Possible drawbacks of relying only on molecular testing for diagnosing SARS-CoV-2 infections

Replacing genetic testing with antigen immunoassays in symptomatic subjects seems the best strategy for rapid and widespread screening and/or diagnosis of SARS-CoV-2 infections. A meta-analysis has recently concluded that the pooled diagnostic sensitivity of SARS-CoV-2 antigen testing in subjects with onset <7 days of typical symptoms of coronavirus disease 2019 (COVID-19) is as high as 84% compared to molecular tests, thus underpinning that these tests represent a trustable means for large population screening, especially during sudden emergence of large local outbreaks. Therefore, we do not agree with the concept that the use of lateral flow tests and laboratory-based SARS-CoV-2 antigen immunoassays should be discouraged to the public, but we rather proffer that the use of (rapid) antigen tests shall be incorporated into validated algorithms aimed at filling the still important gaps that testing programs experience when relying only on SARS-CoV-2 molecular testing, especially when demand is high.