Rapid Antigen Test Combined with Chest Computed Tomography to Rule Out COVID-19 in Patients Admitted to the Emergency Department
Correct and timely identification of SARS-CoV-2-positive patients is critical in the emergency department (ED) prior to admission to medical wards. Antigen-detecting rapid diagnostic tests (Ag-RDTs) are a rapid alternative to Reverse-transcriptase polymerase chain reaction (RT-PCR) for the diagnosis...
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| Veröffentlicht in: | Journal of clinical medicine 2021-08, Vol.10 (16), p.3455 |
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| creator | Kepka, Sabrina Ohana, Mickaël Séverac, François Muller, Joris Bayle, Eric Ruch, Yvon Laugel, Elodie Oberlin, Mathieu Solis, Morgane Hansmann, Yves Bilbault, Pascal Fafi Kremer, Samira |
| description | Correct and timely identification of SARS-CoV-2-positive patients is critical in the emergency department (ED) prior to admission to medical wards. Antigen-detecting rapid diagnostic tests (Ag-RDTs) are a rapid alternative to Reverse-transcriptase polymerase chain reaction (RT-PCR) for the diagnosis of COVID-19 but have lower sensitivity.
We evaluated the performance in real-life conditions of a strategy combining Ag-RDT and chest computed tomography (CT) to rule out COVID-19 infection in 1015 patients presenting in the ED between 16 November 2020 and 18 January 2021 in order to allow non-COVID-19 patients to be hospitalized in dedicated units directly. The combined strategy performed in the ED for patients with COVID-19 symptoms was assessed and compared with RT-PCR.
Compared with RT-PCR, the negative predictive value was 96.7% for Ag-RDT alone, 98.5% for Ag-RDT/CT combined, and increased to 100% for patients with low viral load.
A strategy combining Ag-RDT and chest CT is effective in ruling out COVID-19 in ED patients with high precision. |
| doi_str_mv | 10.3390/jcm10163455 |
| format | Article |
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We evaluated the performance in real-life conditions of a strategy combining Ag-RDT and chest computed tomography (CT) to rule out COVID-19 infection in 1015 patients presenting in the ED between 16 November 2020 and 18 January 2021 in order to allow non-COVID-19 patients to be hospitalized in dedicated units directly. The combined strategy performed in the ED for patients with COVID-19 symptoms was assessed and compared with RT-PCR.
Compared with RT-PCR, the negative predictive value was 96.7% for Ag-RDT alone, 98.5% for Ag-RDT/CT combined, and increased to 100% for patients with low viral load.
A strategy combining Ag-RDT and chest CT is effective in ruling out COVID-19 in ED patients with high precision.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm10163455</identifier><identifier>PMID: 34441750</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Antigens ; Bioengineering ; Brief Report ; Clinical medicine ; Coronaviruses ; COVID-19 ; Emerging diseases ; Human health and pathology ; Imaging ; Immunology ; Infectious diseases ; Length of stay ; Life Sciences ; Patients ; Public health ; Severe acute respiratory syndrome coronavirus 2 ; Tomography</subject><ispartof>Journal of clinical medicine, 2021-08, Vol.10 (16), p.3455</ispartof><rights>2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><rights>2021 by the authors. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c443t-3e026e1b5c9ac6632100662ce035d3f7087e0b295f8aa041ae51c15857c515583</citedby><cites>FETCH-LOGICAL-c443t-3e026e1b5c9ac6632100662ce035d3f7087e0b295f8aa041ae51c15857c515583</cites><orcidid>0000-0002-4713-9478 ; 0000-0002-3419-5307 ; 0000-0003-0179-5784 ; 0000-0003-0904-4600 ; 0000-0002-6611-1921 ; 0000-0003-3886-7833</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8397078/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8397078/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34441750$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-03608609$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Kepka, Sabrina</creatorcontrib><creatorcontrib>Ohana, Mickaël</creatorcontrib><creatorcontrib>Séverac, François</creatorcontrib><creatorcontrib>Muller, Joris</creatorcontrib><creatorcontrib>Bayle, Eric</creatorcontrib><creatorcontrib>Ruch, Yvon</creatorcontrib><creatorcontrib>Laugel, Elodie</creatorcontrib><creatorcontrib>Oberlin, Mathieu</creatorcontrib><creatorcontrib>Solis, Morgane</creatorcontrib><creatorcontrib>Hansmann, Yves</creatorcontrib><creatorcontrib>Bilbault, Pascal</creatorcontrib><creatorcontrib>Fafi Kremer, Samira</creatorcontrib><title>Rapid Antigen Test Combined with Chest Computed Tomography to Rule Out COVID-19 in Patients Admitted to the Emergency Department</title><title>Journal of clinical medicine</title><addtitle>J Clin Med</addtitle><description>Correct and timely identification of SARS-CoV-2-positive patients is critical in the emergency department (ED) prior to admission to medical wards. Antigen-detecting rapid diagnostic tests (Ag-RDTs) are a rapid alternative to Reverse-transcriptase polymerase chain reaction (RT-PCR) for the diagnosis of COVID-19 but have lower sensitivity.
We evaluated the performance in real-life conditions of a strategy combining Ag-RDT and chest computed tomography (CT) to rule out COVID-19 infection in 1015 patients presenting in the ED between 16 November 2020 and 18 January 2021 in order to allow non-COVID-19 patients to be hospitalized in dedicated units directly. The combined strategy performed in the ED for patients with COVID-19 symptoms was assessed and compared with RT-PCR.
Compared with RT-PCR, the negative predictive value was 96.7% for Ag-RDT alone, 98.5% for Ag-RDT/CT combined, and increased to 100% for patients with low viral load.
A strategy combining Ag-RDT and chest CT is effective in ruling out COVID-19 in ED patients with high precision.</description><subject>Antigens</subject><subject>Bioengineering</subject><subject>Brief Report</subject><subject>Clinical medicine</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>Emerging diseases</subject><subject>Human health and pathology</subject><subject>Imaging</subject><subject>Immunology</subject><subject>Infectious diseases</subject><subject>Length of stay</subject><subject>Life Sciences</subject><subject>Patients</subject><subject>Public health</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Tomography</subject><issn>2077-0383</issn><issn>2077-0383</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNpdkk2L2zAQhkVp6S7bPfVeBL10KW5H1oflSyFkPyGQsqS9CkVWYgXbcmV5S2796ZVJuqSri8TMM--MZgah9wS-UFrC151pCRBBGeev0HkORZEBlfT1yfsMXQ7DDtKRkuWkeIvOKGOMFBzO0Z9H3bsKz7rotrbDKztEPPft2nW2wr9drPG8Ptr6MSbbyrd-G3Rf73H0-HFsLF6Oyb_8-XCdkRK7Dn_X0dkuDnhWtS5OQYmMtcU3rQ0pi9nja9vrENtEvUNvNroZ7OXxvkA_bm9W8_tssbx7mM8WmWGMxoxayIUla25KbYSgOQEQIjcWKK_opgBZWFjnJd9IrYERbTkxhEteGE44l_QCfTvo9uO6tZVJqYNuVB9cq8Neee3U_57O1Wrrn5SkZQHFJHB1EKhfhN3PFmqyARUgBZRPJLGfjsmC_zWm_qnWDcY2je6sHweVcyGApgGyhH58ge78GLrUioniuRRUToKfD5QJfhiC3TxXQEBNi6BOFiHRH07_-sz-Gzv9C4oXrDg</recordid><startdate>20210804</startdate><enddate>20210804</enddate><creator>Kepka, Sabrina</creator><creator>Ohana, Mickaël</creator><creator>Séverac, François</creator><creator>Muller, Joris</creator><creator>Bayle, Eric</creator><creator>Ruch, Yvon</creator><creator>Laugel, Elodie</creator><creator>Oberlin, Mathieu</creator><creator>Solis, Morgane</creator><creator>Hansmann, Yves</creator><creator>Bilbault, Pascal</creator><creator>Fafi Kremer, Samira</creator><general>MDPI AG</general><general>MDPI</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>COVID</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>1XC</scope><scope>VOOES</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-4713-9478</orcidid><orcidid>https://orcid.org/0000-0002-3419-5307</orcidid><orcidid>https://orcid.org/0000-0003-0179-5784</orcidid><orcidid>https://orcid.org/0000-0003-0904-4600</orcidid><orcidid>https://orcid.org/0000-0002-6611-1921</orcidid><orcidid>https://orcid.org/0000-0003-3886-7833</orcidid></search><sort><creationdate>20210804</creationdate><title>Rapid Antigen Test Combined with Chest Computed Tomography to Rule Out COVID-19 in Patients Admitted to the Emergency Department</title><author>Kepka, Sabrina ; 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Antigen-detecting rapid diagnostic tests (Ag-RDTs) are a rapid alternative to Reverse-transcriptase polymerase chain reaction (RT-PCR) for the diagnosis of COVID-19 but have lower sensitivity.
We evaluated the performance in real-life conditions of a strategy combining Ag-RDT and chest computed tomography (CT) to rule out COVID-19 infection in 1015 patients presenting in the ED between 16 November 2020 and 18 January 2021 in order to allow non-COVID-19 patients to be hospitalized in dedicated units directly. The combined strategy performed in the ED for patients with COVID-19 symptoms was assessed and compared with RT-PCR.
Compared with RT-PCR, the negative predictive value was 96.7% for Ag-RDT alone, 98.5% for Ag-RDT/CT combined, and increased to 100% for patients with low viral load.
A strategy combining Ag-RDT and chest CT is effective in ruling out COVID-19 in ED patients with high precision.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>34441750</pmid><doi>10.3390/jcm10163455</doi><orcidid>https://orcid.org/0000-0002-4713-9478</orcidid><orcidid>https://orcid.org/0000-0002-3419-5307</orcidid><orcidid>https://orcid.org/0000-0003-0179-5784</orcidid><orcidid>https://orcid.org/0000-0003-0904-4600</orcidid><orcidid>https://orcid.org/0000-0002-6611-1921</orcidid><orcidid>https://orcid.org/0000-0003-3886-7833</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central Open Access; MDPI - Multidisciplinary Digital Publishing Institute; PubMed Central |
| subjects | Antigens Bioengineering Brief Report Clinical medicine Coronaviruses COVID-19 Emerging diseases Human health and pathology Imaging Immunology Infectious diseases Length of stay Life Sciences Patients Public health Severe acute respiratory syndrome coronavirus 2 Tomography |
| title | Rapid Antigen Test Combined with Chest Computed Tomography to Rule Out COVID-19 in Patients Admitted to the Emergency Department |
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