lateral flow
immunochromatographic assays (LFAs) compared with an ELISA and nucleic acid
amplification tests (NATs) in individuals with suspected coronavirus disease 2019
(COVID-19). METHODS: Patients presenting to a Dutch teaching hospital were
eligible between 17 March and 10 April 2020, when they had respiratory symptoms
that were suspected for COVID-19. The performances of six different LFAs were
evaluated in plasma samples obtained on corresponding respiratory sample dates of
NATs testing. Subsequently, the best performing LFA was evaluated in 228 patients
and in 50 sera of a historical patient control group. RESULTS: In the pilot
analysis, sensitivity characteristics of LFA were heterogeneous, ranging from
2/20 (10%; 95% CI 0%-23%) to 11/20 (55%; 95% CI 33%-77%). In the total cohort,
Orient Gene Biotech COVID-19 IgG/IgM Rapid Test LFA had a sensitivity of 43/99
(43%; 95% CI 34%-53%) and specificity of 126/129 (98%; 95% CI 95%-100%).
Sensitivity increased to 31/52 (60%; 95% CI 46%-73%) in patients with at least
7 days of symptoms, and to 21/33 (64%; 95% CI 47%-80%) in patients with
C-reactive protein (CRP) ?100 mg/L. Sensitivity and specificity of Wantai
SARS-CoV-2 Ab ELISA was 59/95 (62%; 95% CI 52%-72%) and 125/128 (98%; 95% CI
95%-100%) in all patients, respectively, but sensitivity increased to 38/48 (79%;
95% CI 68%-91%) in patients with at least 7 days of symptoms. CONCLUSIONS: There
is large variability in diagnostic test performance between rapid LFAs, but
overall limited sensitivity and high specificity in acutely admitted patients.
Sensitivity improved in patients with longer existing symptoms or high CRP. LFAs
should only be considered as additional triage tools when these may lead to the
improvement of hospital logistics.