OBJECTIVES: Reverse-transcription PCR (RT-PCR) is considered the most sensitive method in detecting severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2). However, this method is relatively resource- and time-consuming. Here, we compared SARS-CoV-2 nucleocapsid antigen (N-Ag) testing using an enzyme-linked immunosorbent assay (ELISA) with SARS-CoV-2 RNA detection. METHODS: Parallel SARS-CoV-2 RT-PCR and quantitative N-Ag ELISA analysis was executed in nasopharyngeal specimens obtained during SARS-CoV-2 screening in a cohort of pre-hospitalization patients. RESULTS: In total, 277 specimens were examined, including 182 (65.7%) RT-PCR-positive specimens, which demonstrated a median cycle threshold (Ct) value of 27 (interquartile range [IQR], 23-35). The SARS-CoV-2 N-Ag was detected in 164/182 RT-PCR-positive specimens (overall sensitivity, 90.1%). Among 95 RT-PCR-negative specimens, 72 were N-Ag-negative (specificity, 75.8%). SARS-CoV-2 RT-PCR and N-Ag ELISA results demonstrated a strong agreement (Cramer's V, 0.668; p