Impact of antigen test target failure and testing strategies on the transmission of SARS-CoV-2 variants
File(s)
Published version
Author(s)
Del Vecchio, Claudia
Cracknell Daniels, Bethan
Brancaccio, Giuseppina
Brazzale, Alessandra Rosalba
Lavezzo, Enrico
Type
Journal Article
Abstract
Population testing remains central to COVID-19 control and surveillance, with countries increasingly using antigen tests rather than molecular tests. Here we describe a SARS-CoV-2 variant that escapes N antigen tests due to multiple disruptive amino-acid substitutions in the N protein. By fitting a multistrain compartmental model to genomic and epidemiological data, we show that widespread antigen testing in the Italian region of Veneto favored the undetected spread of the antigen-escape variant compared to the rest of Italy. We highlight novel limitations of widespread antigen testing in the absence of molecular testing for diagnostic or confirmatory purposes. Notably, we find that genomic surveillance systems which rely on antigen population testing to identify samples for sequencing will bias detection of escape antigen test variants. Together, these findings highlight the importance of retaining molecular testing for surveillance purposes, including in contexts where the use of antigen tests is widespread.
Date Issued
2022-10-05
Date Acceptance
2022-09-15
Citation
Nature Communications, 2022, 13 (1), pp.1-16
ISSN
2041-1723
Publisher
Nature Research
Start Page
1
End Page
16
Journal / Book Title
Nature Communications
Volume
13
Issue
1
Copyright Statement
© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
License URL
Sponsor
Medical Research Council (MRC)
Wellcome Trust
Identifier
https://www.nature.com/articles/s41467-022-33460-0
Grant Number
MR/R015600/1
213494/Z/18/Z
Publication Status
Published
Article Number
5870
Date Publish Online
2022-10-05