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SARS-CoV-2/COVID-19 Testing: The Tower of Babel

BACKGROUND AND AIM: Testing represents one of the main pillars of public health response to SARS-CoV-2/COVID-19 pandemic. This paper shows how accuracy and utility of testing programs depend not just on the type of tests, but on the context as well. METHODS: We describe the testing methods that have...

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Detalles Bibliográficos
Autores principales: Reno, Chiara, Lenzi, Jacopo, Golinelli, Davide, Gori, Davide, Signorelli, Carlo, Kraemer, John, Stoto, Michael A., Avitabile, Elisa, Landini, Maria Paola, Lazzarotto, Tiziana, Re, Maria Carla, Rucci, Paola, Taliani, Gloria, Trerè, Davide, Vocale, Caterina, Fantini, Maria Pia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Mattioli 1885 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7927496/
https://www.ncbi.nlm.nih.gov/pubmed/33525202
http://dx.doi.org/10.23750/abm.v91i4.10911
Descripción
Sumario:BACKGROUND AND AIM: Testing represents one of the main pillars of public health response to SARS-CoV-2/COVID-19 pandemic. This paper shows how accuracy and utility of testing programs depend not just on the type of tests, but on the context as well. METHODS: We describe the testing methods that have been developed and the possible testing strategies; then, we focus on two possible methods of population-wide testing, i.e., pooled testing and testing with rapid antigen tests. We show the accuracy of split-pooling method and how, in different pre-test probability scenarios, the positive and negative predictive values vary using rapid antigen tests. RESULTS: Split-pooling, followed by retesting of negative results, shows a higher sensitivity than individual testing and requires fewer tests. In case of low pre-test probability, a negative result with antigen test could allow to rule out the infection, while, in case of a positive result, a confirmatory molecular test would be necessary. CONCLUSIONS: Test performance alone is not enough to properly choose which test to use; goals and context of the testing program are essential. We advocate the use of pooled strategies when planning population-wide screening, and the weekly use of rapid tests for close periodic monitoring in low-prevalence populations. (www.actabiomedica.it)