AUTHOR=Corrêa Isadora Alonso , Faffe Débora Souza , Galliez Rafael Mello , Gonçalves Cássia Cristina Alves , Maia Richard Araújo , da Silva Gustavo Peixoto , Moreira Filipe Romero Rebello , Mariani Diana , Campos Mariana Freire , Leitão Isabela de Carvalho , de Souza Marcos Romário , Cunha Marcela Sabino , Nascimento Érica Ramos dos Santos , Ribeiro Liane de Jesus , da Cruz Thais Felix Cordeiro , Policarpo Cintia , Gonzales Luis , Rodgers Mary A. , Berg Michael , Vijesurier Roy , Cloherty Gavin A. , Hackett John , Ferreira Orlando da Costa , Castiñeiras Terezinha Marta Pereira Pinto , Tanuri Amilcar , da Costa Luciana Jesus TITLE=A SARS-CoV-2 Negative Antigen Rapid Diagnostic in RT-qPCR Positive Samples Correlates With a Low Likelihood of Infectious Viruses in the Nasopharynx JOURNAL=Frontiers in Microbiology VOLUME=13 YEAR=2022 URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2022.912138 DOI=10.3389/fmicb.2022.912138 ISSN=1664-302X ABSTRACT=

Severe acute respiratory syndrome-related coronavirus (SARS-CoV-2) transmission occurs even among fully vaccinated individuals; thus, prompt identification of infected patients is central to control viral circulation. Antigen rapid diagnostic tests (Ag-RDTs) are highly specific, but sensitivity is variable. Discordant RT-qPCR vs. Ag-RDT results are reported, raising the question of whether negative Ag-RDT in positive RT-qPCR samples could imply the absence of infectious viruses. To study the relationship between negative Ag-RDT results with virological, molecular, and serological parameters, we selected a cross-sectional and a follow-up dataset and analyzed virus culture, subgenomic RNA quantification, and sequencing to determine infectious viruses and mutations. We demonstrated that RT-qPCR positive while SARS-CoV-2 Ag-RDT negative discordant results correlate with the absence of infectious virus in nasopharyngeal samples. A decrease in sgRNA detection together with an expected increase in detectable anti-S and anti-N IgGs was also verified in these samples. The data clearly demonstrate that a negative Ag-RDT sample is less likely to harbor infectious SARS-CoV-2 and, consequently, has a lower transmissible potential.