RT Journal Article
SR Electronic
T1 Evaluation of Real-life Use of Point-of-care Rapid Antigen Testing for SARS-CoV-2 in Schools (EPOCRATES): a cohort study
JF CMAJ Open
JO CMAJ
FD Canadian Medical Association
SP E1027
OP E1033
DO 10.9778/cmajo.20210327
VO 10
IS 4
A1 Ana C. Blanchard
A1 Marc Desforges
A1 Annie-Claude Labbé
A1 Cat Tuong Nguyen
A1 Yves Petit
A1 Dominic Besner
A1 Kate Zinszer
A1 Olivier Séguin
A1 Zineb Laghdir
A1 Kelsey Adams
A1 Marie-Ève Benoit
A1 Geneviève Leduc
A1 Jean Longtin
A1 Jiannis Ragoussis
A1 David L. Buckeridge
A1 Caroline Quach
YR 2022
UL http://www.cmajopen.ca/content/10/4/E1027.abstract
AB Background: SARS-CoV-2 transmission has an impact on education. In this study, we assessed the performance of rapid antigen detection tests (RADTs) versus polymerase chain reaction (PCR) for the diagnosis of SARS-CoV-2 infection in school settings, and RADT use for monitoring exposed contacts.Methods: In this real-world, prospective observational cohort study, high-school students and staff were recruited from 2 high schools in Montréal, Canada, and followed from Jan. 25 to June 10, 2021. Twenty-five percent of asymptomatic participants were tested weekly by RADT (nasal) and PCR (gargle). Class contacts of cases were tested. Symptomatic participants were tested by RADT (nasal) and PCR (nasal and gargle). The number of cases and outbreaks were compared with those of other high schools in the same area.Results: Overall, 2099 students and 286 school staff members consented to participate. The overall specificity of RADTs varied from 99.8% to 100%, with a lower sensitivity, varying from 28.6% in asymptomatic to 83.3% in symptomatic participants. Secondary cases were identified in 10 of 35 classes. Returning students to school after a 7-day quarantine, with a negative PCR result on days 6–7 after exposure, did not lead to subsequent outbreaks. Of cases for whom the source was known, 37 of 51 (72.5%) were secondary to household transmission, 13 (25.5%) to intraschool transmission, and 1 to community contacts between students in the same school.Interpretation: Rapid antigen detection tests did not perform well compared with PCR in asymptomatic individuals. Reinforcing policies for symptom screening when entering schools and testing symptomatic individuals with RADTs on the spot may avoid subsequent substantial exposures in class. Preprint: medRxiv — doi.org/10.1101/2021.10.13.21264960