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News Scan for Apr 29, 2022

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Sensitivity of home COVID rapid antigen tests peaks 4 days after illness onset The sensitivity of home rapid antigen COVID-19 tests peaks 4 days after symptom onset, suggesting that a negative antigen test should be followed by a second test in 1 or 2 days, according to a prospective study published today in JAMA Internal Medicine.The study, led by the US Centers for Disease Control and Prevention (CDC) COVID-19 Response Team, studied test sensitivity in 225 adults and children from 107 households who tested positive for COVID-19 in San Diego County, California, and metropolitan Denver from January to May 2021.Participants used antigen tests for 15 days and had at least one same-day reverse-transcription (RT) PCR test and viral culture.

A total of 3,044 antigen tests and 642 PCR tests were performed. Average participant age was 29 years, 52% were female, and 91% had COVID-19 symptoms.Antigen tests were less sensitive than PCR, but more sensitive than viral culture.

During the first few days of illness, antigen test sensitivity was 50% (95% confidence interval [CI], 45% to 55%). Overall antigen test sensitivity was 64% (95% CI, 56% to 70%) and 84% (95% CI, 75% to 90%) compared to PCR and viral culture, respectively.Sensitivity of the antigen tests peaked at 77% (95% CI, 69% to 83%) 4 days after symptom onset and was 81% to 85% on a second test 1 or 2 days later.

PCR positivity peaked at 95% 3 days after illness onset, while viral cultures peaked at 64% on day 2. Six days after symptom onset, antigen test positivity was 61% (95% CI, 53% to 68%), falling to less than 20% by day 11.The researchers noted that antigen test performance may differ in vaccinated and unvaccinated people and among infections with different

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