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Can variants, reinfection, symptoms and test types affect COVID-19 diagnostic performance? A large-scale retrospective study of AG-RDTs during circulation of Delta and Omicron variants, Czechia, December 2021 to February 2022

The result's identifiers

  • Result code in IS VaVaI

    <a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F75010330%3A_____%2F23%3A00014466" target="_blank" >RIV/75010330:_____/23:00014466 - isvavai.cz</a>

  • Alternative codes found

    RIV/68407700:21240/23:00369059 RIV/00216224:14110/23:00133457 RIV/00216208:11310/23:10468458

  • Result on the web

    <a href="https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2023.28.38.2200938" target="_blank" >https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2023.28.38.2200938</a>

  • DOI - Digital Object Identifier

    <a href="http://dx.doi.org/10.2807/1560-7917.ES.2023.28.38.2200938" target="_blank" >10.2807/1560-7917.ES.2023.28.38.2200938</a>

Alternative languages

  • Result language

    angličtina

  • Original language name

    Can variants, reinfection, symptoms and test types affect COVID-19 diagnostic performance? A large-scale retrospective study of AG-RDTs during circulation of Delta and Omicron variants, Czechia, December 2021 to February 2022

  • Original language description

    Background: The sensitivity and specificity of selected antigen detection rapid diagnostic tests (AG-RDTs) for SARS-CoV-2 were determined in the unvaccinated population when the Delta variant was circulating. Viral loads, dynamics, symptoms and tissue tropism differ between Omicron and Delta. Aim: We aimed to compare AG-RDT sensitivity and specificity in selected subgroups during Omicron vs Delta circulation. Methods: We retrospectively paired AG-RDT results with PCRs registered in Czechia's Information System for Infectious Diseases from 1 to 25 December 2021 (Delta, n = 20,121) and 20 January to 24 February 2022 (Omicron, n = 47,104). Results: When confirmatory PCR was conducted on the same day as AG-RDT as a proxy for antigen testing close to peak viral load, the average sensitivity for Delta was 80.4% and for Omicron 81.4% (p < 0.05). Sensitivity in vaccinated individuals was lower for Omicron (OR = 0.94; 95% confidence interval (CI): 0.87-1.03), particularly in reinfections (OR = 0.83; 95% CI: 0.75-0.92). Saliva AG-RDT sensitivity was below average for both Delta (74.4%) and Omicron (78.4%). Tests on the European Union Category A list had higher sensitivity than tests in Category B. The highest sensitivity for Omicron (88.5%) was recorded for patients with loss of smell or taste, however, these symptoms were almost 10-fold less common than for Delta. The sensitivity of AG-RDTs performed on initially asymptomatic individuals done 1, 2 or 3 days before a positive PCR test was consistently lower for Omicron compared with Delta. Conclusion: Sensitivity for Omicron was lower in subgroups that may become more common if SARS-CoV-2 becomes an endemic virus.

  • Czech name

  • Czech description

Classification

  • Type

    J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database

  • CEP classification

  • OECD FORD branch

    30303 - Infectious Diseases

Result continuities

  • Project

    <a href="/en/project/LX22NPO5103" target="_blank" >LX22NPO5103: National Institute of Virology and Bacteriology</a><br>

  • Continuities

    V - Vyzkumna aktivita podporovana z jinych verejnych zdroju

Others

  • Publication year

    2023

  • Confidentiality

    S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Data specific for result type

  • Name of the periodical

    Euro Surveillance

  • ISSN

    1025-496X

  • e-ISSN

    1560-7917

  • Volume of the periodical

    28

  • Issue of the periodical within the volume

    38

  • Country of publishing house

    SE - SWEDEN

  • Number of pages

    14

  • Pages from-to

    2200938

  • UT code for WoS article

    001198382000001

  • EID of the result in the Scopus database

    2-s2.0-85171808891