How Significant Are Xpert Xpress SARS-CoV-2 Test Findings When Only an N2 Gene Is Detected?

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


The rapid identification of patients infected with COVID-19 during the SARS-CoV-2 pandemic is critical to operating emergency rooms effectively. Xpert Xpress SARS-CoV-2 (Xpert) assays are increasingly being used in the rapid screening of COVID-19. We evaluated the clinical performance of Xpert by comparing findings with those of qRT-PCR evaluations and included the clinical features of patients visiting the emergency department. Positive results with Xpert testing (n = 370) were compared with qRT-PCR findings, demonstrating a 91.9% intertest agreement. We reviewed the subsequent COVID-19 test results and SARS-CoV-2 infection histories for individuals showing discrepancies in Xpert and qRT-PCR testing and determined whether the findings were true-positive or false-positive. The true-positive rate for Xpert testing was 95.4% (353/370); the remaining 17 samples (4.6%) were false-positive. All false-positive data for Xpert testing showed N2 signals amplified to Ct values of ≥40 with no E gene signals. Rapid Xpert testing is highly sensitive and shows a good performance overall in challenging situations, such as an emergency room. However, we considered the possibility of false-positive Xpert results given an N2 gene signal only, especially given high Ct values. We recommend interpreting test data with caution and considering retesting over time.

Original languageEnglish
Article number2133
Issue number9
StatePublished - Sep 2022

Bibliographical note

Publisher Copyright:
© 2022 by the authors.


  • COVID-19
  • SARS-CoV-2
  • Xpert
  • emergency medicine
  • qRT-PCR
  • rapid screening


Dive into the research topics of 'How Significant Are Xpert Xpress SARS-CoV-2 Test Findings When Only an N2 Gene Is Detected?'. Together they form a unique fingerprint.

Cite this