Table 3.
PICO questions and recommendations in asymptomatic individuals and those with close contact with an infected person
| C | PICO question | Recommendation | Strength of recommendationa | Overall certainty of evidenceb | References |
|---|---|---|---|---|---|
| Rapid antigen testing | |||||
| 1 | In asymptomatic children<12 years old without risk factors for severe COVID-19, should rapid antigen tests be used compared with laboratory-based NAAT to diagnose COVID-19? | In asymptomatic children <12 years old without risk factors for severe COVID-19, we suggest the use of laboratory-based NAAT versus rapid antigen testing for diagnosis of COVID-19. | Weak against | Very low | [6,23,30,33,40,51,62,67,79,83] |
| 2 | In asymptomatic patients ≥12 years old without risk factors for severe COVID-19, should rapid antigen tests be used compared with laboratory-based NAAT to diagnose COVID-19? | In asymptomatic patients ≥12 years old without risk factors for severe COVID-19, we suggest the use of laboratory-based NAAT versus rapid antigen testing for diagnosis of COVID-19. | Weak against | Very low | [6,23,26,27,31,45,46,48,[54], [55], [56], [57],60,74,75,82] |
| 3 | In asymptomatic people of any age with any risk factor(s) for severe COVID-19 (including age <3monthsor ≥65 years) should rapid antigen tests be used compared with laboratory-based NAAT to diagnose COVID-19? | In asymptomatic people of any age with any risk factor(s) for severe COVID-19 (including age <3 months or ≥65 years), we suggest the use of laboratory-based NAAT versus antigen testing for diagnosis of COVID-19. | Weak against | Very low | [6,23,26,27,30,31,33,40,45,46,48,51,[54], [55], [56], [57],60,62,67,74,75,[77], [78], [79],82,83] |
| 4 | In asymptomatic people, should rapid antigen test be used compared with laboratory-based NAAT in nasopharyngeal samples to diagnose COVID-19? | In asymptomatic people, we suggest the use of laboratory-based NAAT in nasopharyngeal samples versus rapid antigen testing in nasopharyngeal samples for diagnosis of COVID-19. | Weak against | Very low | [6,23,26,27,33,45,46,48,51,[54], [55], [56], [57],60,62,75,77,82,89] |
| 5 | In asymptomatic people, should rapid antigen test be used compared with laboratory-based NAAT in non-nasopharyngeal/non-saliva samples to diagnose COVID-19? | In asymptomatic people, we suggest the use of laboratory-based NAAT in non-nasopharyngeal/non-saliva samples versus rapid antigen testing in non-nasopharyngeal/non-saliva for diagnosis of COVID-19. | Weak against | Very low | [6,23,31,40,67,74,78,79,83] |
| 6 | In asymptomatic people, should rapid antigen tests be used in saliva samples compared with laboratory-based NAAT to diagnose COVID-19? | In asymptomatic people, we suggest the use of laboratory-based NAAT in saliva samples versus rapid antigen testing in saliva for diagnosis of COVID-19. | Weak against | Very low | [6,23,30,40] |
| NAAT in saliva samples | |||||
| 7 | In asymptomatic children <12 years old, should NAAT in saliva samples be used compared with nasopharyngeal samples to diagnose COVID-19? | In asymptomatic children <12 years old, we suggest the use of NAAT in saliva samples versus NAAT in nasopharyngeal swab samples for diagnosis of COVID-19. | Weak for | Very low | [108,115,123,124] |
| 8 | In asymptomatic patients ≥12 years old, should NAAT test in saliva samples be used compared with nasopharyngeal samples to diagnose COVID-19? | In asymptomatic patients ≥12 years old, we suggest the use of NAAT in nasopharyngeal swab samples versus NAAT in saliva samples for diagnosis of COVID-19. | Weak against | Very low | [96,97,105,115,125] |
| 9 | In close-contact asymptomatic children <12 years old, should NAAT in saliva samples be used compared with nasopharyngeal samples to diagnose COVID-19? | In close-contact asymptomatic children <12 years old, we suggest that NAAT in saliva samples be used compared with NAAT testing in nasopharyngeal swab samples for diagnosis of COVID-19. | Weak for | Very low | [126] |
| 10 | In close-contact asymptomatic patients ≥12 years old, should NAAT in saliva samples be used compared with nasopharyngeal samples to diagnose COVID-19? | In close-contact asymptomatic patients ≥12 years old, we suggest the use of NAAT in nasopharyngeal swab samples versus NAAT in saliva samples for diagnosis of COVID-19. | Weak against | Very low | [96,105,115,124,125] |
| 11 | In close-contact asymptomatic children <12 years old with <7 days since contact, should NAAT in saliva samples be used compared with nasopharyngeal samples to diagnose COVID-19? | In close-contact asymptomatic children <12 years old with <7 days since contact, we suggest the use of NAAT in saliva samples versus NAAT in nasopharyngeal swab samples for diagnosis of COVID-19. | Weak for | Very low | [108,115,123,124] |
| 12 | In close-contact asymptomatic patients ≥12 years old with <7 days since contact, should NAAT in saliva samples be used compared with nasopharyngeal samples to diagnose COVID-19? | In close-contact asymptomatic patients ≥12 years old with <7 days since contact, we suggest the use of NAAT in nasopharyngeal swab samples versus NAAT in saliva samples for diagnosis of COVID-19. | Weak against | Very low | [96,97,105,115] |
NAAT, rapid nucleic acid amplification test; PICO, patient/population, intervention.
a
Strength of recommendation (strong against, weak against, in research only, weak for, strong for).
b
Overall certainty of the evidence (high, moderate, low, very low).