AI Article Synopsis
- A large-scale COVID-19 testing program was conducted by the NFL and NFLPA during the 2020 season, involving multiple testing platforms for daily monitoring.
- Out of 632,370 tests on players and staff, 270 COVID-19 cases (2.4%) were identified, with positive predictive values between 73% and 82%, and high cycle threshold (Ct) values often indicating early infections.
- While routine RT-PCR testing proved effective for early detection, antigen point-of-care testing frequently produced negative results, highlighting its unreliability in ruling out COVID-19.
Article Abstract
Background: Evidence to understand effective strategies for surveillance and early detection of SARS-CoV-2 is limited.
Objective: To describe the results of a rigorous, large-scale COVID-19 testing and monitoring program.
Design: The U.S. National Football League (NFL) and the NFL Players Association (NFLPA) instituted a large-scale COVID-19 monitoring program involving daily testing using 2 reverse transcription polymerase chain reaction (RT-PCR) platforms (Roche cobas and Thermo Fisher QuantStudio), a transcription-mediated amplification platform (Hologic Panther), and an antigen point-of-care (aPOC) test (Quidel Sofia).
Setting: 32 NFL clubs in 24 states during the 2020 NFL season.
Participants: NFL players and staff.
Measurements: SARS-CoV-2 test results were described in the context of medically adjudicated status. Cycle threshold (Ct) values are reported when available.
Results: A total of 632 370 tests administered across 11 668 persons identified 270 (2.4%) COVID-19 cases from 1 August to 14 November 2020. Positive predictive values ranged from 73.0% to 82.0% across the RT-PCR platforms. High Ct values (33 to 37) often indicated early infection. For the first positive result, the median Ct value was 32.77 (interquartile range, 30.02 to 34.72) and 22% of Ct values were above 35. Among adjudicated COVID-19 cases tested with aPOC, 42.3% had a negative result. Positive concordance between aPOC test result and adjudicated case status increased as viral load increased.
Limitations: Platforms varied by laboratory, and test variability may reflect procedural differences.
Conclusion: Routine RT-PCR testing allowed early detection of infection. Cycle threshold values provided a useful guidepost for understanding results, with high values often indicating early infection. Antigen POC testing was unable to reliably rule out COVID-19 early in infection.
Primary Funding Source: The NFL and the NFLPA.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8252091 | PMC |
| http://dx.doi.org/10.7326/M21-0319 | DOI Listing |
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