Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Performance of an antigen test for detection of SARS-CoV-2, influenza, and respiratory syncytial virus—a prospective study

Berger, Karoline ; Vang, Siv Hege ; Bekkeseth, Roy H.O. and Bredberg, Anders LU (2026) In Clinical Microbiology and Infection
Abstract

Objectives To assess the performance of the ALL IN TRIPLEX rapid antigen-based test for SARS-CoV-2, influenza A, influenza B, and respiratory syncytial virus. We focus on the potential of the test to be used in acute clinical settings as a marker of infectiousness, by determining the sensitivity at different real-time PCR cycle threshold (Ct) levels, as well as the quantity of absorbed viral RNA needed to produce an antigen band. Methods In total, 1372 patients with symptoms and signs of an acute respiratory infection were included in the study; 150 were children. All patients were tested using the nasal swab Triplex kit, as well as with PCR on a separately taken nasopharyngeal sample. The antigen test was analysed by emergency... (More)

Objectives To assess the performance of the ALL IN TRIPLEX rapid antigen-based test for SARS-CoV-2, influenza A, influenza B, and respiratory syncytial virus. We focus on the potential of the test to be used in acute clinical settings as a marker of infectiousness, by determining the sensitivity at different real-time PCR cycle threshold (Ct) levels, as well as the quantity of absorbed viral RNA needed to produce an antigen band. Methods In total, 1372 patients with symptoms and signs of an acute respiratory infection were included in the study; 150 were children. All patients were tested using the nasal swab Triplex kit, as well as with PCR on a separately taken nasopharyngeal sample. The antigen test was analysed by emergency department staff, whereas PCR was performed at a central laboratory. In 226 cases, also the Triplex device medium was subjected to PCR. Results The sensitivity was 87.0% (95% CI, 66.4–97.7), 79.0% (95% CI, 72.7–84.4), 87.5% (95% CI, 67.6–97.3), and 91.2% (95% CI, 80.7–97.1) for SARS-CoV-2, influenza A, influenza B, and respiratory syncytial virus, respectively, using the nasopharyngeal sample PCR Ct 30 level as reference. Specificity was 100% (95% CI, 99.7–100.0) for all agents. A comparison with Triplex medium PCR Ct results showed a trend suggesting that less viral RNA is absorbed by the nasal swab than by the nasopharyngeal swab. Although there was no sign of this trend in children, it reached significance among the total of patients for influenza A (mean Ct value 31.8 for the Triplex swab and 26.0 for the nasopharyngeal swab, p < 0.0001). Conclusions The observed performance of Triplex, for all four viruses and across all age groups, implies that Triplex may serve as a marker of infectiousness in acute clinical care settings.

(Less)
Please use this url to cite or link to this publication:
author
; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Infectiousness, Influenza, Rapid antigen test, Respiratory syncytial virus, SARS-CoV-2
in
Clinical Microbiology and Infection
publisher
Wiley-Blackwell
external identifiers
  • pmid:41962657
  • scopus:105037336879
ISSN
1198-743X
DOI
10.1016/j.cmi.2026.03.041
language
English
LU publication?
yes
id
e948f13b-0f3d-4eeb-b737-601862df0f8a
date added to LUP
2026-06-29 10:29:54
date last changed
2026-09-08 22:09:25
@article{e948f13b-0f3d-4eeb-b737-601862df0f8a,
  abstract     = {{<p>Objectives To assess the performance of the ALL IN TRIPLEX rapid antigen-based test for SARS-CoV-2, influenza A, influenza B, and respiratory syncytial virus. We focus on the potential of the test to be used in acute clinical settings as a marker of infectiousness, by determining the sensitivity at different real-time PCR cycle threshold (Ct) levels, as well as the quantity of absorbed viral RNA needed to produce an antigen band. Methods In total, 1372 patients with symptoms and signs of an acute respiratory infection were included in the study; 150 were children. All patients were tested using the nasal swab Triplex kit, as well as with PCR on a separately taken nasopharyngeal sample. The antigen test was analysed by emergency department staff, whereas PCR was performed at a central laboratory. In 226 cases, also the Triplex device medium was subjected to PCR. Results The sensitivity was 87.0% (95% CI, 66.4–97.7), 79.0% (95% CI, 72.7–84.4), 87.5% (95% CI, 67.6–97.3), and 91.2% (95% CI, 80.7–97.1) for SARS-CoV-2, influenza A, influenza B, and respiratory syncytial virus, respectively, using the nasopharyngeal sample PCR Ct 30 level as reference. Specificity was 100% (95% CI, 99.7–100.0) for all agents. A comparison with Triplex medium PCR Ct results showed a trend suggesting that less viral RNA is absorbed by the nasal swab than by the nasopharyngeal swab. Although there was no sign of this trend in children, it reached significance among the total of patients for influenza A (mean Ct value 31.8 for the Triplex swab and 26.0 for the nasopharyngeal swab, p &lt; 0.0001). Conclusions The observed performance of Triplex, for all four viruses and across all age groups, implies that Triplex may serve as a marker of infectiousness in acute clinical care settings.</p>}},
  author       = {{Berger, Karoline and Vang, Siv Hege and Bekkeseth, Roy H.O. and Bredberg, Anders}},
  issn         = {{1198-743X}},
  keywords     = {{Infectiousness; Influenza; Rapid antigen test; Respiratory syncytial virus; SARS-CoV-2}},
  language     = {{eng}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Clinical Microbiology and Infection}},
  title        = {{Performance of an antigen test for detection of SARS-CoV-2, influenza, and respiratory syncytial virus—a prospective study}},
  url          = {{http://dx.doi.org/10.1016/j.cmi.2026.03.041}},
  doi          = {{10.1016/j.cmi.2026.03.041}},
  year         = {{2026}},
}