Role of admission rapid antigen testing (RATs) for COVID-19 on patients transferred from acute hospitals to a postacute rehabilitation setting

Am J Infect Control. 2024 Nov 1:S0196-6553(24)00822-8. doi: 10.1016/j.ajic.2024.10.031. Online ahead of print.

Abstract

Background: Rapid antigen tests (RATs) are suitable for point-of-care testing, require no laboratory time, and give immediate results. However, are RATs useful for detecting asymptomatic COVID-19 infection when compared with polymerase chain reaction (PCR) testing in health care settings?

Methods: RAT testing was carried out on all new admissions without a history of confirmed COVID-19 infection within 3 months of admission. PCR testing was carried out on all patients with a positive RAT for confirmation purposes. The cycle threshold values of COVID-19-detected results on PCR testing were examined to determine the utility of the RATs.

Results: A total of 1,403 patients were transferred to the postacute rehabilitation unit from January to December 2023. The results of the study revealed an 85% accuracy of RATs with a 15% rate of false-negative results at the time of admission. All patients who had a positive RAT at the time of admission also had a positive PCR test.

Conclusions: This testing algorithm resulted in early detection and prompt isolation of positive cases reducing the likely spread of COVID-19 infection, hospital outbreaks, and bed/ward closures.

Keywords: Cycle threshold value; Infection prevention and control; Polymerase chain reaction; Postacute rehabilitation unit; Rapid antigen tests.