The role of SARS-CoV-2 testing in COVID-19

• Main Author: Cole, Manisha
• Other Authors: Kataria, Yachana
• Language: en_US
• Published: 2021
• Subjects: Epidemiology; Antibodies; Antigen testing; COVID-19; SARS-CoV-2
• Online Access: https://hdl.handle.net/2144/43341

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the novel coronavirus that causes coronavirus disease 2019 (COVID-19) and has escalated, becoming a pandemic in early 2020. Multiple testing modalities have been developed to detect this virus including RT-PCR, antigen, and serology testing. RT-PCR testing is the clinical gold standard and is used for diagnostic purposes of current infections. Antigen testing is rapid and requires significantly less equipment, but lacks the sensitivity of RT-PCR testing. Serology assays detect antibodies raised against SARS-CoV-2, so only detect prior exposure. It is important to note that use of antibody tests may also detect prior asymptomatic infections. For these reasons, it is imperative that all testing modalities be continuously developed and improved to better our understanding of disease transmission, helping to inform and change infection control policies and protecting both employees in the workplace and patients. We aim to quantify the seroprevalence of anti-SARS-CoV-2 IgG in the healthcare workers at Boston Medical Center, including those with asymptomatic infections. Our results show an overall seroprevalence of 5.5% with an asymptomatic seroprevalence of 1.8%. High risk groups include those who are obese, smokers, and Hispanic/LatinX. Experiencing some symptoms was associated with a higher risk of seropositivity, as was lack of social distancing amongst coworkers. In a separate study, we aim to assess the direct antigen rapid tests (DART) created by E25Bio in patients seeking care at Boston Medical Center. This study has been significantly limited by number of participants, as recruitment has been paused during both COVID-19 surges in Boston, MA. The current data shows poor positive agreement between DART and RT-PCR, but acceptable negative agreement. Each testing modality works to fill in the gaps of knowledge that still persist around SARS-CoV-2. Each of these testing types provides a unique piece of information and when used together, will help to inform strategies to overcome the SARS-CoV-2 pandemic.