Utility of COVID‐19 antigen testing in the emergency department
Abstract Background The BinaxNOW coronavirus disease 2019 (COVID‐19) Ag Card test (Abbott Diagnostics Scarborough, Inc.) is a lateral flow immunochromatographic point‐of‐care test for the qualitative detection of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) nucleocapsid protein antig...
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-02-01
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| Series: | Journal of the American College of Emergency Physicians Open |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/emp2.12605 |
| _version_ | 1818986865487773696 |
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| author | W. Frank Peacock Karina M. Soto‐Ruiz Stacey L. House Chad M. Cannon Gary Headden Brian Tiffany Sergey Motov Kian Merchant‐Borna Anna Marie Chang Claire Pearson Brian W. Patterson Alan E. Jones Joseph Miller Joseph Varon Aveh Bastani Carol Clark Zubaid Rafique Bory Kea John Eppensteiner James M. Williams Simon A. Mahler Brian E. Driver Phyllis Hendry Eugenia Quackenbush David Robinson Jon W. Schrock James P. D'Etienne Christopher J. Hogan Anwar Osborne Ralph Riviello Stephen Young |
| author_facet | W. Frank Peacock Karina M. Soto‐Ruiz Stacey L. House Chad M. Cannon Gary Headden Brian Tiffany Sergey Motov Kian Merchant‐Borna Anna Marie Chang Claire Pearson Brian W. Patterson Alan E. Jones Joseph Miller Joseph Varon Aveh Bastani Carol Clark Zubaid Rafique Bory Kea John Eppensteiner James M. Williams Simon A. Mahler Brian E. Driver Phyllis Hendry Eugenia Quackenbush David Robinson Jon W. Schrock James P. D'Etienne Christopher J. Hogan Anwar Osborne Ralph Riviello Stephen Young |
| author_sort | W. Frank Peacock |
| collection | DOAJ |
| description | Abstract Background The BinaxNOW coronavirus disease 2019 (COVID‐19) Ag Card test (Abbott Diagnostics Scarborough, Inc.) is a lateral flow immunochromatographic point‐of‐care test for the qualitative detection of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) nucleocapsid protein antigen. It provides results from nasal swabs in 15 minutes. Our purpose was to determine its sensitivity and specificity for a COVID‐19 diagnosis. Methods Eligible patients had symptoms of COVID‐19 or suspected exposure. After consent, 2 nasal swabs were collected; 1 was tested using the Abbott RealTime SARS‐CoV‐2 (ie, the gold standard polymerase chain reaction test) and the second run on the BinaxNOW point of care platform by emergency department staff. Results From July 20 to October 28, 2020, 767 patients were enrolled, of which 735 had evaluable samples. Their mean (SD) age was 46.8 (16.6) years, and 422 (57.4%) were women. A total of 623 (84.8%) patients had COVID‐19 symptoms, most commonly shortness of breath (n = 404; 55.0%), cough (n = 314; 42.7%), and fever (n = 253; 34.4%). Although 460 (62.6%) had symptoms ≤7 days, the mean (SD) time since symptom onset was 8.1 (14.0) days. Positive tests occurred in 173 (23.5%) and 141 (19.2%) with the gold standard versus BinaxNOW test, respectively. Those with symptoms >2 weeks had a positive test rate roughly half of those with earlier presentations. In patients with symptoms ≤7 days, the sensitivity, specificity, and negative and positive predictive values for the BinaxNOW test were 84.6%, 98.5%, 94.9%, and 95.2%, respectively. Conclusions The BinaxNOW point‐of‐care test has good sensitivity and excellent specificity for the detection of COVID‐19. We recommend using the BinasNOW for patients with symptoms up to 2 weeks. |
| first_indexed | 2024-12-20T18:57:35Z |
| format | Article |
| id | doaj.art-14cb4d1346c4443291672e4d14248d2c |
| institution | Directory Open Access Journal |
| issn | 2688-1152 |
| language | English |
| last_indexed | 2024-12-20T18:57:35Z |
| publishDate | 2022-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American College of Emergency Physicians Open |
| spelling | doaj.art-14cb4d1346c4443291672e4d14248d2c2022-12-21T19:29:29ZengWileyJournal of the American College of Emergency Physicians Open2688-11522022-02-0131n/an/a10.1002/emp2.12605Utility of COVID‐19 antigen testing in the emergency departmentW. Frank Peacock0Karina M. Soto‐Ruiz1Stacey L. House2Chad M. Cannon3Gary Headden4Brian Tiffany5Sergey Motov6Kian Merchant‐Borna7Anna Marie Chang8Claire Pearson9Brian W. Patterson10Alan E. Jones11Joseph Miller12Joseph Varon13Aveh Bastani14Carol Clark15Zubaid Rafique16Bory Kea17John Eppensteiner18James M. Williams19Simon A. Mahler20Brian E. Driver21Phyllis Hendry22Eugenia Quackenbush23David Robinson24Jon W. Schrock25James P. D'Etienne26Christopher J. Hogan27Anwar Osborne28Ralph Riviello29Stephen Young30Department of Emergency Medicine Baylor College of Medicine Houston Texas USAComprehensive Research Associates LLC Houston Texas USADepartment of Emergency Medicine Washington University School of Medicine St. Louis Missouri USADepartment of Emergency Medicine University of Kansas Medical Center Kansas City Kansas USADepartment of Emergency Medicine Medical University of South Carolina Charleston South Carolina USADignity Health Research Institute Phoenix Arizona USADepartment of Emergency Medicine Maimonides Medical Center Brooklyn New York USADepartment of Emergency Medicine University of Rochester Medical Center University of Rochester School of Medicine and Dentistry Rochester New York USADepartment of Emergency Medicine Thomas Jefferson University Philadelphia Pennsylvania USADepartment of Emergency Medicine, Wayne State University Ascension St. John Detroit Michigan USADepartment of Emergency Medicine University of Wisconsin School of Medicine and Public Health Madison Wisconsin USADepartment of Emergency Medicine University of Mississippi Medical Center Jackson Mississippi USADepartment of Emergency Medicine Henry Ford Hospital Detroit Michigan USADepartment of Intensive Care Medicine United Memorial Medical Center The University of Houston School of Medicine Houston Texas USADepartment of Emergency Medicine William Beaumont Health System Troy Michigan USADepartment of Emergency Medicine William Beaumont Health System Royal Oak Michigan USADepartment of Emergency Medicine Baylor College of Medicine Houston Texas USADepartment of Emergency Medicine Oregon Health & Sciences University Portland Oregon USADepartment of Emergency Medicine Duke University Durham North Carolina USADepartment of Emergency Medicine School of Medicine Meritus Medical Center, Texas Tech University Health Science Center Lubbock Texas USADepartment of Emergency Medicine Wake Forest School of Medicine Winston‐Salem North Carolina USADepartment of Emergency Medicine Hennepin County Medical Center Minneapolis Minnesota USADepartment of Emergency Medicine University of Florida College of Medicine Jacksonville Florida USADepartment of Emergency Medicine University of North Carolina School of Medicine Chapel Hill North Carolina USADepartment of Emergency Medicine at McGovern Medical School The University of Texas Houston Texas USADepartment of Emergency Medicine MetroHealth Medical Center Case Western Reserve University School of Medicine Cleveland Ohio USAJohn Peter Smith Health Network/Integrative Emergency Services Fort Worth Texas USAVirginia Commonwealth University Medical Center Departments of Emergency Medicine and Surgery Richmond Virginia USADepartment of Emergency Medicine Emory University School of Medicine Atlanta GeorgiaDepartment of Emergency Medicine University of Texas Health San Antonio San Antonio Texas USATriCore Reference Laboratories Albuquerque New Mexico USAAbstract Background The BinaxNOW coronavirus disease 2019 (COVID‐19) Ag Card test (Abbott Diagnostics Scarborough, Inc.) is a lateral flow immunochromatographic point‐of‐care test for the qualitative detection of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) nucleocapsid protein antigen. It provides results from nasal swabs in 15 minutes. Our purpose was to determine its sensitivity and specificity for a COVID‐19 diagnosis. Methods Eligible patients had symptoms of COVID‐19 or suspected exposure. After consent, 2 nasal swabs were collected; 1 was tested using the Abbott RealTime SARS‐CoV‐2 (ie, the gold standard polymerase chain reaction test) and the second run on the BinaxNOW point of care platform by emergency department staff. Results From July 20 to October 28, 2020, 767 patients were enrolled, of which 735 had evaluable samples. Their mean (SD) age was 46.8 (16.6) years, and 422 (57.4%) were women. A total of 623 (84.8%) patients had COVID‐19 symptoms, most commonly shortness of breath (n = 404; 55.0%), cough (n = 314; 42.7%), and fever (n = 253; 34.4%). Although 460 (62.6%) had symptoms ≤7 days, the mean (SD) time since symptom onset was 8.1 (14.0) days. Positive tests occurred in 173 (23.5%) and 141 (19.2%) with the gold standard versus BinaxNOW test, respectively. Those with symptoms >2 weeks had a positive test rate roughly half of those with earlier presentations. In patients with symptoms ≤7 days, the sensitivity, specificity, and negative and positive predictive values for the BinaxNOW test were 84.6%, 98.5%, 94.9%, and 95.2%, respectively. Conclusions The BinaxNOW point‐of‐care test has good sensitivity and excellent specificity for the detection of COVID‐19. We recommend using the BinasNOW for patients with symptoms up to 2 weeks.https://doi.org/10.1002/emp2.12605antigen testingCovid‐19diagnostic devicesemergency departmentnasal swabpoint of care |
| spellingShingle | W. Frank Peacock Karina M. Soto‐Ruiz Stacey L. House Chad M. Cannon Gary Headden Brian Tiffany Sergey Motov Kian Merchant‐Borna Anna Marie Chang Claire Pearson Brian W. Patterson Alan E. Jones Joseph Miller Joseph Varon Aveh Bastani Carol Clark Zubaid Rafique Bory Kea John Eppensteiner James M. Williams Simon A. Mahler Brian E. Driver Phyllis Hendry Eugenia Quackenbush David Robinson Jon W. Schrock James P. D'Etienne Christopher J. Hogan Anwar Osborne Ralph Riviello Stephen Young Utility of COVID‐19 antigen testing in the emergency department Journal of the American College of Emergency Physicians Open antigen testing Covid‐19 diagnostic devices emergency department nasal swab point of care |
| title | Utility of COVID‐19 antigen testing in the emergency department |
| title_full | Utility of COVID‐19 antigen testing in the emergency department |
| title_fullStr | Utility of COVID‐19 antigen testing in the emergency department |
| title_full_unstemmed | Utility of COVID‐19 antigen testing in the emergency department |
| title_short | Utility of COVID‐19 antigen testing in the emergency department |
| title_sort | utility of covid 19 antigen testing in the emergency department |
| topic | antigen testing Covid‐19 diagnostic devices emergency department nasal swab point of care |
| url | https://doi.org/10.1002/emp2.12605 |
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