Comparison of antigen- and RT-PCR-based testing strategies for detection of SARS-CoV-2 in two high-exposure settings.

Surveillance testing for infectious disease is an important tool to combat disease transmission at the population level. During the SARS-CoV-2 pandemic, RT-PCR tests have been considered the gold standard due to their high sensitivity and specificity. However, RT-PCR tests for SARS-CoV-2 have been s...

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Main Authors: Jay Love, Megan T Wimmer, Damon J A Toth, Arthi Chandran, Dilip Makhija, Charles K Cooper, Matthew H Samore, Lindsay T Keegan
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2021-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0253407&type=printable
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author Jay Love
Megan T Wimmer
Damon J A Toth
Arthi Chandran
Dilip Makhija
Charles K Cooper
Matthew H Samore
Lindsay T Keegan
author_facet Jay Love
Megan T Wimmer
Damon J A Toth
Arthi Chandran
Dilip Makhija
Charles K Cooper
Matthew H Samore
Lindsay T Keegan
author_sort Jay Love
collection DOAJ
description Surveillance testing for infectious disease is an important tool to combat disease transmission at the population level. During the SARS-CoV-2 pandemic, RT-PCR tests have been considered the gold standard due to their high sensitivity and specificity. However, RT-PCR tests for SARS-CoV-2 have been shown to return positive results when performed to individuals who are past the infectious stage of the disease. Meanwhile, antigen-based tests are often treated as a less accurate substitute for RT-PCR, however, new evidence suggests they may better reflect infectiousness. Consequently, the two test types may each be most optimally deployed in different settings. Here, we present an epidemiological model with surveillance testing and coordinated isolation in two congregate living settings (a nursing home and a university dormitory system) that considers test metrics with respect to viral culture, a proxy for infectiousness. Simulations show that antigen-based surveillance testing coupled with isolation greatly reduces disease burden and carries a lower economic cost than RT-PCR-based strategies. Antigen and RT-PCR tests perform different functions toward the goal of reducing infectious disease burden and should be used accordingly.
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institution OA Journals
issn 1932-6203
language English
publishDate 2021-01-01
publisher Public Library of Science (PLoS)
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spelling doaj-art-8d256b2b04864cb1b173edf508854f412025-08-20T02:33:43ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01169e025340710.1371/journal.pone.0253407Comparison of antigen- and RT-PCR-based testing strategies for detection of SARS-CoV-2 in two high-exposure settings.Jay LoveMegan T WimmerDamon J A TothArthi ChandranDilip MakhijaCharles K CooperMatthew H SamoreLindsay T KeeganSurveillance testing for infectious disease is an important tool to combat disease transmission at the population level. During the SARS-CoV-2 pandemic, RT-PCR tests have been considered the gold standard due to their high sensitivity and specificity. However, RT-PCR tests for SARS-CoV-2 have been shown to return positive results when performed to individuals who are past the infectious stage of the disease. Meanwhile, antigen-based tests are often treated as a less accurate substitute for RT-PCR, however, new evidence suggests they may better reflect infectiousness. Consequently, the two test types may each be most optimally deployed in different settings. Here, we present an epidemiological model with surveillance testing and coordinated isolation in two congregate living settings (a nursing home and a university dormitory system) that considers test metrics with respect to viral culture, a proxy for infectiousness. Simulations show that antigen-based surveillance testing coupled with isolation greatly reduces disease burden and carries a lower economic cost than RT-PCR-based strategies. Antigen and RT-PCR tests perform different functions toward the goal of reducing infectious disease burden and should be used accordingly.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0253407&type=printable
spellingShingle Jay Love
Megan T Wimmer
Damon J A Toth
Arthi Chandran
Dilip Makhija
Charles K Cooper
Matthew H Samore
Lindsay T Keegan
Comparison of antigen- and RT-PCR-based testing strategies for detection of SARS-CoV-2 in two high-exposure settings.
PLoS ONE
title Comparison of antigen- and RT-PCR-based testing strategies for detection of SARS-CoV-2 in two high-exposure settings.
title_full Comparison of antigen- and RT-PCR-based testing strategies for detection of SARS-CoV-2 in two high-exposure settings.
title_fullStr Comparison of antigen- and RT-PCR-based testing strategies for detection of SARS-CoV-2 in two high-exposure settings.
title_full_unstemmed Comparison of antigen- and RT-PCR-based testing strategies for detection of SARS-CoV-2 in two high-exposure settings.
title_short Comparison of antigen- and RT-PCR-based testing strategies for detection of SARS-CoV-2 in two high-exposure settings.
title_sort comparison of antigen and rt pcr based testing strategies for detection of sars cov 2 in two high exposure settings
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0253407&type=printable
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