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N-antigenemia detection by a rapid lateral flow test predicts 90-day mortality in COVID-19: A prospective cohort study

2022; Elsevier BV; Volume: 28; Issue: 10 Linguagem: Inglês

10.1016/j.cmi.2022.05.023

1469-0691

Raquel Almansa, José Marı́a Eiros Bouza, David de Gonzalo‐Calvo, Tamara Postigo, Alicia Ortega, Raúl López‐Izquierdo, Anna Moncusí‐Moix, Clara Gort‐Paniello, Marta Domínguez‐Gil, Amanda de la Fuente, Laura González‐González, Tania Luis-García, Nadia García‐Mateo, Ana P. Tedim, Fátima Rodríguez‐Jara, Noelia Jorge, Jessica González, Gerard Torres, Oliver Norberto Gutiérrez-Pérez, Maria José Villegas, Sonia Campo, Eva Ayllon, Tomás Ruíz Albi, Julio de Frutos Arribas, Ainhoa Arroyo Domingo, Jésica Abadía‐Otero, Julia Gómez Barquero, Wysali Trapiello, L.J. García Frade, Luis Inglada, Félix del Campo, Jesús F. Bermejo-Martín, Ferrán Barbé, Antoní Torres,

SARS-CoV-2 detection and testing

ObjectivesTo evaluate if the detection of N antigen of SARS-CoV-2 in plasma by a rapid lateral flow test predicts 90-day mortality in COVID-19 patients hospitalized at the wards.MethodsThe presence of N-antigenemia was evaluated in the first 36 hours after hospitalization in 600 unvaccinated COVID-19 patients, by using the Panbio COVID-19 Ag Rapid Test Device from Abbott (Abbott Laboratories Inc., Chicago, IL, USA). The impact of N-antigenemia on 90-day mortality was assessed by multivariable Cox regression analysis.ResultsPrevalence of N-antigenemia at hospitalization was higher in nonsurvivors (69% (82/118) vs. 52% (250/482); p < 0.001). The patients with N-antigenemia showed more frequently RNAemia (45.7% (148/324) vs. 19.8% (51/257); p < 0.001), absence of anti-SARS-CoV-2 N antibodies (80.7% (264/327) vs. 26.6% (69/259); p < 0.001) and absence of S1 antibodies (73.4% (240/327) vs. 23.6% (61/259); p < 0.001). The patients with antigenemia showed more frequently acute respiratory distress syndrome (30.1% (100/332) vs. 18.7% (50/268); p = 0.001) and nosocomial infections (13.6% (45/331) vs. 7.9% (21/267); p = 0.026). N-antigenemia was a risk factor for increased 90-day mortality in the multivariable analysis (HR, 1.99 (95% CI,1.09–3.61), whereas the presence of anti-SARS-CoV-2 N-antibodies represented a protective factor (HR, 0.47 (95% CI, 0.26–0.85).DiscussionThe presence of N-antigenemia or the absence of anti-SARS-CoV-2 N-antibodies after hospitalization is associated to increased 90-day mortality in unvaccinated COVID-19 patients. Detection of N-antigenemia by using lateral flow tests is a quick, widely available tool that could contribute to early identify those COVID-19 patients at risk of deterioration.