Comparison of SARS-CoV-2 Antigen Tests in
Asymptomatic Testing of Passengers at
German Airports under Time Constraints:
Application of Three Different Antigen Test
Formats
People infected asymptomatically with SARS-CoV-2 can spread the virus very
efficiently. To break infection chains, massive testing efforts are underway. While the
value of RT-PCR in asymptomatic patients is established, point-of-care (POC) antigen
tests against SARS-CoV-2 are considered inferior to RT-PCR in terms of sensitivity and
specificity but have demonstrated utility, mostly in symptomatic patients. We
compared the performance of three different antigen tests with colorimetric (Roche),
fluorometric (Quidel Sofia 2), and instrument-based chemiluminescent (Fujirebio
Lumipulse® G) readout. Sensitivities for Roche, Quidel, and Fujirebio were 62.5%,
90.9%, 97.5% (≤ct 26); 43.8%, 90.9%, 95.1% (≤ct 30); and 4.3%, 0.0%, 57.6% (˃ct 30),
respectively. The two assays with increased sensitivity were employed to screen >
35,000 passengers at German airports under time constraints. Under real-world
conditions, the rate of false positives was low: 0.15% (Quidel) and 0.06% for the
instrument based Fujirebio assay. Our study exemplifies that antigen tests with
enhanced detection methods have an acceptable sensitivity of >90% in samples
containing SARS-CoV-2 RNA that are considered to be infectious. Therefore, our
results support the view of the WHO that discourages the use of antigen assays with
a sensitivity of “only” 80% for screening travelers.
Keywords: SARS-CoV-2; RT-PCR; asymptomatic; antigen test; point-of-care
Asymptomatic Testing of Passengers at
German Airports under Time Constraints:
Application of Three Different Antigen Test
Formats
People infected asymptomatically with SARS-CoV-2 can spread the virus very
efficiently. To break infection chains, massive testing efforts are underway. While the
value of RT-PCR in asymptomatic patients is established, point-of-care (POC) antigen
tests against SARS-CoV-2 are considered inferior to RT-PCR in terms of sensitivity and
specificity but have demonstrated utility, mostly in symptomatic patients. We
compared the performance of three different antigen tests with colorimetric (Roche),
fluorometric (Quidel Sofia 2), and instrument-based chemiluminescent (Fujirebio
Lumipulse® G) readout. Sensitivities for Roche, Quidel, and Fujirebio were 62.5%,
90.9%, 97.5% (≤ct 26); 43.8%, 90.9%, 95.1% (≤ct 30); and 4.3%, 0.0%, 57.6% (˃ct 30),
respectively. The two assays with increased sensitivity were employed to screen >
35,000 passengers at German airports under time constraints. Under real-world
conditions, the rate of false positives was low: 0.15% (Quidel) and 0.06% for the
instrument based Fujirebio assay. Our study exemplifies that antigen tests with
enhanced detection methods have an acceptable sensitivity of >90% in samples
containing SARS-CoV-2 RNA that are considered to be infectious. Therefore, our
results support the view of the WHO that discourages the use of antigen assays with
a sensitivity of “only” 80% for screening travelers.
Keywords: SARS-CoV-2; RT-PCR; asymptomatic; antigen test; point-of-care
