Abstract
Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) caused the global pandemic of coronavirus disease 2019 (COVID-19). Rapid identification and isolation of infectious patients are critical methods to block COVID-19 transmission. Antigen tests can contribute to prompt identification of infectious individuals. This meta-analysis aims to evaluate the diagnostic accuracy of antigen tests for SARS-CoV-2. We conducted a literature search in PubMed, Embase, the Cochrane Library, and Biomed Central databases. Studies evaluating the diagnostic accuracy of antigen tests for SARS-CoV-2 in community participants were included. Only English-language articles were reviewed. We included eligible studies that provided available data to construct a 2 × 2 table on a per-patient basis. Overall sensitivity and specificity for antigen tests were generated using a bivariate random-effects model. Eighteen studies with 34,865 participants were retrieved. The meta-analysis for SARS-CoV-2 antigen tests generated a pooled sensitivity of 0.82 and a pooled specificity of 1.00. A subgroup analysis of ten studies that reported outcomes for 5629 symptomatic participants generated a pooled sensitivity of 0.87 and a pooled specificity of 1.00. Antigen tests might have higher sensitivity in detecting SARS-CoV-2 in symptomatic patients in the community and may be an effective tool to identify patients to be quarantined to prevent further SARS-CoV-2 transmission.
Highlights
Eight studies evaluated the diagnostic performance of antigen tests with nasal swab specimens [16,18,22,23,28,29,30,33], six assessed the accuracy of antigen tests with nasopharyngeal swab specimens [21,24,25,26,27,31], seven provided cycle threshold (Ct) values of positive reverse-transcription polymerase chain reaction (RT-PCR) tests [24,25,28,29,30,31,32], and eight reported cutoff values of Ct [16,21,22,23,25,27,28,33]
Our major findings indicated that antigen tests had high sensitivity and excellent specificity in detecting SARS-CoV-2 in individuals in the community
Our major findings indicated that antigen tests had high sensitivity in detecting the SARS-CoV-2 virus in symptomatic patients in the community
Summary
Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) caused the global pandemic of coronavirus disease 2019 (COVID-19). Asymptomatic cases make COVID-19 difficult to monitor and prevent. It is estimated that at least 50% of COVID-19 patients contract the virus from asymptomatic people [1]. To break the transmission chains of SARS-CoV-2, testing infected individuals and tracing and quarantining their contacts have been used as major nonpharmaceutical interventions [2]. Rapid identification and isolation of infectious patients with SARS-CoV-2 are critical methods to block COVID-19 community
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