Objective To assess the diagnostic accuracy of antigen compared with reverse transcriptase (RT)-PCR testing in an asymptomatic athlete screening programme and to monitor infection in college athletes. Methods Quidel Sofia-2 SARS-CoV-2 Antigen Tests were performed daily before sports participation for football, basketball, wrestling and water polo from 29 September 2020 to 28 February 2021. Paired RT-PCR and antigen tests were performed at least once a week. Positive antigen tests were confirmed with RT-PCR. Results 81 175 antigen and 42 187 RT-PCR tests were performed, including 23 462 weekly paired antigen/RT-PCR screening tests in 1931 athletes. One hundred and seventy-two athletes had a positive screening RT-PCR (0.4%), of which 83 (48%) occurred on paired testing days. The sensitivity of antigen tests varied with the frequency of RT-PCR testing and prevalence of COVID-19. The sensitivity of antigen testing was 35.7% (95% CI: 17% to 60%) and specificity 99.8% (95% CI: 99.7% to 99.9%) with once-a-week RT-PCR testing after adjusting for school prevalence. Daily antigen testing was similar to RT-PCR testing two to three times a week in identifying infection. Antigen testing identified infection before the next scheduled PCR on 89 occasions and resulted in 234 days where potentially infectious athletes were isolated before they would have been isolated with RT-PCR testing alone. Two athletic-related outbreaks occurred; 86% of total infections were community acquired. Conclusion Antigen testing has high specificity with a short turnaround time but is not as sensitive as RT-PCR. Daily antigen testing or RT-PCR testing two to three times a week is similar. There are benefits and drawbacks to each testing approach. Data are available upon reasonable request. Data is from the Pac-12 Health Analytics Program and is subject to the terms of the data use agreement. Reasonable request to the authors will be accommodated as allowed.

中文翻译：

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无症状运动员人群中 SARS-COV-2 感染的监测检测：一项前瞻性队列研究，包含 123 362 项检测和 23 463 对 RT-PCR/抗原样本

目的在无症状运动员筛查计划中评估抗原与逆转录酶 (RT)-PCR 检测相比的诊断准确性，并监测大学生运动员的感染情况。方法 2020 年 9 月 29 日至 2021 年 2 月 28 日期间，在参加足球、篮球、摔跤和水球运动之前，每天进行 Quidel Sofia-2 SARS-CoV-2 抗原检测。每周至少进行一次配对的 RT-PCR 和抗原检测. 阳性抗原测试通过 RT-PCR 确认。结果 对1931名运动员进行了81 175次抗原检测和42 187次RT-PCR检测，其中每周23 462次抗原/RT-PCR配对筛查检测。172 名运动员的 RT-PCR 筛查呈阳性 (0.4%)，其中 83 名 (48%) 出现在配对测试日。抗原检测的敏感性因 RT-PCR 检测的频率和 COVID-19 的流行而异。在调整学校流行率后，每周一次的 RT-PCR 检测的抗原检测灵敏度为 35.7%（95% CI：17% 至 60%），特异性为 99.8%（95% CI：99.7% 至 99.9%）。在识别感染方面，每日抗原检测类似于每周 2 至 3 次的 RT-PCR 检测。抗原检测在 89 次计划的下一次 PCR 之前确定了感染，并导致在 234 天内分离出可能具有传染性的运动员，然后再单独使用 RT-PCR 检测将其隔离。发生了两次与运动有关的疫情；86% 的总感染是社区获得的。结论抗原检测特异性高，周转时间短，但灵敏度不如RT-PCR。每周 2 到 3 次的每日抗原检测或 RT-PCR 检测是相似的。每种测试方法都有其优点和缺点。可应合理要求提供数据。数据来自 Pac-12 健康分析计划，并受数据使用协议条款的约束。对作者的合理要求将在允许的情况下得到满足。