Evaluation of Four Rapid Antigen Tests for the Detection of SARS-CoV-2 Infection with Nasopharyngeal Swabs

Owing to the high transmissibility of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants, the capacity of testing systems based on the gold standard real-time reverse transcription-polymerase chain reaction (rRT-PCR) is limited. Rapid antigen tests (RATs) can substantially contribute to the prevention of community transmission, but their further assessment is required. Here, using 1503 nasopharyngeal swabs, we compared the diagnostic performance of four RAT kits (Abbott Panbio (TM) COVID-19 Ag Rapid Test, SD Biosensor Standard (TM) Q COVID-19 Ag Test, Humasis COVID-19 Ag Test, and SG Medical Acrosis COVID-19 Ag Test) to the cycle threshold (Ct) values obtained from rRT-PCR. The precision values, area under the curve values, SARS-CoV-2 variant detection ability, and non-SARS-CoV-2 specificity of all four kits were similar. An assay using the Acrosis kit had a significantly better positive detection rate with a higher recall value and cut-off value than that using the other three RAT kits. During the current COVID-19 pandemic, the Acrosis kit is an effective tool to prevent the spread of SARS-CoV-2 in communities.

Automated summary

Due to the high transmissibility of SARS-CoV-2 variants, the capacity of rRT-PCR testing systems is limited. RATs can play a significant role in preventing community transmission, but further evaluation is needed. We compared the diagnostic performance of four RAT kits to rRT-PCR using 1503 nasopharyngeal swabs and found that all four kits had similar performance in terms of precision, area under the curve, SARS-CoV-2 variant detection, and non-SARS-CoV-2 specificity. The Acrosis kit showed significantly better positive detection rate compared to the other three kits, making it an effective tool to prevent the spread of SARS-CoV-2 in communities during the current COVID-19 pandemic.