The Center for Health Policy Evaluation in Long-Term Care has issued, “Preliminary Report: Discordant Results between COVID-19 Point of Care Antigen and PCR Tests in Nursing Homes”. Discordant results include situations when an antigen test is positive, but the RT-PCR test is negative. (Please see the full report here.)
Recommendations made included:
- Continued use of Point of Care devices for widespread testing in SNFs.
- Ensure users understand the importance of following manufactures protocols and CDC recommendations to conduct confirmation testing when antigen tests are positive among asymptomatic individuals.
- Need for clearer guidance on what providers should do when the antigen test and confirmation tests are discordant with respect to patient care decisions, cohorting decisions, family notifications, NHSN reporting, and triggering an outbreak investigation.
In response, the CDC has updated their Frequently Asked Questions to address facility response if confirmatory RT-PCR testing is performed in response to a positive antigen test and results are discordant. https://www.cdc.gov/coronavirus/2019-ncov/hcp/faq.html#Testing-in-Nursing-Homes