Antigen Test Performance Among Children and Adults at a SARS-CoV-2 Community Testing Site

Details

• Alternative Title:
  J Pediatric Infect Dis Soc
• Personal Author:
  Ford, Laura ; Whaley, Melissa J. ; Shah, Melisa M. ; Salvatore, Phillip P. ; Segaloff, Hannah E. ; Delaney, Augustina ; Currie, Dustin W. ; Boyle-Estheimer, Lauren ; O'Hegarty, Michelle ; Morgan, Clint N. ; Meece, Jennifer ; Ivacic, Lynn ; Thornburg, Natalie J. ; Tamin, Azaibi ; Harcourt, Jennifer L. ; Folster, Jennifer M. ; Medrzycki, Magdalena ; Jain, Shilpi ; Wong, Phili ; Goffard, Kimberly ; Gieryn, Douglas ; Kahrs, Juliana ; Langolf, Kimberly ; Zochert, Tara ; Tate, Jacqueline E. ; Hsu, Christopher H. ; Kirking, Hannah L.
• Description:
  Background.
  
  Performance characteristics of SARS-CoV-2 antigen tests among children are limited despite the need for point-of-care testing in school and childcare settings. We describe children seeking SARS-CoV-2 testing at a community site and compare antigen test performance to real-time reverse transcription-polymerase chain reaction (RT-PCR) and viral culture.
  
  Methods.
  
  Two anterior nasal specimens were self-collected for BinaxNOW antigen and RT-PCR testing, along with demographics, symptoms, and exposure information from individuals ≥5 years at a community testing site. Viral culture was attempted on residual antigen or RT-PCR-positive specimens. Demographic and clinical characteristics, and the performance of SARS-CoV-2 antigen tests, were compared among children (<18 years) and adults.
  
  Results.
  
  About 1 in 10 included specimens were from children (225/2110); 16.4% (37/225) were RT-PCR-positive. Cycle threshold values were similar among RT-PCR-positive specimens from children and adults (22.5 vs 21.3, P = .46) and among specimens from symptomatic and asymptomatic children (22.5 vs 23.2, P = .39). Sensitivity of antigen test compared to RT-PCR was 73.0% (27/37) among specimens from children and 80.8% (240/297) among specimens from adults; among specimens from children, specificity was 100% (188/188), positive and negative predictive values were 100% (27/27) and 94.9% (188/198), respectively. Virus was isolated from 51.4% (19/37) of RT-PCR-positive pediatric specimens; all 19 had positive antigen test results.
  
  Conclusions.
  
  With lower sensitivity relative to RT-PCR, antigen tests may not diagnose all positive COVID-19 cases; however, antigen testing identified children with live SARS-CoV-2 virus.
  
  
• Subjects:
  Adult Antigens, Viral Child COVID-19 Testing Humans SARS-CoV-2 Sensitivity And Specificity
• Source:
  J Pediatric Infect Dis Soc. 10(12):1052-1061
• Pubmed ID:
  34468732
• Pubmed Central ID:
  PMC8932441
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/ ; CC/CDC HHSUnited States/
• Volume:
  10
• Issue:
  12
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:c44e1fc04b97bd400e1f4c0de6490a6c3077669b8b4e5f6b62b4c62f2733e1cd
• Download URL:
  https://stacks.cdc.gov/view/cdc/115511/cdc_115511_DS1.pdf
• File Type:
  [PDF - 716.68 KB ]