Rapid, point‐of‐care antigen and molecular‐based tests for SARS‐CoV‐2 (research up to 30 September 2020)

Added March 25, 2021

Citation: Dinnes J, Deeks JJ, Berhane S, et al. Rapid, point‐of‐care antigen and molecular‐based tests for diagnosis of SARS‐CoV‐2 infection. Cochrane Database of Systematic Reviews. 2021;(3):CD013705.

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What is this? Rapid, point-of-care tests are being used to identify patients infected with SARS-CoV-2, the virus that causes COVID-19.

In this Cochrane living review, the authors are searching for studies of the accuracy of point-of-care antigen and molecular-based tests for diagnosing patients with SARS-CoV-2. They do not restrict their searches by language of publication and the latest version of the review uses research published up to 30 September 2020. It includes 78 study cohorts (described in 64 study reports, including 20 pre‐prints) with results for 24,087 samples (7415 with confirmed SARS‐CoV‐2). 39 studies were from Europe (39) and 20 were from North America. The studies evaluated 16 antigen and five molecular assays.

What was found: The authors concluded that some antigen tests are accurate enough to replace RT‐PCR laboratory-based tests when used in people with COVID-19 symptoms and that antigen tests may be most useful to identify outbreaks, or to select people with symptoms for testing with RT-PCR. However, the included studies showed that people who receive a negative antigen test result may still be infected with SARS-CoV-2.

At the time of this review, the included studies showed that several point‐of‐care molecular tests showed very high accuracy and potential for use, but the authors concluded that more evidence of their performance in real life settings is needed.

The authors also concluded that more evidence is needed on rapid testing in people without symptoms, on the accuracy of repeated testing, testing in non‐healthcare settings (e.g. schools and self‐testing), and direct comparisons of test brands.


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