Recommendations for use of antigenic tests in the diagnosis of acute SARS-CoV-2 infection in the second pandemic wave: attitude in different clinical settings.
Recommendations for use of antigenic tests in the diagnosis of acute SARS-CoV-2 infection in the second pandemic wave: attitude in different clinical settings.
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DOI：
10.37201/req/120.2020
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发表时间：
2020-12
期刊：
影响因子：
--
通讯作者：
Zapatero A
中科院分区：
文献类型：
--
作者：
Candel FJ;Barreiro P;San Román J;Abanades JC;Barba R;Barberán J;Bibiano C;Canora J;Cantón R;Calvo C;Carretero M;Cava F;Delgado R;García-Rodríguez J;González Del Castillo J;González de Villaumbrosia C;Hernández M;Losa JE;Martínez-Peromingo FJ;Molero JM;Muñoz P;Onecha E;Onoda M;Rodríguez J;Sánchez-Celaya M;Serra JA;Zapatero A
SARS-CoV-2 在症状出现之前和之后不久的高传播性表明，仅诊断和隔离有症状的患者可能不足以阻止感染的传播；因此，保持个人距离等公共卫生措施也是必要的。此外，检测仍然无症状的新感染者也很重要，这些人可能占病例的 50% 或更多。分子技术是诊断 SARS-CoV-2 感染的“金标准”。然而，这些技术的大量使用产生了一些问题。一方面是资源（分析仪、可替代品和试剂）的稀缺，另一方面是结果通知的延迟。这两个事实导致病例和接触者之间隔离措施的滞后，从而有利于感染的传播。抗原检测测试也是直接诊断方法，其优点是可以在几分钟内“即时”获得结果。此外，这些测试的简单性和低成本使得它们可以在某些临床环境中连续几天重复进行。抗原检测的灵敏度通常低于核酸检测，尽管它们的特异性相当。抗原检测已被证明在症状出现前后几天更有效，此时鼻咽部的病毒载量较高。与更敏感的测试相比，快速、实时的病毒检测分析（例如抗原测试）已被证明对于控制感染的传播更有用，但成本和响应时间更长（例如在分子测试的情况下）。世界卫生组织、疾病预防控制中心和西班牙政府卫生部等主要卫生机构建议在应对这一流行病的各种策略中使用抗原检测。本文件旨在为参与疑似 SC2 感染患者护理的医生提供支持，因为西班牙自 2020 年 9 月以来发病率不断上升，这已经代表了第二波 COVID-19 大流行。
The high transmissibility of SARS-CoV-2 before and shortly after the onset of symptoms suggests that only diagnosing and isolating symptomatic patients may not be sufficient to interrupt the spread of infection; therefore, public health measures such as personal distancing are also necessary. Additionally, it will be important to detect the newly infected individuals who remain asymptomatic, which may account for 50% or more of the cases. Molecular techniques are the “gold standard” for the diagnosis of SARS-CoV-2 infection. However, the massive use of these techniques has generated some problems. On the one hand, the scarcity of resources (analyzers, fungibles and reagents), and on the other the delay in the notification of results. These two facts translate into a lag in the application of isolation measures among cases and contacts, which favors the spread of the infection. Antigen detection tests are also direct diagnostic methods, with the advantage of obtaining the result in a few minutes and at the very “point-of-care”. Furthermore, the simplicity and low cost of these tests allow them to be repeated on successive days in certain clinical settings. The sensitivity of antigen tests is generally lower than that of nucleic acid tests, although their specificity is comparable. Antigenic tests have been shown to be more valid in the days around the onset of symptoms, when the viral load in the nasopharynx is higher. Having a rapid and real-time viral detection assay such as the antigen test has been shown to be more useful to control the spread of the infection than more sensitive tests, but with greater cost and response time, such as in case of molecular tests. The main health institutions such as the WHO, the CDC and the Ministry of Health of the Government of Spain propose the use of antigenic tests in a wide variety of strategies to respond to the pandemic. This document aims to support physicians involved in the care of patients with suspected SC2 infection, in the context of a growing incidence in Spain since September 2020, which already represents the second pandemic wave of COVID-19.
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影响因子：
64.5
作者：
Gruber, Conor N.;Patel, Roosheel S.;Bogunovic, Dusan
通讯作者：
Bogunovic, Dusan
影响因子：
82.9
作者：
He, Xi;Lau, Eric H. Y.;Leung, Gabriel M.
通讯作者：
Leung, Gabriel M.
影响因子：
3.7
作者：
Guan WZ;Qiu GF;Feng-Liu
通讯作者：
Feng-Liu
DOI：
10.1056/nejmp2026913
发表时间：
2020-10-29
期刊：
The New England journal of medicine
影响因子：
--
作者：
Gandhi M;Rutherford GW
通讯作者：
Rutherford GW
影响因子：
8.4
作者：
Hirotsu, Yosuke;Maejima, Makoto;Omata, Masao
通讯作者：
Omata, Masao