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Antigen Detection Tests for SARS-CoV-2: a systematic review and meta-analysis on real world data.
Riccò, Matteo; Ranzieri, Silvia; Peruzzi, Simona; Valente, Marina; Marchesi, Federico; Bragazzi, Nicola Luigi; Donelli, Davide; Balzarini, Federica; Ferraro, Pietro; Gianfredi, Vincenza; Signorelli, Carlo.
  • Riccò M; Azienda USL-IRCCS di Reggio Emilia; V.le Amendola n.2 - 42122 RE; Servizio di Prevenzione e Sicurezza negli Ambienti di Lavoro (SPSAL)Dip. di Prevenzione. mricco2000@gmail.com.
  • Ranzieri S; University of Parma, Department of Medicine and Surgery, School of Occupational Medicine, I-43123 Parma (PR), Italy. silvia.ranzieri@unipr.it.
  • Peruzzi S; AUSL-IRCCS di Reggio Emilia, Laboratorio Analisi Chimico Cliniche e Microbiologiche, Ospedale Civile di Guastalla, I-42016 Guastalla . simona.peruzzi@ausl.re.it.
  • Valente M; University of Parma, Department of Medicine and Surgery, Unit of Clinical Surgery, I-43123 Parma (PR), Italy. marinavalente.bis@gmail.com.
  • Marchesi F; University of Parma, Department of Medicine and Surgery, Unit of Clinical Surgery, I-43123 Parma (PR), Italy. federico.marchesi@unipr.it.
  • Bragazzi NL; Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, University of York, Toronto (ON), Canada. bragazzi@yorku.ca.
  • Donelli D; AUSL-IRCCS di Reggio Emilia, Department of Primary Care, I-42122, Reggio Emilia RE, Italy. donelli.davide@gmail.com.
  • Balzarini F; ATS Bergamo, Dipartimento P.A.A.P.S.S., Servizio Autorizzazione e Accreditamento, Via Galliccioli, 4, Bergamo. federica.balzarini@gmail.com.
  • Ferraro P; ASL di Foggia, Occupational Health and Safety Service of Local Health Unit of Foggia, Piazza Pavoncelli 11, I-41121 Foggia. dott.pietro.ferraro@gmail.com.
  • Gianfredi V; University "Vita e Salute", San Raffaele Hospital; Via Olgettina n. 58, I-20132; Milan (MI), Italy. gianfredi.vincenza@hsr.it.
  • Signorelli C; University "Vita e Salute", San Raffaele Hospital; Via Olgettina n. 58, I-20132; Milan (MI), Italy. signorelli.carlo@hsr.it.
Acta Biomed ; 93(2): e2022036, 2022 05 11.
Article in English | MEDLINE | ID: covidwho-1848001
ABSTRACT
Background and aim Rapid antigen detection (RAD) tests on nasopharyngeal specimens have been recently made available for SARS-CoV-2 infections, and early studies suggested their potential utilization as rapid screening and diagnostic testing. The present systematic review and meta-analysis was aimed to assess available evidence and to explore the reliability of antigenic tests in the management of the SARS-CoV-2 pandemic. MATERIALS AND

METHODS:

We reported our meta-analysis according to the PRISMA statement. We searched Pubmed, Embase, and pre-print archive medRxiv.og for eligible studies published up to November 5th, 2020. Raw data included true/false positive and negative tests, and the total number of tests. Sensitivity and specificity data were calculated for every study, and then pooled in a random-effects model. Heterogeneity was assessed using the I2 measure. Reporting bias was assessed by means of funnel plots and regression analysis.

RESULTS:

Based on 25 studies, we computed a pooled sensitivity of 72.8% (95%CI 62.4-81.3), a specificity of 99.4% (95%CI 99.0-99.7), with high heterogeneity and risk of reporting bias. More precisely, RAD tests exhibited higher sensitivity on samples with high viral load (i.e. <25 Cycle Threshold; 97.6%; 95%CI 94.1-99.0), compared to those with low viral load (≥25 Cycle Threshold; 43.6%; 95% 27.6-61.1).

DISCUSSION:

As the majority of collected reports were either cohort or case-control studies, deprived of preventive power analysis and often oversampling positive tests, overall performances may have been overestimated. Therefore, the massive referral to antigenic tests in place of RT-qPCR is currently questionable, and also their deployment as mass screening test may lead to intolerable share of missing diagnoses. On the other hand, RAD tests may find a significant role in primary care and in front-line settings (e.g. Emergency Departments). (www.actabiomedica.it).
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: Acta Biomed Journal subject: Medicine Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: Acta Biomed Journal subject: Medicine Year: 2022 Document Type: Article