Clinical validation of quantitative SARS-CoV-2 antigen assays to estimate SARS-CoV-2 viral loads in nasopharyngeal swabs

J Infect Chemother. 2021 Apr;27(4):613-616. doi: 10.1016/j.jiac.2020.11.021. Epub 2020 Dec 3.

Abstract

Background: Expansion of the testing capacity for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an important issue to mitigate the pandemic of coronavirus disease-2019 (COVID-19) caused by this virus. Recently, a sensitive quantitative antigen test (SQT), Lumipulse® SARS-CoV-2 Ag, was developed. It is a fully automated chemiluminescent enzyme immunoassay system for SARS-CoV-2.

Methods: In this study, the analytical performance of SQT was examined using clinical specimens from nasopharyngeal swabs using reverse transcription polymerase chain reaction (RT-PCR) as a control.

Results: Receiver operating characteristic analysis of 24 SARS-CoV-2-positive and 524 -negative patients showed an area under the curve of 0.957 ± 0.063. Using a cut-off value of 1.34 pg/ml, the sensitivity was 91.7%, the specificity was 98.5%, and the overall rate of agreement was 98.2%. In the distribution of negative cases, the 99.5 percentile value was 1.03 pg/ml. There was a high correlation between the viral load calculated using the cycle threshold value of RT-PCR and the concentration of antigen. The tendency for the antigen concentration to decrease with time after disease onset correlated with that of the viral load.

Conclusions: Presented results indicate that SQT is highly concordant with RT-PCR and should be useful for the diagnosis of COVID-19 in any clinical setting. Therefore, this fully automated kit will contribute to the expansion of the testing capability for SARS-CoV-2.

Keywords: Chemiluminescent enzyme immunoassay; Covid-19; Nasopharyngeal swab; Nasopharynx; SARS-CoV-2; Saliva; Sensitive quantitative antigen test.

Publication types

  • Validation Study

MeSH terms

  • Antigens, Viral / analysis*
  • COVID-19 / diagnosis*
  • COVID-19 / virology
  • Humans
  • Nasopharynx / virology*
  • Reverse Transcriptase Polymerase Chain Reaction
  • SARS-CoV-2 / immunology*
  • Viral Load*

Substances

  • Antigens, Viral