Utility of COVID‐19 antigen testing in the emergency department

AbstractWe compared rotavirus detection patterns before (2001–2006) and after (2008–2015) rotavirus vaccine introduction. We also compared rotavirus detection patterns in odd (2009, 2011, 2013, 2015) and even (2008, 2010, 2012, 2014) years post-vaccine separately. Results of stool rotavirus antigen testing from inpatient, outpatient and emergency department encounters from July 2000 to July 2015 at two paediatric hospital laboratories in Atlanta, Georgia were reviewed. Post-vaccine, rotavirus detection declined (30.2% vs. 13.7% (overall 54.6% decline, P <0.001)), occurred more frequently outside the rotavirus season (19.8% vs. 3.5%; P < 0.001), and was more common among older children (26 vs. 13 median months of age; P < 0.001). During odd years post-vaccine, rotavirus detection was significantly higher than even years (20.2% vs. 6.4%; P < 0.001). Rotavirus detection declined substantially and developed a biennial pattern in the post-vaccine era. The intensity and temporality of rotavirus detection in odd years post-vaccine resembled that observed pre-vaccine, although considerably reduced in magnitude.

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Around-the-Clock, Rapid Diagnosis of Influenza by Means of Membrane Chromatography Antigen Testing Confirmed by Polymerase Chain Reaction

Infection Control and Hospital Epidemiology ◽

10.1086/526446 ◽

2008 ◽

Vol 29 (2) ◽

pp. 177-179 ◽

Cited By ~ 6

Author(s):

Anna C. Nilsson ◽

Birgitta Alemo ◽

Per Björkman ◽

Lena Dillner ◽

Åsa Melhus ◽

...

Keyword(s):

Emergency Department ◽

Polymerase Chain Reaction ◽

Rapid Diagnosis ◽

Immunofluorescence Test ◽

Chain Reaction ◽

Membrane Chromatography ◽

Rapid Tests ◽

Polymerase Chain ◽

Antigen Testing

One rapid membrane chromatography test and 2 immunofluorescence tests were compared with polymerase chain reaction as tools for the diagnosis of influenza in 277 patients treated in an emergency department. The sensitivity on days 1-3 of symptoms was 71% for the rapid membrane chromatography test, 70% for the first immunofluorescence test, and 79% for the second immunofluorescence test. Rapid tests are useful for round-the-clock identification of influenza, with follow-up polymerase chain reaction used for confirmation.

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Can we trust in Sars-CoV-2 rapid antigen testing? Preliminary results from a paediatric cohort in the emergency department

Irish Journal of Medical Science (1971 -) ◽

10.1007/s11845-021-02776-z ◽

2021 ◽

Author(s):

Marco Denina ◽

Virginia Giannone ◽

Antonio Curtoni ◽

Elisa Zanotto ◽

Silvia Garazzino ◽

...

Keyword(s):

Emergency Department ◽

Preliminary Results ◽

Paediatric Cohort ◽

Antigen Testing

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Rapid Antigen Testing for Trichomoniasis in an Emergency Department

PEDIATRICS ◽

10.1542/peds.2015-2072 ◽

2016 ◽

Vol 137 (6) ◽

pp. e20152072-e20152072 ◽

Cited By ~ 5

Author(s):

N. R. Postenrieder ◽

J. L. Reed ◽

E. Hesse ◽

J. A. Kahn ◽

L. Ding ◽

...

Keyword(s):

Emergency Department ◽

Antigen Testing

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SARS-CoV-2 Antigen Detection to Expand Testing Capacity for COVID-19: Results from a Hospital Emergency Department Testing Site

Diagnostics ◽

10.3390/diagnostics11071211 ◽

2021 ◽

Vol 11 (7) ◽

pp. 1211

Author(s):

Giulia Menchinelli ◽

Giulia De Angelis ◽

Margherita Cacaci ◽

Flora Marzia Liotti ◽

Marcello Candelli ◽

...

Keyword(s):

Emergency Department ◽

Predictive Value ◽

Tertiary Care ◽

Antigen Detection ◽

Care Hospital ◽

Hospital Emergency Department ◽

Rt Pcr ◽

Hospital Emergency ◽

Asymptomatic Patients ◽

Antigen Testing

Background: SARS-CoV-2 antigen detection has currently expanded the testing capacity for COVID-19, which yet relies on the SARS-CoV-2 RNA RT-PCR amplification. Objectives: To report on a COVID-19 testing algorithm from a tertiary care hospital emergency department (ED) that combines both antigen (performed on the ED) and RT-PCR (performed outside the ED) testing. Methods: Between December 2020 and January 2021, in a priori designated, spatially separated COVID-19 or non-COVID-19 ED areas, respectively, symptomatic or asymptomatic patients received SARS-CoV-2 antigen testing on nasopharyngeal swab samples. Antigen results were promptly accessible to guide subsequent, outside performed confirmatory (RT-PCR) testing. Results: Overall, 1083 (100%) of 1083 samples in the COVID-19 area and 1815 (49.4%) of 3670 samples in the non-COVID-19 area had antigen results that required confirmation by RT-PCR. Antigen positivity rates were 12.4% (134/1083) and 3.7% (66/1815), respectively. Compared to RT-PCR testing results, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of antigen testing were, respectively, 68.0%, 98.3%, 88.8%, and 94.1% in the COVID-19 area, and 41.9%, 97.3%, 27.3%, and 98.6% in non-COVID-19 area. Practically, RT-PCR tests were avoided in 50.6% (1855/3670) of non-COVID-19 area samples (all antigen negative) from patients who, otherwise, would have needed antigen result confirmation. Conclusions: Our algorithm had value to preserve RT-PCR from avoidable usage and, importantly, to save time, which translated into a timely RT-PCR result availability in the COVID-19 area.

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