• Efrén Murillo-Zamora, Xóchitl Trujillo, Miguel Huerta, Mónica Ríos-Silva, and Oliver Mendoza-Cano.
• Departamento de Epidemiología, Unidad de Medicina Familiar No. 19, Instituto Mexicano del Seguro Social, Av. Javier Mina 301, Col. Centro, Colima C.P. 28000, Mexico.
• Medicina (Kaunas). 2021 Aug 21; 57 (8).

AbstractBackground and Objectives: To evaluate the performance of antigen-based detection tests as the frontline diagnosis of coronavirus disease 2019 (COVID-19). Materials and Methods: We conducted a nationwide retrospective cohort study in Mexico. A cross-sectional analysis of a cohort study was conducted in Mexico and data from 15,408 suspected (all of them symptomatic) cases of COVID-19 were analyzed. The results of antigen-based tests were compared with those obtained by molecular (polymerase chain reaction-based) assays. Results: The antigen-based tests showed sensitivity below 50% and high specificity in all the analyzed age groups. The highest Youden index (J) was observed among adults aged 25-44 years old (45.5, 95% CI 43.7-47.3). Conclusions: We documented the poor performance of serologic techniques as frontline diagnosis of symptomatic COVID-19 and inaccurate results may impact negatively on pandemic progression.

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