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Mohammad Haroon
Awais Naeem
Aakash Ahmad Khattak
Noor Rehman
Muhammad Asghar
Shafiq Azam
Haidar Ali
Aamir Aziz




Background: RAT are essential to identify SARS-CoV-2-positive patients, isolate them, break the transmission chain, and contain COVID-19. However, rapid antigen tests (RATs) have low sensitivity, which can lead to missed cases. This study evaluated the effectiveness of a RAT kit with reference to the gold standard real-time RT-PCR for suspected COVID-19 patients.

Methods: We investigated 370 nasopharyngeal swabs at MTI, Khyber Teaching Hospital Peshawar, Pakistan for RAT and the real-time RT-qPCR. We evaluated the effectiveness of the RAT by determining its sensitivity, specificity, PPV (positive predictive value), NPV (negative predictive value), diagnostic accuracy and kappa statistics.

Results: The results indicated a sensitivity of 79.35% and a specificity of 98.6%. The PPV was 97.62% and the NPV was 86.89%. The accuracy between the two techniques was found to be 90.54% with a kappa coefficient of 0.800. We identified that at lower cycle threshold (CT) values, the RAT was more sensitive. However, at higher CT values, the rapid antigen test sensitivity decreased.

Conclusion: The RAT had a high specificity but its sensitivity become low with high CT values and low viral load, thus it was more likely to miss some positives cases. Our findings suggest that the rapid antigen test can be a beneficial tool in mass screening of COVID-19, particularly in settings where RT-PCR is not feasible due to resource constraints or turnaround time but it is important to be aware of its limitations.

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1. Yamayoshi S, Sakai-Tagawa Y, Koga M, Akasaka O, Nakachi I, Koh H, et al. Comparison of rapid antigen tests for COVID-19. Viruses. 2020;12(12):1420.
2. Rajnik M, Cascella M, Cuomo A, Dulebohn SC, Di Napoli R. Features, evaluation, and treatment of coronavirus (COVID-19). Uniformed Services University Of The Health Sciences. 2021.
3. Pakistan: WHO Coronavirus Disease (COVID-19) Dashboard With Vaccination Data: WHO; 2023 [cited 2023 26, August]. Available from:
4. Treggiari D, Piubelli C, Caldrer S, Mistretta M, Ragusa A, Orza P, et al. SARS‐CoV‐2 rapid antigen test in comparison to RT‐PCR targeting different genes: A real‐life evaluation among unselected patients in a regional hospital of Italy. Journal of Medical Virology. 2022;94(3):1190-5.
5. Mohanty A, Kabi A, Mohanty AP, Kumar N, Kumar S. Laboratory diagnosis of COVID-19 infection: current issues and challenges: an Indian perspective. Journal of Advances in Medicine and Medical Research. 2020;32(14):10-7.
6. Nagura-Ikeda M, Imai K, Tabata S, Miyoshi K, Murahara N, Mizuno T, et al. Clinical evaluation of self-collected saliva by quantitative reverse transcription-PCR (RT-qPCR), direct RT-qPCR, reverse transcription–loop-mediated isothermal amplification, and a rapid antigen test to diagnose COVID-19. Journal of clinical microbiology. 2020;58(9):10.1128/jcm. 01438-20.
7. Porte L, Legarraga P, Vollrath V, Aguilera X, Munita JM, Araos R, et al. Evaluation of a novel antigen-based rapid detection test for the diagnosis of SARS-CoV-2 in respiratory samples. International Journal of Infectious Diseases. 2020;99:328-33.
8. Fenollar F, Bouam A, Ballouche M, Fuster L, Prudent E, Colson P, et al. Evaluation of the Panbio Covid-19 rapid antigen detection test device for the screening of patients with Covid-19. Journal of clinical microbiology. 2021;59(2):10.1128/jcm. 02589-20.
9. Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. The Lancet infectious diseases. 2020;20(5):533-4.
10. Sallam M. COVID-19 vaccine hesitancy worldwide: a concise systematic review of vaccine acceptance rates. Vaccines. 2021;9(2):160.
11. Love J, Keegan LT, Angulo FJ, McLaughlin JM, Shea KM, Swerdlow DL, et al. Continued need for non-pharmaceutical interventions after COVID-19 vaccination in long-term-care facilities. Scientific Reports. 2021;11(1):18093.
12. Mak GC, Cheng PK, Lau SS, Wong KK, Lau C, Lam ET, et al. Evaluation of rapid antigen test for detection of SARS-CoV-2 virus. Journal of Clinical Virology. 2020;129:104500.
13. Organization WH. Antigen-detection in the diagnosis of SARS-CoV-2 infection using rapid immunoassays: interim guidance, 11 September 2020. World Health Organization; 2020.
14. Prevention ECfD, Control. Options for the use of rapid antigen tests for COVID-19 in the EU/EEA and the UK. Technical Report. 2020.
15. Sabat J, Subhadra S, Rath S, Ho LM, Satpathy T, Pattnaik D, et al. A comparison of SARS-CoV-2 rapid antigen testing with realtime RT-PCR among symptomatic and asymptomatic individuals. BMC Infectious Diseases. 2023;23(1):87.
16. Platten M, Hoffmann D, Grosser R, Wisplinghoff F, Wisplinghoff H, Wiesmüller G, et al. SARS-CoV-2, CT-values, and infectivity—conclusions to be drawn from side observations. MDPI; 2021. p. 1459.
17. Keaney D, Whelan S, Finn K, Lucey B. Misdiagnosis of SARS-CoV-2: a critical review of the influence of sampling and clinical detection methods. Medical Sciences. 2021;9(2):36.
18. Gupta A, Khurana S, Das R, Srigyan D, Singh A, Mittal A, et al. Rapid chromatographic immunoassay-based evaluation of COVID-19: A cross-sectional, diagnostic test accuracy study & its implications for COVID-19 management in India. The Indian journal of medical research. 2021;153(1-2):126.

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