Original Article
Potential usage of anterior nasal sampling in clinical practice with three rapid antigen tests for SARS-CoV-2

https://doi.org/10.1016/j.jiac.2022.09.001Get rights and content
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Abstract

Introduction

Anterior nasal sampling (AN) might be more convenient for patients than NP sampling to diagnose coronavirus disease. This study investigated the feasibility of rapid antigen tests for AN sampling, and the factors affecting the test accuracy.

Methods

This single-center prospective study evaluated one qualitative (ESP) and two quantitative (LUMI and LUMI-P) rapid antigen tests using AN and NP swabs. Symptomatic patients aged 20 years or older, who were considered eligible for reverse-transcription quantitative polymerase chain reaction using NP samples within 9 days of onset were recruited. Sensitivity, specificity, and positive and negative concordance rates between AN and NP samples were assessed for the rapid antigen tests. We investigated the characteristics that affected the concordance between AN and NP sampling results.

Results

A total of 128 cases were recruited, including 28 positive samples and 96 negative samples. The sensitivity and specificity of AN samples using ESP were 0.81 and 1.00, while those of NP samples were 0.94 and 1.00. The sensitivity of AN and NP samples was 0.91 and 0.97, respectively, and specificity was 1.00, for both LUMI and LUMI-P. The positive concordance rates of AN to NP sampling were 0.87, 0.94, and 0.85 for ESP, LUMI, and LUMI-P, respectively. No factor had a significant effect on the concordance between the sampling methods.

Conclusions

ESP, LUMI, and LUMI-P showed practical diagnostic accuracy for AN sampling compared to NP sampling. There was no significant factor affecting the concordance between AN and NP sampling for these rapid antigen tests.

Keywords

Espline
Lumipulse
Rapid antigen test
Anterior nasal
COVID-19
SARS-CoV-2

Abbreviations

COVID-19
coronavirus disease
AN
Anterior nasal sampling
NP
nasopharyngeal sampling
RT-qPCR
reverse-transcription quantitative polymerase chain reaction
SARS-CoV-2
severe acute respiratory syndrome coronavirus 2
Ct
cycle threshold
IQR
interquartile range

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