Diagnostic accuracy of SARS-CoV-2 antigen test in the pediatric population: A systematic review and meta-analysis

Background: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has caused the global coronavirus disease 2019 (COVID-19) pandemic. Rapid identification and isolation of patients infected with SARS-CoV-2 are critical methods for blocking COVID-19 transmission. The advantages of antigen test...

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Main Authors: Cheng-Chieh Chen, Shih-Yen Chen, Shiuh-Bin Fang, Shou-Cheng Lu, Chyi-Huey Bai, Yuan-Hung Wang
Format: Article
Language:English
Published: Elsevier 2023-05-01
Series:Pediatrics and Neonatology
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Online Access:http://www.sciencedirect.com/science/article/pii/S1875957222002248
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author Cheng-Chieh Chen
Shih-Yen Chen
Shiuh-Bin Fang
Shou-Cheng Lu
Chyi-Huey Bai
Yuan-Hung Wang
author_facet Cheng-Chieh Chen
Shih-Yen Chen
Shiuh-Bin Fang
Shou-Cheng Lu
Chyi-Huey Bai
Yuan-Hung Wang
author_sort Cheng-Chieh Chen
collection DOAJ
description Background: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has caused the global coronavirus disease 2019 (COVID-19) pandemic. Rapid identification and isolation of patients infected with SARS-CoV-2 are critical methods for blocking COVID-19 transmission. The advantages of antigen tests, such as their relatively low cost and short turnaround time, can contribute to the prompt identification of infectious individuals. However, the diagnostic accuracy of antigen tests for COVID-19 in children remains inconclusive. This meta-analysis aimed to evaluate the diagnostic performance of antigen tests for SARS-CoV-2 in the pediatric population. Methods: We conducted a literature search for relevant studies in the PubMed, Embase, Google Scholar, and Biomed Central databases. Studies evaluating the diagnostic accuracy of antigen tests for SARS-CoV-2 in pediatric patients were included. In addition, we included studies that provided sufficient data to construct a 2 × 2 table on a per-patient basis. The final literature search was performed on October 10, 2021. Days after symptom onset, asymptomatic and symptomatic individuals may have been potential sources of heterogeneity. The overall sensitivity and specificity of the antigen tests were generated using a bivariate random-effects model. Results: Five studies with 4400 participants were included. The meta-analysis of antigen tests generated a pooled sensitivity of 65.9% (95% CI: 52.8%–77.0%) and pooled specificity of 99.9% (95% CI: 98.9%–100.0%). A subgroup analysis of studies reporting antigen test data for symptomatic patients showed a pooled sensitivity of 64.5% and a pooled specificity of 99.7%. The subgroup analysis of studies that included 881 asymptomatic participants generated a pooled sensitivity of 48.4% and a pooled specificity of 99.5%. Conclusion: Antigen tests exhibit moderate sensitivity and high specificity for detecting SARS-CoV-2 in children. Antigen tests might have moderate sensitivity for detecting SARS-CoV-2 in symptomatic children, and serial testing might effectively prevent further SARS-CoV-2 transmission.
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spelling doaj-art-eb6563669ab046f09a31ba3d1cdb48112025-08-20T03:06:21ZengElsevierPediatrics and Neonatology1875-95722023-05-0164324725510.1016/j.pedneo.2022.07.012Diagnostic accuracy of SARS-CoV-2 antigen test in the pediatric population: A systematic review and meta-analysisCheng-Chieh Chen0Shih-Yen Chen1Shiuh-Bin Fang2Shou-Cheng Lu3Chyi-Huey Bai4Yuan-Hung Wang5Department of Pathology and Laboratory Medicine, Shin Kong Wu Ho-Su Memorial, Hospital, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, TaiwanDivision of Pediatric Gastroenterology and Hepatology, Department of Pediatrics, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, TaiwanDivision of Pediatric Gastroenterology and Hepatology, Department of Pediatrics, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan; Master Program for Clinical Pharmacogenomics and Pharmacoproteomics, College of Pharmacy, Taipei Medical University, Taipei, TaiwanDepartment of Laboratory Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, TaiwanDepartment of Public Health, College of Medicine, Taipei Medical University, Taipei, TaiwanGraduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Medical Research, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Corresponding author. Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, 250 Wu-Hsing Street, Taipei 11031, TaiwanBackground: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has caused the global coronavirus disease 2019 (COVID-19) pandemic. Rapid identification and isolation of patients infected with SARS-CoV-2 are critical methods for blocking COVID-19 transmission. The advantages of antigen tests, such as their relatively low cost and short turnaround time, can contribute to the prompt identification of infectious individuals. However, the diagnostic accuracy of antigen tests for COVID-19 in children remains inconclusive. This meta-analysis aimed to evaluate the diagnostic performance of antigen tests for SARS-CoV-2 in the pediatric population. Methods: We conducted a literature search for relevant studies in the PubMed, Embase, Google Scholar, and Biomed Central databases. Studies evaluating the diagnostic accuracy of antigen tests for SARS-CoV-2 in pediatric patients were included. In addition, we included studies that provided sufficient data to construct a 2 × 2 table on a per-patient basis. The final literature search was performed on October 10, 2021. Days after symptom onset, asymptomatic and symptomatic individuals may have been potential sources of heterogeneity. The overall sensitivity and specificity of the antigen tests were generated using a bivariate random-effects model. Results: Five studies with 4400 participants were included. The meta-analysis of antigen tests generated a pooled sensitivity of 65.9% (95% CI: 52.8%–77.0%) and pooled specificity of 99.9% (95% CI: 98.9%–100.0%). A subgroup analysis of studies reporting antigen test data for symptomatic patients showed a pooled sensitivity of 64.5% and a pooled specificity of 99.7%. The subgroup analysis of studies that included 881 asymptomatic participants generated a pooled sensitivity of 48.4% and a pooled specificity of 99.5%. Conclusion: Antigen tests exhibit moderate sensitivity and high specificity for detecting SARS-CoV-2 in children. Antigen tests might have moderate sensitivity for detecting SARS-CoV-2 in symptomatic children, and serial testing might effectively prevent further SARS-CoV-2 transmission.http://www.sciencedirect.com/science/article/pii/S1875957222002248antigentestCOVID-19meta-analysispediatricSARS-CoV-2
spellingShingle Cheng-Chieh Chen
Shih-Yen Chen
Shiuh-Bin Fang
Shou-Cheng Lu
Chyi-Huey Bai
Yuan-Hung Wang
Diagnostic accuracy of SARS-CoV-2 antigen test in the pediatric population: A systematic review and meta-analysis
Pediatrics and Neonatology
antigentest
COVID-19
meta-analysis
pediatric
SARS-CoV-2
title Diagnostic accuracy of SARS-CoV-2 antigen test in the pediatric population: A systematic review and meta-analysis
title_full Diagnostic accuracy of SARS-CoV-2 antigen test in the pediatric population: A systematic review and meta-analysis
title_fullStr Diagnostic accuracy of SARS-CoV-2 antigen test in the pediatric population: A systematic review and meta-analysis
title_full_unstemmed Diagnostic accuracy of SARS-CoV-2 antigen test in the pediatric population: A systematic review and meta-analysis
title_short Diagnostic accuracy of SARS-CoV-2 antigen test in the pediatric population: A systematic review and meta-analysis
title_sort diagnostic accuracy of sars cov 2 antigen test in the pediatric population a systematic review and meta analysis
topic antigentest
COVID-19
meta-analysis
pediatric
SARS-CoV-2
url http://www.sciencedirect.com/science/article/pii/S1875957222002248
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