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Comparison of SARS-CoV-2 Reverse Transcriptase Polymerase Chain Reaction and BinaxNOW Rapid Antigen Tests at a Community Site During an Omicron Surge : A Cross-Sectional Study.
Schrom, John; Marquez, Carina; Pilarowski, Genay; Wang, Chung-Yu; Mitchell, Anthea; Puccinelli, Robert; Black, Doug; Rojas, Susana; Ribeiro, Salustiano; Tulier-Laiwa, Valerie; Martinez, Jacqueline; Payan, Joselin; Rojas, Susy; Jones, Diane; Martinez, Daniel; Nakamura, Robert; Chamie, Gabriel; Jain, Vivek; Petersen, Maya; DeRisi, Joe; Havlir, Diane.
Affiliation
  • Schrom J; University of California, San Francisco, San Francisco, California (J.S., C.M., D.B., G.C., V.J., D.H.).
  • Marquez C; University of California, San Francisco, San Francisco, California (J.S., C.M., D.B., G.C., V.J., D.H.).
  • Pilarowski G; Unidos en Salud, San Francisco, California (G.P., S.Ribeiro, J.M., J.P., D.J., D.M.).
  • Wang CY; Chan Zuckerberg Biohub, San Francisco, California (C.W., A.M., J.D.).
  • Mitchell A; Chan Zuckerberg Biohub, San Francisco, California (C.W., A.M., J.D.).
  • Puccinelli R; University of California, Berkeley, Berkeley, California (R.P., M.P.).
  • Black D; University of California, San Francisco, San Francisco, California (J.S., C.M., D.B., G.C., V.J., D.H.).
  • Rojas S; Unidos en Salud and San Francisco Latino Task Force for COVID-19, San Francisco, California (Susana Rojas, V.T., Susy Rojas).
  • Ribeiro S; Unidos en Salud, San Francisco, California (G.P., S.Ribeiro, J.M., J.P., D.J., D.M.).
  • Tulier-Laiwa V; Unidos en Salud and San Francisco Latino Task Force for COVID-19, San Francisco, California (Susana Rojas, V.T., Susy Rojas).
  • Martinez J; Unidos en Salud, San Francisco, California (G.P., S.Ribeiro, J.M., J.P., D.J., D.M.).
  • Payan J; Unidos en Salud, San Francisco, California (G.P., S.Ribeiro, J.M., J.P., D.J., D.M.).
  • Rojas S; Unidos en Salud and San Francisco Latino Task Force for COVID-19, San Francisco, California (Susana Rojas, V.T., Susy Rojas).
  • Jones D; Unidos en Salud, San Francisco, California (G.P., S.Ribeiro, J.M., J.P., D.J., D.M.).
  • Martinez D; Unidos en Salud, San Francisco, California (G.P., S.Ribeiro, J.M., J.P., D.J., D.M.).
  • Nakamura R; California Department of Public Health, Richmond, California (R.N.).
  • Chamie G; University of California, San Francisco, San Francisco, California (J.S., C.M., D.B., G.C., V.J., D.H.).
  • Jain V; University of California, San Francisco, San Francisco, California (J.S., C.M., D.B., G.C., V.J., D.H.).
  • Petersen M; University of California, Berkeley, Berkeley, California (R.P., M.P.).
  • DeRisi J; Chan Zuckerberg Biohub, San Francisco, California (C.W., A.M., J.D.).
  • Havlir D; University of California, San Francisco, San Francisco, California (J.S., C.M., D.B., G.C., V.J., D.H.).
Ann Intern Med ; 175(5): 682-690, 2022 05.
Article in En | MEDLINE | ID: mdl-35286144
ABSTRACT

BACKGROUND:

SARS-CoV-2 rapid antigen tests are an important public health tool.

OBJECTIVE:

To evaluate field performance of the BinaxNOW rapid antigen test (Abbott) compared with reverse transcriptase polymerase chain reaction (RT-PCR) for detecting infection with the Omicron variant of SARS-CoV-2.

DESIGN:

Cross-sectional surveillance study.

SETTING:

Free, walk-up, outdoor, urban community testing and vaccine site led by Unidos en Salud, serving a predominantly Latinx community highly impacted by COVID-19.

PARTICIPANTS:

Persons seeking COVID-19 testing in January 2022. MEASUREMENTS Simultaneous BinaxNOW and RT-PCR from nasal, cheek, and throat swabs, including cycle threshold (Ct) measures; a lower Ct value is a surrogate for higher amounts of virus.

RESULTS:

Among 731 persons tested with nasal swabs, there were 296 (40.5%) positive results on RT-PCR; 98.9% were the Omicron variant. BinaxNOW detected 95.2% (95% CI, 91% to 98%) of persons who tested positive on RT-PCR with a Ct value below 30, 82.1% (CI, 77% to 87%) of those who tested positive on RT-PCR with a Ct value below 35, and 65.2% (CI, 60% to 71%) of all who were positive on RT-PCR. Among 75 persons with simultaneous nasal and cheek swabs, BinaxNOW using a cheek swab failed to detect 91% (20 of 22) of specimens that were positive on BinaxNOW with a nasal swab. Among persons with simultaneous nasal and throat swabs who were positive on RT-PCR with a Ct value below 30, 42 of 49 (85.7%) were detected by nasal BinaxNOW, 23 of 49 (46.9%) by throat BinaxNOW, and 44 of 49 (89.8%) by either.

LIMITATION:

Participants were a cross-sectional sample from a community-based sentinel surveillance site, precluding study of viral or symptom dynamics.

CONCLUSION:

BinaxNOW detected persons with high SARS-CoV-2 levels during the Omicron surge, enabling rapid responses to positive test results. Cheek or throat swabs should not replace nasal swabs. As currently recommended, high-risk persons with an initial negative BinaxNOW result should have repeated testing. PRIMARY FUNDING SOURCE University of California, San Francisco.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Type of study: Diagnostic_studies / Observational_studies / Prevalence_studies / Risk_factors_studies Limits: Humans Language: En Journal: Ann Intern Med Year: 2022 Document type: Article
Fulltext
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PubMed Links
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Type of study: Diagnostic_studies / Observational_studies / Prevalence_studies / Risk_factors_studies Limits: Humans Language: En Journal: Ann Intern Med Year: 2022 Document type: Article