key: cord-0759405-4pf11llo
authors: Matteo, Ricco’
title: ENG: A systematic review on Rapid Antigen Test devices for SARS-CoV-2 in Nursing Homes: useful, but handle with care
date: 2022-03-03
journal: Enferm Infecc Microbiol Clin
DOI: 10.1016/j.eimc.2022.02.012
sha: 7a47adc02732a5c2341b54b6656417c254868b7d
doc_id: 759405
cord_uid: 4pf11llo

nan

the COVID-19 pandemic has disproportionately affected Nursing homes (NHs), with mortality rates largely exceeding those of the general population, particularly during the first wave 1, 2 . A recent study from England and Wales has estimated an 18-fold difference in mortality rates when figures were compared to the pre-pandemic time period, but this is a likely an underestimate given the low levels of testing in NHs, particularly when nasal swabs with subsequent Real-Time quantitative polymerase chain reaction (RT-qPCR) represented the only validated diagnostic items 2 .

As recently pointed out by Domínguez Fernandez et al. 3 , rapid antigen tests (RAT), with their reduced costs and turnaround times 4 , could significantly speed and scale up diagnoses, benefiting residents' and workers' safety. However, available evidence appears far more controversial. We specifically performed a systematic review and meta-analysis on RAT in NHs according to PRISMA guidelines (see Annex 1A for the detailed search strategy) 5 , being able to retrieve 5 studies (Table 1) In other words, real-world estimates suggest that actual reliability of RAT may be quite far from optimal, particularly for non-seriated testing strategy. As acknowledged by Dominguez-Fernández et 3 , in cases characterized by high viral load, RAT may be quite reliable 6, 8 , but they exhibited substantial lack of sensitivity when employed in individuals that exhibit low viral replication. Indeed, RAT may be quite unreliable when employed to screen earlier stages of SARS-CoV-2 infections, or in individuals who, because of their even transitory lack of symptoms, may actively spread the infection not only among other residents, but also in NH workers failing to cope with appropriate preventive measures 1,2 . As a consequence, as suggested by McKay et al 9 , early and frequent referral to RAT rather than a single and synchronous sampling campaign may be quite effective in identifying individuals with the greatest potential to transmit the virus. 

Implementing lateral flow devices in long-term care facilities: experiences from the Liverpool COVID-19 community testing pilot in care homes-a qualitative study

Mortality among Care Home Residents in England during the first and second wave of the COVID-19 pandemic: an observational study of 4.3 million adults over the age of 65

Experience with Panbio TM rapid antigens test device for the detection of SARS-CoV-2 in nursing homes

Pointof-Care Diagnostic Tests for Detecting SARS-CoV-2 Antibodies : A Systematic Review and Meta-Analysis of Real-World Data

Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement

Clinical evaluation of single-swab sampling for rapid COVID-19 detection in outbreak settings in Dutch nursing homes

The effectiveness of rapid antigen test-based for SARS-CoV-2 detection in nursing homes in Valencia, Spain

Sánchez Antolín G. Internal validity of a rapid test for COVID-19 antigens in a nursing home

Performance evaluation of serial sars-cov-2 rapid antigen testing during a nursing home outbreak