Recommendations for use of antigenic tests in the diagnosis of acute SARS-CoV-2 infection in the second pandemic wave: attitude in different clinical settings

被引:56
作者
Javier Candel, Francisco [1 ]
Barreiro, Pablo [2 ]
San Roman, Jesus [3 ]
Carlos Abanades, Juan [4 ]
Barba, Raquel [5 ]
Barberan, Jose [6 ]
Bibiano, Carlos [7 ]
Canora, Jesus [8 ]
Canton, Rafael [9 ]
Calvo, Cristina [10 ]
Carretero, Mar [11 ]
Cava, Fernando [12 ]
Delgado, Rafael [13 ]
Garcia-Rodriguez, Julio [14 ]
Gonzalez del Castillo, Juan [15 ]
Gonzalez de Villaumbrosia, Cristina [16 ]
Hernandez, Montserrat [17 ]
Emilio Losa, Juan [18 ]
Javier Martinez-Peromingo, Francisco [19 ]
Maria Molero, Jose [20 ]
Munoz, Patricia [21 ]
Onecha, Elena [22 ]
Onoda, Mamiko [23 ]
Rodriguez, Juan [24 ]
Sanchez-Celaya, Marta [25 ]
Antonio Serra, Jose [26 ]
Zapatero, Antonio [8 ]
机构
[1] Hosp Univ San Carlos SEQ SEMES, Serv Enfermedades Infecciosas & Microbiol Clin, Madrid, Spain
[2] Hosp Univ La Paz, Enfermedades Infecciosas, Serv Med Interna, Madrid, Spain
[3] Univ Rey Juan Carlos, Dept Med, Madrid, Spain
[4] Ctr Salud Univ Monovar SEMFYC, Ciudad Real, Spain
[5] Hosp Univ Rey Juan Carlos SEMI, Madrid, Spain
[6] Hosp Monteprincipe SEQ SEMI, Unidad Enfermedades Infecciosas, Madrid, Spain
[7] Hosp Infanta Leonor SEMES, Serv Urgencias, Madrid, Spain
[8] Viceconsejeria Salud PUbl & COVID19 SEMI, Madrid, Spain
[9] Hosp Univ Ramon y Cajal IRYCIS SMMC, Serv Microbiol Clin, Madrid, Spain
[10] Hosp Univ La Paz SEIP, Serv Pediat, Madrid, Spain
[11] Lab Reg Salud Publ, Madrid, Spain
[12] Microbiol Clin, Lab Cent BR Salud, Madrid, Spain
[13] Hosp Univ 12 Octubre SMMC, Serv Microbiol Clin, Madrid, Spain
[14] Hosp Univ La Paz SMMC, Serv Microbiol Clin, Madrid, Spain
[15] Hosp Univ San Carlos SEMES SEQ, Serv Urgencias, Madrid, Spain
[16] Hosp Univ Rey Juan Carlos SEGG, Serv Geriatr, Madrid, Spain
[17] SFRMAS SEMFYC, Gerencia Atenc Primaria, Madrid, Spain
[18] Fdn Hosp Alcorcon SEMI, Serv Med Inter, Enfermedades Infecciosas, Madrid, Spain
[19] Viceconsejeria Salud Publ & COVID19 SEGG, Coordinac Sociosanitaria, Madrid, Spain
[20] Ctr Salud San Andres SEMFYC, Madrid, Spain
[21] Hosp Univ Gregorio Maranon SMMC, Serv Enfermedades Infecciosas & Microbiol Clin, Madrid, Spain
[22] Ctr Salud Monterrozas SEMFYC, Madrid, Spain
[23] Ctr Salud Valdelasfuentes AEPap, Madrid, Spain
[24] Ctr Salud Alpedrete, Madrid, Spain
[25] SERMAS SEMFYC, Gerencia Atenc Primaria, Madrid, Spain
[26] Hosp Univ Gregorio Maranon SEGG, Serv Geriatr, Madrid, Spain
关键词
SARS-COV-2; COVID-19; diagnosis; antigenic test; PCR; primary care; pediatrics; nursing home and long-term facilities; emergency departments; microbiology; COVID-19; INFECTION;
D O I
10.37201/req/120.2020
中图分类号
Q93 [微生物学];
学科分类号
071005 ; 100705 ;
摘要
The high transmissibility of SARS-CoV-2 before and shortly after the onset of symptoms suggests that only diagnosing and isolating symptomatic patients may not be sufficient to interrupt the spread of infection; therefore, public health measures such as personal distancing are also necessary. Additionally, it will be important to detect the newly infected individuals who remain asymptomatic, which may account for 50% or more of the cases. Molecular techniques are the "gold standard" for the diagnosis of SARS-CoV-2 infection. However, the massive use of these techniques has generated some problems. On the one hand, the scarcity of resources (analyzers, fungibles and reagents), and on the other the delay in the notification of results. These two facts translate into a lag in the application of isolation measures among cases and contacts, which favors the spread of the infection. Antigen detection tests are also direct diagnostic methods, with the advantage of obtaining the result in a few minutes and at the very "pointof-care". Furthermore, the simplicity and low cost of these tests allow them to be repeated on successive days in certain clinical settings. The sensitivity of antigen tests is generally lower than that of nucleic acid tests, although their specificity is comparable. Antigenic tests have been shown to be more valid in the days around the onset of symptoms, when the viral load in the nasopharynx is higher. Having a rapid and real-time viral detection assay such as the antigen test has been shown to be more useful to control the spread of the infection than more sensitive tests, but with greater cost and response time, such as in case of molecular tests. The main health institutions such as the WHO, the CDC and the Ministry of Health of the Government of Spain propose the use of antigenic tests in a wide variety of strategies to respond to the pandemic. This document aims to support physicians involved in the care of patients with suspected SC2 infection, in the context of a growing incidence in Spain since September 2020, which already represents the second pandemic wave of COVID-19.
引用
收藏
页码:466 / 484
页数:19
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