Impact of SARS-CoV-2 Arrival Surveillance Screening by Nucleic Acid Amplification Versus Rapid Antigen Detection on Subsequent COVID-19 Infections in Military Trainees

Daniel J Cybulski, Zachary K Matthews, John W. Kieffer, Theresa M. Casey, Angela B Osuna, Korey Kasper, Dianne Frankel, James K. Aden, Heather Yun, Joseph Marcus

Research output: Contribution to journalArticlepeer-review

Abstract

Background
For persons entering congregate settings optimal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) arrival surveillance screening method, nucleic acid amplification (NAAT) versus rapid antigen detection test (RADT), is debated. To aid this, we sought to determine the risk of secondary symptomatic coronavirus disease 19 (COVID-19) among military trainees with negative arrival NAAT or RADT screening.

Methods
Individuals who arrived for United States Air Force basic military training from January 1st - August 31st, 2021 were placed into training groups and screened for SARS-CoV-2 via NAAT or RADT. Secondary symptomatic COVID-19 cases within two weeks of training were then measured. A case-cluster was defined as ≥5 individual symptomatic COVID-19 cases.

Results
406 (1.6%) of 24,601 trainees screened positive upon arrival. Rate of positive screen was greater for those tested with NAAT versus RADT (2.5% vs 0.4%, RR: 5.4, 95% CI: 4.0-7.3, P
Conclusion
NAAT versus RADT arrival surveillance screening method impacted individual transmission of COVID-19, but had no effect on number of training groups developing a secondary symptomatic case or case-cluster. This study provides consideration for RADT arrival screening in congregate settings.
Original languageAmerican English
JournalClinical Infectious Diseases
DOIs
StateE-pub ahead of print - 10 Aug 2023

Keywords

  • SARS-CoV-2 screening, COVID-19, military trainees

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