Performance Evaluation of the Microfluidic Antigen LumiraDx SARS-CoV-2 and Flu A/B Test in Diagnosing COVID-19 and Influenza in Patients with Respiratory Symptoms

Jayne E Ellis, Poppy Guest, Vicki Lawson, Julia Loecherbach, Nigel Lindner, Andrew McCulloch, Jayne E Ellis, Poppy Guest, Vicki Lawson, Julia Loecherbach, Nigel Lindner, Andrew McCulloch

Abstract

Introduction: Coronavirus disease 2019 (COVID-19) and influenza share similar symptoms, which hampers diagnosis. Given that they require different containment and treatment strategies, fast and accurate distinction between the two infections is needed. This study evaluates the sensitivity and specificity of the microfluidic antigen LumiraDx SARS-CoV-2 and Flu A/B Test for simultaneous detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and influenza A/B from a single nasal swab.

Methods: Nasal samples were collected from patients as part of the ASPIRE (NCT04557046) and INSPIRE (NCT04288921) studies at point-of-care testing sites in the USA. ASPIRE study participants were included after developing COVID-19 symptoms in the last 14 days or following a positive SARS-CoV-2 test in the last 48 h. INSPIRE study participants were included after developing influenza symptoms in the last 4 days. Samples were extracted into proprietary buffer and analysed using the LumiraDx SARS-CoV-2 and Flu A/B Test. A reference sample was taken from each subject, placed into universal transport medium and tested using reference SARS-CoV-2 and influenza reverse transcription polymerase chain reaction (RT-PCR) tests. The test and reference samples were compared using the positive percent agreement (PPA) and negative percent agreement (NPA), together with their 95% confidence intervals (CIs).

Results: Analysis of the data from the ASPIRE (N = 124) and INSPIRE (N = 159) studies revealed high levels of agreement between the LumiraDx SARS-CoV-2 and Flu A/B Test and the reference tests in detecting SARS-CoV-2 (PPA = 95.5% [95% CI 84.9%, 98.7%]; NPA = 96.0% [95% CI 90.9%, 98.3%]), influenza A (PPA = 83.3% [95% CI 66.4%, 92.7%]; NPA = 97.7% [95% CI 93.4%, 99.2%]) and influenza B (PPA = 80.0% [95% CI 62.7%, 90.5%]; NPA = 95.3% [95% CI 90.2%, 97.9%]).

Conclusions: The LumiraDx SARS-CoV-2 and Flu A/B Test shows a high agreement with the reference RT-PCR tests while simultaneously detecting and differentiating between SARS-CoV-2 and influenza A/B.

Trial registration: ClinicalTrials.gov identifiers NCT04557046 and NCT04288921.

Keywords: COVID-19; Coinfection; Influenza test; Point-of-care; SARS-CoV-2 test.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Flow of participants in ASPIRE and INSPIRE studies. At the time influenza samples were being collected for the INSPIRE study, SARS-CoV-2 was only just beginning to emerge and access to PCR methods for SARS-CoV-2 identification was restricted. We were able to use the Quidel Lyra SARS-CoV-2 Assay for only 44 of the collected influenza samples. None of them tested positive for SARS-CoV-2. Moreover, remnant samples from the ASPIRE study were not available for additional influenza A/B testing. DSSO, days since symptom onset
Fig. 2
Fig. 2
Cycle threshold ranges detected for positive samples of SARS-CoV-2, influenza A and influenza B using the LumiraDx SARS-CoV-2 and Flu A/B Test. SARS-CoV-2, severe acute respiratory syndrome coronavirus 2
Fig. 3
Fig. 3
SARS-CoV-2 detection sensitivity of the LumiraDx SARS-CoV-2 and Flu A/B Test across days since symptom onset. PPA, positive percent agreement

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Source: PubMed

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