Screening for Severe Acute Respiratory Syndrome Coronavirus 2 in Close Contacts of Individuals With Confirmed Infection: Performance and Operational Considerations

Point-of-care and decentralized testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is critical to inform public health responses. Performance evaluations in priority use cases such as contact tracing can highlight trade-offs in test selection and testing strategies. A prospecti...

Full description

Saved in:
Bibliographic Details
Published in:The Journal of infectious diseases 2022-12, Vol.226 (12), p.2118-2128
Main Authors: Zobrist, Stephanie, Oliveira-Silva, Michelle, Vieira, Alexia Martines, Bansil, Pooja, Gerth-Guyette, Emily, Leader, Brandon T, Golden, Allison, Slater, Hannah, Cruz, Catherine Duran de Lucena, Garbin, Eduardo, Sagalovsky, Mariana, Pal, Sampa, Gupta, Vin, Wolansky, Leo, Dall'Acqua, Deusilene Souza Vieira, Naveca, Felipe Gomes, Nascimento, Valdinete Alves do, Salcedo, Juan Miguel Villalobos, Drain, Paul K, Costa, Alexandre Dias Tavares, Domingo, Gonzalo J, Pereira, Dhélio
Format: Article
Language:English
Subjects:
Contact Tracing
COVID-19 - diagnosis
COVID-19 - epidemiology
Humans
Prospective Studies
SARS-CoV-2 - genetics
Sensitivity and Specificity
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Point-of-care and decentralized testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is critical to inform public health responses. Performance evaluations in priority use cases such as contact tracing can highlight trade-offs in test selection and testing strategies. A prospective diagnostic accuracy study was conducted among close contacts of coronavirus disease 2019 (COVID-19) cases in Brazil. Two anterior nares swabs (ANS), a nasopharyngeal swab (NPS), and saliva were collected at all visits. Vaccination history and symptoms were assessed. Household contacts were followed longitudinally. Three rapid antigen tests and 1 molecular method were evaluated for usability and performance against reference reverse-transcription polymerase chain reaction (RT-PCR) on nasopharyngeal swab specimens. Fifty index cases and 214 contacts (64 household) were enrolled. Sixty-five contacts were RT-PCR positive during ≥1 visit. Vaccination did not influence viral load. Gamma variants were most prevalent; Delta variants emerged increasingly during implementation. The overall sensitivity of evaluated tests ranged from 33% to 76%. Performance was higher among symptomatic cases and those with cycle threshold (Ct) values 70% and almost 90% after 4 days. The near-immediate time to results for antigen tests significantly offsets lower analytical sensitivity in settings where RT-PCR results are delayed or unavailable.
ISSN:0022-1899
1537-6613
DOI:10.1093/infdis/jiac204