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You have all the symptoms of the virus, including a very high fever for several days. And then the cough and a feeling of shortness of breath that recurs several times during the day. But the antigen test he was subjected to in the Termoli hospital, in the so-called “gray area”, gave a negative result. “It’s not Covid” was heard from doctors who were able to see the test result after just 15 minutes. A great sigh of relief, a sense of release. That didn’t last long. Because, two days later and with a still absolutely critical clinical situation, the response of the molecular swab arrived, the traditional one to be clear. It is Covid 19, without a doubt.
It happened to a 48-year-old man from Termoli whose conditions are very serious. Yesterday morning, Thursday, he found out that it was positive because he checked Asrem’s website through the code that was given to him during the oral-pharyngeal sample. This is a summary of the story: the man had contact with a positive person dating back more than 10 days. He began to feel ill, suffering from the typical symptoms of the infection that has the world under control. Inserted into Asrem’s lists, he was last Tuesday in old San Timoteo to do the molecular swab, which is the most reliable test system at the moment. The results of this swab – it is now known – are not immediate but require a period of time that varies according to the number of daily swabs to be processed in the only equipped laboratory in Molise, that of Cardarelli.
“In 48 hours you will know the result,” the nurses told him, who immediately contacted 118 because the patient appeared to be visibly deteriorating. Taken to San Timoteo, he was subjected to the so-called “antigen test” or rapid: this is also a molecular test, which however does not directly analyze the sample taken in the nose by putting it in contact with a specific reagent, but rather “reads” in just over 10 minutes the physiological solution in which the sample is dissolved. Negative result.
The 48-year-old man returned home with a diagnosis of bronchitis and antibiotic therapy appropriate to his case. But it has not improved, on the contrary. And yesterday morning when you logged into Asrem’s website and read his report, you discovered that you had Covid.
It occurs, because although the reliability declared by the antigens is indicated at 97% (only one point less than that of the molecular swab), since the system for the rapid detection of positive cases has become established within the national health service, in the Soon Italian Rescue and in the many private laboratories, doctors have begun to find “False negatives” and “false positives” in substantial numbers.
False positives outnumber false negatives, based on common experience. But the question remains: how reliable are these tests really? There is a queue at the Termoli, Campobasso and Isernia laboratories that perform them for a fee (80 euros). So much so that booking for the same day is almost impossible. Requests are in abundance, especially from those who fear they have had a contact at risk and cannot wait for the canonical times of the molecular swab that in Molise, where the number of positives continues to increase, travels on average for 6 days: 4 days of waiting for withdrawal (except in serious cases) and two days of waiting for a response.
Thus, inevitably, more and more citizens choose to privately perform the rapid test, which is always performed using a biological sample stick in the patient’s nose. The labs then send the positive reports to Asrem’s Hygiene offices, which include the patients who will undergo the molecular swab. And here, as happened to the 48-year-old from Termoli, there may be surprises.
The issue is important considering that the Regions also send the results of the antigenic tests in the data set referred to the epidemiological curve, which can be an important indicator of the progress of the epidemic. But how reliable? This was the question in Veneto, where the microbiology and virology laboratory of the University of Padua led by Professor Andrea Crisanti, a well-known face in this emergency, communicated on October 21 to the Region of Veneto the results of a study on the Abbott Rapid Antigen Test. , carried out together with the department of infectious diseases and the emergency room of the Padua hospital.
Practically, reports the newspaper La Cronaca di Verona, “By superimposing the results of rapid swabs with those of a classic molecular swab, performed simultaneously on the same patients, 18 out of 61 infected antigen tests would have escaped the scrutiny of the new 70% , lower than declared “by Abbott. In practice, according to Crisanti, With the rapid test, 3 out of 10 positives could be negative and continue to spread the infection without any control. False negatives: the most dangerous because they can potentially create new outbreaks of which nothing is known. The study was conducted in an audience of 1,593 patients and the results were discordant. not only concern subjects with low viral load, against which it is known that rapid tests would have little sensitivity “.
Among the samples that tested negative for antigen, Crisanti noted, “There are good 6 cases of patients with very high viral load ”. These would be the famous superdiffusers or in any case possible superdiffusers. Therefore, the question is well founded: how reliable are they really? Is it possible, with this medical history, that it is practically the same as the traditional molecular one?
The scientific world on the subject is divided. Given the perplexities expressed by Crisanti, to the point that the Padua virology has decided in legitimate defense not to issue negative reports based on these tests, other experts have ruled otherwise. “Rapid antigenic tests have been shown to be effective and efficient for detection activity,” distinguished medical personalities, including Dr. Rigoli and Dr. Maria Rosaria Capobianchi of Spallanzani, have declared several times.
Even Asrem, Molise’s health company, has purchased 30 thousand rapid antigenic tests to improve the tracking and isolation system of Covid patients in Molise, destined for emergency rooms to speed up processing times (about 15 minutes) but alsoor to shorten screening in nursing homes and schools. Supplies of antigenic tests of Civil Protection were also allocated for the activities of the Family Physicians, as required by the order of President Toma. (MV)
Very positive, Toma requests rapid tests: they can be performed by general practitioners and pediatricians
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