Performance of Blood-Based Nucleocapsid Antigen Tests for Diagnosis of Severe Acute Respiratory Syndrome Coronavirus 2 Infection and Infectious Viral Shedding: A Systematic Review

Sujata Mathur; Matthew So; Peggy Tahir; Michael J Peluso; Jeffrey N Martin; J Daniel Kelly

doi:10.1093/ofid/ofad346

Performance of Blood-Based Nucleocapsid Antigen Tests for Diagnosis of Severe Acute Respiratory Syndrome Coronavirus 2 Infection and Infectious Viral Shedding: A Systematic Review

Open Forum Infect Dis. 2023 Jul 10;10(8):ofad346. doi: 10.1093/ofid/ofad346. eCollection 2023 Aug.

Authors

Sujata Mathur¹, Matthew So¹, Peggy Tahir², Michael J Peluso³, Jeffrey N Martin¹, J Daniel Kelly^{1

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Affiliations

¹ Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.
² UCSF Library, University of California, San Francisco, CA, USA.
³ Division of HIV, Infectious Diseases, and Global Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, California, USA.
⁴ Institute for Global Health Sciences, University of California, San Francisco, CA, USA.
⁵ Francis I. Proctor foundation, University of California, San Francisco, USA.
⁶ San Francisco Veterans Affairs Medical Centre, San Francisco, CA, USA.

Abstract

Data on the performance of blood-based nucleocapsid antigen tests for diagnosing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and infectious viral shedding are limited. To address this knowledge gap, we conducted a systematic review to assess the performance of blood-based nucleocapsid (N) antigen tests in diagnosing SARS-CoV-2 infection and identifying infectiousness. This review was registered on PROSPERO (registration no. CRD42022339635). We comprehensively searched PubMed, Embase, Web of Science, and the Coronavirus Research Database for relevant studies published through 27 February 2023. Each study's risk of bias was evaluated using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. Our findings indicate that the performance of the N-antigen test is influenced by factors such as assay type, sampling timing, and illness severity. Sensitive assays provide suitable methods for viable screening and laboratory diagnostic tests in different clinical and research settings during the early phase of illness.

Keywords: SARS-CoV-2; blood; nucleocapsid antigen; sensitivity and specificity; systematic review.

Publication types

Review

Abstract

Publication types

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