From more testing to smart testing: data-guided SARS-CoV-2 testing choices, the Netherlands, May to September 2020

Janko van Beek*, Zsofia Igloi, Timo Boelsums, Ewout Fanoy, Hannelore Gotz, Richard Molenkamp, Jeroen van Kampen, Corine GeurtsvanKessel, Annemiek A. van der Eijk, David van de Vijver, Marion Koopmans

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

6 Citations (Scopus)
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Background: SARS-CoV-2 RT-PCR assays are more sensitive than rapid antigen detection assays (RDT) and can detect viral RNA even after an individual is no longer infectious. RDT can reduce the time to test and the results might better correlate with infectiousness. Aim: We assessed the ability of five RDT to identify infectious COVID-19 cases and systematically recorded the turnaround time of RT-PCR testing. Methods: Sensitivity of RDT was determined using a serially diluted SARS-CoV-2 stock with known viral RNA concentration. The probability of detecting infectious virus at a given viral load was calculated using logistic regression of viral RNA concentration and matched culture results of 78 specimens from randomly selected non-hospitalised cases. The probability of each RDT to detect infectious cases was calculated as the sum of the projected probabilities for viral isolation success for every viral RNA load found at the time of diagnosis in 1,739 confirmed non-hospitalised COVID-19 cases. Results: The distribution of quantification cycle values and estimated RNA loads for patients reporting to drive-through testing was skewed to high RNA loads. With the most sensitive RDT (Abbott and SD Biosensor), 97.30% (range: 88.65-99.77) of infectious individuals would be detected. This decreased to 92.73% (range: 60.30-99.77) for Coris BioConcept and GenBody, and 75.53% (range: 17.55-99.77) for RapiGEN. Only 32.9% of RT-PCR results were available on the same day as specimen collection. Conclusion: The most sensitive RDT detected infectious COVID-19 cases with high sensitivity and may considerably improve containment through more rapid isolation and contact tracing.

Original languageEnglish
Issue number8
Publication statusPublished - 24 Feb 2022

Bibliographical note

Funding Information:
Funding: This work was funded through EU COVID-19 grant RECOVER [grant agreement ID: 101003589]. This work was published as a preprint article on MedRxiv (van Beek J, Igloi Z, Boelsums T, Fanoy E, Gotz H, Molenkamp R, van Kampen J, GeurtsvanKessel C, van der Eijk AA, van de Vijver D, Koopmans M. From more testing to smart testing: data-guided SARS-CoV-2 testing choices. MedRxiv. 2020 Oct 14).

Publisher Copyright:
© 2022 European Centre for Disease Prevention and Control (ECDC). All rights reserved.


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