Implementing SARS-CoV-2 Rapid Antigen Testing in the Emergency Ward of a Swiss University Hospital: The INCREASE Study
Following the Swiss Federal Office of Public Health (FOPH) authorization of the rapid antigen test (RAT), we implemented the use of the RAT in the emergency ward of our university hospital for patients’ cohorting. RAT triaging in association with RT-PCR allowed us to promptly isolate positive patien...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-04-01
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| Series: | Microorganisms |
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| Online Access: | https://www.mdpi.com/2076-2607/9/4/798 |
| _version_ | 1797538143644155904 |
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| author | Giorgia Caruana Antony Croxatto Eleftheria Kampouri Antonios Kritikos Onya Opota Maryline Foerster René Brouillet Laurence Senn Reto Lienhard Adrian Egli Giuseppe Pantaleo Pierre-Nicolas Carron Gilbert Greub |
| author_facet | Giorgia Caruana Antony Croxatto Eleftheria Kampouri Antonios Kritikos Onya Opota Maryline Foerster René Brouillet Laurence Senn Reto Lienhard Adrian Egli Giuseppe Pantaleo Pierre-Nicolas Carron Gilbert Greub |
| author_sort | Giorgia Caruana |
| collection | DOAJ |
| description | Following the Swiss Federal Office of Public Health (FOPH) authorization of the rapid antigen test (RAT), we implemented the use of the RAT in the emergency ward of our university hospital for patients’ cohorting. RAT triaging in association with RT-PCR allowed us to promptly isolate positive patients and save resources. Among 532 patients, overall sensitivities were 48.3% for Exdia and 41.2% for Standard Q<sup>®</sup>, Panbio<sup>TM</sup> and BD Veritor™. All RATs exhibited specificity above 99%. Sensitivity increased to 74.6%, 66.2%, 66.2% and 64.8% for Exdia, Standard Q<sup>®</sup>, Panbio<sup>TM</sup> and BD Veritor™, respectively, for viral loads above 10<sup>5</sup> copies/mL, to 100%, 97.8%, 96.6% and 95.6% for viral loads above 10<sup>6</sup> copies/mL and 100% for viral loads above 10<sup>7</sup> copies/mL. Sensitivity was significantly higher for patients with symptoms onset within four days (74.3%, 69.2%, 69.2% and 64%, respectively) versus patients with the evolution of symptoms longer than four days (36.8%, 21.1%, 21.1% and 23.7%, respectively). Among COVID-19 asymptomatic patients, sensitivity was 33%. All Immunoglobulin-A-positive patients resulted negative for RAT. The RAT might represent a useful resource in selected clinical settings as a complementary tool in RT-PCR for rapid patient triaging, but the lower sensitivity, especially in late presenters and COVID-19 asymptomatic subjects, must be taken into account. |
| first_indexed | 2024-03-10T12:26:20Z |
| format | Article |
| id | doaj.art-ae3e222f05704c519605bd19c50701cd |
| institution | Directory Open Access Journal |
| issn | 2076-2607 |
| language | English |
| last_indexed | 2024-03-10T12:26:20Z |
| publishDate | 2021-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Microorganisms |
| spelling | doaj.art-ae3e222f05704c519605bd19c50701cd2023-11-21T15:02:33ZengMDPI AGMicroorganisms2076-26072021-04-019479810.3390/microorganisms9040798Implementing SARS-CoV-2 Rapid Antigen Testing in the Emergency Ward of a Swiss University Hospital: The INCREASE StudyGiorgia Caruana0Antony Croxatto1Eleftheria Kampouri2Antonios Kritikos3Onya Opota4Maryline Foerster5René Brouillet6Laurence Senn7Reto Lienhard8Adrian Egli9Giuseppe Pantaleo10Pierre-Nicolas Carron11Gilbert Greub12Institute of Microbiology, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, SwitzerlandInstitute of Microbiology, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, SwitzerlandService of Hospital Preventive Medicine, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, SwitzerlandInstitute of Microbiology, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, SwitzerlandInstitute of Microbiology, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, SwitzerlandEmergency Department, Lausanne University Hospital, 1011 Lausanne, SwitzerlandInstitute of Microbiology, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, SwitzerlandService of Hospital Preventive Medicine, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, SwitzerlandADMed Microbiologie Laboratory, 2300 La Chaux-de-Fonds, SwitzerlandClinical Bacteriology and Mycology, University Hospital Basel, 4001 Basel, SwitzerlandInstitute of immunology, University Hospital of Lausanne, 1011 Lausanne, SwitzerlandEmergency Department, Lausanne University Hospital, 1011 Lausanne, SwitzerlandInstitute of Microbiology, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, SwitzerlandFollowing the Swiss Federal Office of Public Health (FOPH) authorization of the rapid antigen test (RAT), we implemented the use of the RAT in the emergency ward of our university hospital for patients’ cohorting. RAT triaging in association with RT-PCR allowed us to promptly isolate positive patients and save resources. Among 532 patients, overall sensitivities were 48.3% for Exdia and 41.2% for Standard Q<sup>®</sup>, Panbio<sup>TM</sup> and BD Veritor™. All RATs exhibited specificity above 99%. Sensitivity increased to 74.6%, 66.2%, 66.2% and 64.8% for Exdia, Standard Q<sup>®</sup>, Panbio<sup>TM</sup> and BD Veritor™, respectively, for viral loads above 10<sup>5</sup> copies/mL, to 100%, 97.8%, 96.6% and 95.6% for viral loads above 10<sup>6</sup> copies/mL and 100% for viral loads above 10<sup>7</sup> copies/mL. Sensitivity was significantly higher for patients with symptoms onset within four days (74.3%, 69.2%, 69.2% and 64%, respectively) versus patients with the evolution of symptoms longer than four days (36.8%, 21.1%, 21.1% and 23.7%, respectively). Among COVID-19 asymptomatic patients, sensitivity was 33%. All Immunoglobulin-A-positive patients resulted negative for RAT. The RAT might represent a useful resource in selected clinical settings as a complementary tool in RT-PCR for rapid patient triaging, but the lower sensitivity, especially in late presenters and COVID-19 asymptomatic subjects, must be taken into account.https://www.mdpi.com/2076-2607/9/4/798SARS-CoV-2COVID-19 diagnostic testingrapid antigen testhealth plan implementationnucleocapsid proteinemergency ward |
| spellingShingle | Giorgia Caruana Antony Croxatto Eleftheria Kampouri Antonios Kritikos Onya Opota Maryline Foerster René Brouillet Laurence Senn Reto Lienhard Adrian Egli Giuseppe Pantaleo Pierre-Nicolas Carron Gilbert Greub Implementing SARS-CoV-2 Rapid Antigen Testing in the Emergency Ward of a Swiss University Hospital: The INCREASE Study Microorganisms SARS-CoV-2 COVID-19 diagnostic testing rapid antigen test health plan implementation nucleocapsid protein emergency ward |
| title | Implementing SARS-CoV-2 Rapid Antigen Testing in the Emergency Ward of a Swiss University Hospital: The INCREASE Study |
| title_full | Implementing SARS-CoV-2 Rapid Antigen Testing in the Emergency Ward of a Swiss University Hospital: The INCREASE Study |
| title_fullStr | Implementing SARS-CoV-2 Rapid Antigen Testing in the Emergency Ward of a Swiss University Hospital: The INCREASE Study |
| title_full_unstemmed | Implementing SARS-CoV-2 Rapid Antigen Testing in the Emergency Ward of a Swiss University Hospital: The INCREASE Study |
| title_short | Implementing SARS-CoV-2 Rapid Antigen Testing in the Emergency Ward of a Swiss University Hospital: The INCREASE Study |
| title_sort | implementing sars cov 2 rapid antigen testing in the emergency ward of a swiss university hospital the increase study |
| topic | SARS-CoV-2 COVID-19 diagnostic testing rapid antigen test health plan implementation nucleocapsid protein emergency ward |
| url | https://www.mdpi.com/2076-2607/9/4/798 |
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