Lateral Flow Tests Detect COVID-19 with Similar Accuracy to Laboratory-Based PCR Tests When Used at Onset of Symptoms

As part of the study, over 2,500 people with mild to moderate flu-like symptoms were assessed by GPs in the district of Liezen (population 79,652), Austria, between October 22 and November 30, 2020 and tested for viral antigen using lateral flow tests. Those who were suspected to have COVID-19 were also tested using a PCR test. The lateral flow tests detected more than 95% of the cases found by PCR, and correctly identified 89% of cases as negative.

The study was the first to compare lateral flow and PCR testing on the same group of people on a large scale. It also included the variables of a real-world setting: five different brands of test kit, three laboratories, and professional swabbing offered at 20 GP practices. In summary, the study provides evidence that lateral flow tests can accurately detect SARS-CoV-2 infection as an alternative to PCR testing among symptomatic patients in a real-life primary care setting across a large geographical area.

“Previous studies have suggested lateral flow tests may be less sensitive than PCR in detecting COVID-19, particularly among asymptomatic individuals and during the early or late stage of an infection when the viral load is lowest. But we have found that in patients who are newly symptomatic, the two testing methods have similar levels of accuracy,” said study author Dr Werner Leber from Queen Mary University of London. “Countries are considering using lateral flow tests to manage future waves of the pandemic. Our findings support this move, but ensuring tests are properly administered should be integral to any strategy.”

“In our study, both shorter duration of symptoms and higher viral load were significantly associated with positive lateral flow tests. This highlights the necessity of testing at early infection with lateral flow tests, and shows that in patients who are newly symptomatic, the two testing methods have similar levels of accuracy,” added Dr. Jasmina Panovska-Griffiths from the Big Data Institute and The Queen’s College at University of Oxford. “Our study is the first study to demonstrate that point-of-care antigen testing using lateral flow tests combined with clinical assessment of symptomatic patients can rapidly and accurately detect SARS-CoV-2 infection in primary care.”

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Queen Mary University of London
University of Oxford
Institute for Advanced Studies
Medical University of Graz