{"doi":"10.1101/2022.02.05.22270481","title":"Limitations of molecular and antigen test performance for SARS-CoV-2 in symptomatic and asymptomatic COVID-19 contacts","abstract":"OBJECTIVES: COVID-19 has brought unprecedented attention to the crucial role of diagnostics in pandemic control. We compared SARS-CoV-2 test performance by sample type and modality in close contacts of SARS-CoV-2 cases. METHODS: Close contacts of SARS-CoV-2 positive individuals were enrolled after informed consent. Clinician-collected nasopharyngeal (NP) swabs in viral transport media (VTM) were tested with a nucleic acid test (NAT). NP VTM and self-collected passive drool were tested using the PerkinElmer real-time reverse transcription PCR (RT-PCR) assay. For the first 4 months of study, mid-turbinate swabs were tested using the BD Veritor rapid antigen test. NAT positive NP samples were tested for infectivity using a VeroE6TMPRSS2 cell culture model. RESULTS: Between November 17, 2020, and October 1, 2021, 235 close contacts of SARS-CoV-2 cases were recruited, including 95 with symptoms (82% symptomatic for < 5 days) and 140 asymptomatic individuals. NP swab reference tests were positive for 53 (22.6%) participants; 24/50 (48%) were culture positive. PerkinElmer testing of NP and saliva samples identified an additional 28 (11.9%) SARS-CoV-2 cases who tested negative by clinical NAT. Antigen tests performed for 99 close contacts showed 83% positive percent agreement (PPA) with reference NAT among early symptomatic persons, but 18% PPA in others; antigen tests in 8 of 11 (72.7%) culture-positive participants were positive. CONCLUSIONS: Contacts of SARS-CoV-2 cases may be falsely negative early after contact, which more sensitive platforms may identify. Repeat or serial SARS-CoV-2 testing with both antigen and molecular assays may be warranted for individuals with high pretest probability for infection.","journal":"medRxiv","year":2022,"id":297646,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":8,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9303,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":626403,"name":"Agha Zeeshan Mirza","orcid":"0000-0003-2688-8215","position":1,"is_corresponding":false},{"id":627310,"name":"Nicholas Gallagher","orcid":null,"position":2,"is_corresponding":false},{"id":986211,"name":"Alec Boudreau","orcid":null,"position":3,"is_corresponding":false},{"id":986212,"name":"Lydia Garcia","orcid":null,"position":4,"is_corresponding":false},{"id":495798,"name":"Tong Yu","orcid":"0009-0002-9463-9085","position":5,"is_corresponding":false},{"id":874978,"name":"Julie M. Norton","orcid":"0000-0001-6270-5557","position":6,"is_corresponding":false},{"id":628530,"name":"Chun Huai Luo","orcid":"0000-0002-1775-8606","position":7,"is_corresponding":false},{"id":626404,"name":"Abigail Conte","orcid":"0000-0002-2821-1964","position":8,"is_corresponding":false},{"id":636789,"name":"Ruifeng Zhou","orcid":"0000-0003-2844-0107","position":9,"is_corresponding":false},{"id":986213,"name":"Kim Kafka","orcid":null,"position":10,"is_corresponding":false},{"id":292570,"name":"Justin Hardick","orcid":"0000-0003-3926-7784","position":11,"is_corresponding":false},{"id":306787,"name":"David D. McManus","orcid":"0000-0002-9343-6203","position":12,"is_corresponding":false},{"id":512074,"name":"Laura Gibson","orcid":"0000-0003-0224-305X","position":13,"is_corresponding":false},{"id":227501,"name":"Andrew Pekosz","orcid":"0000-0003-3248-1761","position":14,"is_corresponding":false},{"id":251887,"name":"Heba H. Mostafa","orcid":"0000-0002-0274-8966","position":15,"is_corresponding":false},{"id":237961,"name":"Yukari C. Manabe","orcid":"0000-0001-8619-5598","position":16,"is_corresponding":false},{"id":108416,"name":"Matthew L. Robinson","orcid":"0000-0003-0376-8560","position":0,"is_corresponding":true}],"reference_count":21,"raw_metadata":null,"created_at":"2026-07-19T00:31:26.161109Z","pmid":"35169814","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}