Implementing Rapid Antibody Test to Identify Asymptomatic SARS-CoV-2 Infection as Initial Screening in Admitting Pregnant Women, Yes or No?

ABSTRACT

Introduction: Assessing patient history is solely insufficient to identify the asymptomatic Covid-19 cases in pregnancy. Therefore, regular laboratory examinations should be deemed to find the actual case. However, this strategy might be more challenging for a limited-resource area. Hence, finding the most effective laboratory screening is beneficial. This study aimed to collate the effectiveness of rapid antibody and universal reverse transcriptase-polymerase chain reaction (RT-PCR) for asymptomatic Covid-19 testing among pregnant women in low-resource settings. Methods: We performed a study using one-year retrospective data of asymptomatic Covid-19 cases among pregnant women admitted in Dr. Soetomo General Academic Hospital Surabaya, conducted with the paired rapid antibody test and RT-PCR SARS-CoV-2 result. Results: Of 265 cases included, 217 samples had a reactive rapid antibody test (81.89%). There was a significant association between rapid antibody test and RT-PCR (p=0.026) with sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 89%, 22%, 38%, and 79%, respectively. Thus, it can identify more asymptomatic cases compared to identification by history and symptoms only. This study also revealed a higher significant efficiency cost (p<0.001) by reducing the overall expense up to IDR 36, 180, 000 (USD 2, 514) or 15% lower than the universal RT-PCR SARS-CoV-2 testing strategy. Conclusion: This study suggests that implementing a rapid antibody test has favour in identifying more asymptomatic Covid-19 cases in pregnancy and evince more cost-effective than universal PCR testing. © 2022 UPM Press. All rights reserved.