Accuracy of rapid antigen testing for COVID-19 in shelter settings
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Background
The COVID-19 pandemic disproportionally affected congregate living settings, including shelters. COVID-19 transmission can have more adverse outcomes in these settings due to the vulnerability of residents. Point of care rapid antigen testing (RAT) represents a strategy with potential benefits for COVID-19 detection in shelters, including rapid results, ease of use, cost-effectiveness, and early detection.
Objectives
Our primary objective was to assess the real-world test accuracy of RAT for COVID-19 using the Quidel Sofia 2 Flu + SARS Antigen fluorescent immunoassay (Sofia RAT) compared to polymerase chain reaction (PCR) testing among shelter residents in Ontario, Canada.
Study Design
A consecutive sample of 102 residents across six shelters who were symptomatic for, or exposed to COVID-19 were included. The RAT and PCR samples were taken on the same day for each participant. Results from the Sofia RAT were compared to PCR test results to determine test accuracy. Participant demographic data could not be collected due to workforce constraints.
Results
We reported our methods and findings using the QUality Assessment tool of Diagnostic Accuracy Studies (QUADAS-2) guidelines. Sofia 2 RAT specificity was 97.9% (95% CI: 92.7% to 99.7%) for COVID-19 compared to PCR. Due to a lack of true positive cases, sensitivity could not accurately be calculated (0.00% (95% CI: 0.00% to 52.2%)).
Conclusion
These data suggest that the Sofia RAT is a highly specific test for COVID-19.
