Sars-cov-2 antibody test for the hospitalised emergency obstetric cases: Useful or wasteful

Background: The emergency, labor and delivery conditions in obstetric cases need a clinical decision in a timely manner. The identification of Covid-19 especially in asymptomatic obstetric cases with ease and rapid antibody test need further investigation. Objective: To analyze the usability and performance of rapid antibody test in obstetric cases. Methods: Case control study using medical record on Covid-19 obstetric cases over 9 months with paired nasopharyngeal reverse transcriptase polymerase chain reaction severe acute respiratory syndrome coronavirus 2 and rapid antibody test results. Results: There were 92 Covid-19 obstetric cases (incidence: 17.4%) and 210 reactive rapid antibody test (seroprevalence: 39.6%). The sensitivity, specificity, positive predictive value and negative predictive value of rapid antibody tests was 89%, 24%, 40%, 80%. Symptomatic cases have lower sensitivity (73% vs. 96%) and higher specificity (48% vs. 20%). The presence of Covid-19 symptoms (p<0.05) and reactive rapid antibody test (p<0.001) were associated with Covid-19. Rapid antibody test will identify larger Covid-19 obstetric cases compare with the presence of symptom only (89.4% vs. 27.7%. Conclusion: Screening by rapid antibody test had a high sensitivity but low specificity. This test will identify more Covid-19 cases compared by symptoms only due to majority asymptomatic obstetric cases. This simple, cheap and rapid antibody test still has a place in initial screening to help identify Covid-19 in areas with widespread transmission and has limited capacity to carry out universal screening.