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Arikan A, Sanlidag T, Sayan M, Uzun B, Uzun Ozsahin D. Fuzzy-Based PROMETHEE Method for Performance Ranking of SARS-CoV-2 IgM Antibody Tests. Diagnostics (Basel) 2022; 12:diagnostics12112830. [PMID: 36428889 PMCID: PMC9689080 DOI: 10.3390/diagnostics12112830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/07/2022] [Accepted: 11/14/2022] [Indexed: 11/18/2022] Open
Abstract
Antibody tests, widely used as a complementary approach to reverse transcriptase-polymerase chain reaction testing in identifying COVID-19 cases, are used to measure antibodies developed for COVID-19. This study aimed to evaluate the different parameters of the FDA-authorized SARS-CoV-2 IgM antibody tests and to rank them according to their performance levels. In the study, we involved 27 antibody tests, and the analyzes were performed using the fuzzy preference ranking organization method for the enrichment evaluation model, a multi-criteria decision-making model. While criteria such as analytical sensitivity, specificity, positive predictive value, and negative predictive value were evaluated in the study, the ranking was reported by determining the importance levels of the criteria. According to our evaluation, Innovita 2019-nCoV Ab Test (colloidal gold) was at the top of the ranking. While Cellex qSARS-CoV-2 IgG/IgM Rapid Test and Assure COVID-19 IgG/IgM Rapid Tester ranked second and third on the list, the InBios-SCoV 2 Detect Ig M ELISA Rapid Test Kit was determined as the least preferable. The fuzzy preference ranking organization method for enrichment evaluation, which has been applied to many fields, can help decision-makers choose the appropriate antibody test for managing COVID-19 in controlling the global pandemic.
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Affiliation(s)
- Ayse Arikan
- DESAM Research Institute, Near East University, TRNC Mersin 10, Nicosia 99138, Turkey
- Department of Medical Microbiology and Clinical Microbiology, Faculty of Medicine, Near East University, TRNC Mersin 10, Nicosia 99138, Turkey
- Department of Medical Microbiology and Clinical Microbiology, Kyrenia University, TRNC Mersin 10, Kyrenia 99320, Turkey
| | - Tamer Sanlidag
- DESAM Research Institute, Near East University, TRNC Mersin 10, Nicosia 99138, Turkey
| | - Murat Sayan
- DESAM Research Institute, Near East University, TRNC Mersin 10, Nicosia 99138, Turkey
- PCR Unit, Research and Education Hospital, Kocaeli University, Kocaeli 41001, Turkey
| | - Berna Uzun
- Department of Statistics, Carlos III Madrid University, 28903 Getafe, Madrid, Spain
- Department of Mathematics, Near East University, TRNC Mersin 10, Nicosia 99138, Turkey
- Operational Research Center in Healthcare, Near East University, TRNC Mersin 10, Nicosia 99138, Turkey
| | - Dilber Uzun Ozsahin
- Operational Research Center in Healthcare, Near East University, TRNC Mersin 10, Nicosia 99138, Turkey
- Department of Medical Diagnostic Imaging, College of Health Sciences, Sharjah University, Sharjah 27272, United Arab Emirates
- Correspondence:
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Nath H, Mallick A, Roy S, Kayal T, Ranjan S, Sengupta S, Sukla S, Biswas S. COVID-19 serum can be cross-reactive and neutralizing against the dengue virus, as observed by the dengue virus neutralization test. Int J Infect Dis 2022; 122:576-584. [PMID: 35811081 PMCID: PMC9262656 DOI: 10.1016/j.ijid.2022.07.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 06/02/2022] [Accepted: 07/03/2022] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES Observing the serological cross-reactivity between SARS-CoV-2 and dengue virus (DV), we aimed to elucidate its effect on dengue serodiagnosis and infectivity in a highly dengue-endemic city in India. METHODS A total of 52 COVID-19 (reverse transcription-polymerase chain reaction [RT-PCR] positive) serum samples were tested in rapid lateral flow immunoassays and DV immunoglobulin G (IgG) enzyme-linked immunosorbent assay (ELISA) to detect DV or SARS-CoV-2 IgG/immunoglobulin M. The COVID-19 antibody (Ab) positive samples were subjected to a virus neutralization test (Huh7 cells) using DV type 1 (DV1) clinical isolate. RESULTS Most (93%) of the SARS-CoV-2 Ab-positive serum samples cross-reacted with DV in rapid or ELISA tests. All were DV RNA and nonstructural protein 1 (NS1) antigen-negative. COVID-19 serum samples that were DV cross-reactive neutralized DV1. Of these, 57% had no evidence of DV pre-exposure (DV NS1 Ab-negative). The computational study also supported potential interactions between SARS-CoV-2 Ab and DV1. CONCLUSION DV serodiagnosis will be inconclusive in areas co-endemic for both viruses. The COVID-19 pandemic appears to impart a protective response against DV in DV-endemic populations.
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Affiliation(s)
- Himadri Nath
- Infectious Diseases and Immunology Division, CSIR-Indian Institute of Chemical Biology, Kolkata, India
| | - Abinash Mallick
- Infectious Diseases and Immunology Division, CSIR-Indian Institute of Chemical Biology, Kolkata, India
| | - Subrata Roy
- Infectious Diseases and Immunology Division, CSIR-Indian Institute of Chemical Biology, Kolkata, India
| | - Tathagata Kayal
- Infectious Diseases and Immunology Division, CSIR-Indian Institute of Chemical Biology, Kolkata, India
| | - Sumit Ranjan
- Department of Medicine, M.R. Bangur Hospital, Kolkata, India
| | - Susanta Sengupta
- Department of Medicine, Behala Balananda Brahmachari Hospital and Research Center, Kolkata, India
| | - Soumi Sukla
- National Institute of Pharmaceuticals Education and Research, Kolkata, India.
| | - Subhajit Biswas
- Infectious Diseases and Immunology Division, CSIR-Indian Institute of Chemical Biology, Kolkata, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India.
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Lau CS, Aw TC. Disease Prevalence Matters: Challenge for SARS-CoV-2 Testing. Antibodies (Basel) 2021; 10:antib10040050. [PMID: 34940002 PMCID: PMC8698426 DOI: 10.3390/antib10040050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/23/2021] [Accepted: 12/13/2021] [Indexed: 01/03/2023] Open
Abstract
While sensitivity and specificity are important characteristics for any diagnostic test, the influence of prevalence is equally, if not more, important when such tests are used in community screening. We review the concepts of positive/negative predictive values (PPV/NPV) and how disease prevalence affects false positive/negative rates. In low-prevalence situations, the PPV decreases drastically. We demonstrate how using two tests in an orthogonal fashion can be especially beneficial in low-prevalence settings and greatly improve the PPV of the diagnostic test results.
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Affiliation(s)
- Chin-Shern Lau
- Department of Laboratory Medicine, Changi General Hospital, Singapore 529889, Singapore;
| | - Tar-Choon Aw
- Department of Laboratory Medicine, Changi General Hospital, Singapore 529889, Singapore;
- Department of Medicine, National University of Singapore, Singapore 119077, Singapore
- Academic Pathology Program, Duke-NUS Medical School, Singapore 169857, Singapore
- Correspondence: ; Tel.: +65-68504927; Fax: +65-64269507
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Lau CS, Wong MS, Hoo SP, Heng PY, Phua SK, Aw TC. Performance of the Roche/Snibe electrochemiluminescent anti-SARS-COV-2 spike assays compared to the Roche/Abbott IgG nucleocapsid and Abbott IgM spike assays. Pract Lab Med 2021; 27:e00257. [PMID: 34660869 PMCID: PMC8513513 DOI: 10.1016/j.plabm.2021.e00257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 08/31/2021] [Accepted: 10/08/2021] [Indexed: 11/26/2022] Open
Abstract
Introduction We evaluated the Roche Elecsys Anti-SARS-CoV-2 and Snibe SARS-CoV-2 S-RBD IgG spike chemiluminescent immunoassays and compared them to existing Roche/Abbott nucleocapsid and Abbott IgM spike assays. Methods We enrolled 184 SARS-CoV-2 RT-PCR positive samples and 215 controls (172 pre-pandemic, and 43 cross-reactivity) to evaluate the Roche spike antibody (anti-SARS-CoV-2-S) assay. For the Snibe evaluation, we included 119 RT-PCR positive samples and 249 controls (200 pre-pandemice, 49 cross-reactivity). 98 cases had been tested on three spike assays (Roche total antibody, Snibe IgG and Abbott IgM). Results The Roche anti-SARS-CoV-2-S assay had a CV of 0.5% (0.82U/mL) and 2.3% (8.72U/mL) and was linear from 1.16 to 240U/mL. The Snibe assay was linear from 6.43 to 77.7AU/mL, CV of 5.5% (0.43AU/mL) and 8.8% (0.18AU/mL). The Snibe spike assay was significantly more sensitive than the Abbott IgG assay at 0–6 days POS (35.2% vs 3.6%, mean difference 29.6%, 95% CI 17.5 to 41.8, p < 0.0001). Optimized LORs significantly improved the sensitivity of the Roche spike (48.1%–56.7%) and both nucleocapsid assays (Roche 43.3%–65.5%, Abbott 3.6%–18.5%) in early disease. Conclusion Although both spike assays showed higher sensitivity than their nucleocapsid counterparts, lower, optimized LORs provided the most significant improvements to sensitivity. We report the performance of the Roche and Snibe anti-SARS-CoV-2 spike assays. The Snibe spike assay displayed the greatest sensitivity in early disease. The Snibe assay showed cross-reactivity with dengue and hepatitis antibodies. Optimized limits of reactivity improved the sensitivities of assays.
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Affiliation(s)
- C S Lau
- Department of Laboratory Medicine, Changi General Hospital, Singapore
| | - M S Wong
- Department of Laboratory Medicine, Khoo Teck Puat Hospital, Singapore
| | - S P Hoo
- Department of Laboratory Medicine, Changi General Hospital, Singapore
| | - P Y Heng
- Department of Laboratory Medicine, Khoo Teck Puat Hospital, Singapore
| | - S K Phua
- Department of Laboratory Medicine, Changi General Hospital, Singapore
| | - T C Aw
- Department of Laboratory Medicine, Changi General Hospital, Singapore.,Department of Medicine, National University of Singapore, Singapore.,Academic Pathology Program, Duke-NUS Medical School, Singapore
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Ismail G, Abdel Halim R, Mostafa MS, H Abdelhamid D, Abdelghaffar H, Omar NN, Fahim NAE. Comparative Evaluation of SARS-CoV-2 Rapid Immunochromatographic Test Assays with Chemiluminescent Immunoassay for the Diagnosis of COVID-19. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background
To date, the molecular assay is the gold-standard method for COVID-19 diagnosis. However, they are expensive and complex. There is a pressing necessity for developing other effective diagnostics for SARS‐CoV‐2 patients. Therefore, serological detection of antibodies against SARS‐CoV‐2 might provide a good alternative.
Aim
We aimed to compare and evaluate seven rapid diagnostic tests with Mindray chemiluminescent automated immunoassay as a reference method for SARS-CoV-2 antibodies detection.
Methods:
This study included the serum of a total of 49 attendees to the Reference Laboratory of Egyptian university hospitals during the period from April 2021 to May 2021. Anti-Covid-19 antibodies detection in serum samples was performed by Mindray fully automated system as our reference method and seven rapid antibody tests; Wondfo, Vazyme, Dynamiker, Panbio, Artron Maccura and Roche.
Results:
The chemiluminescent assay revealed 30 (61.2%) positive samples and 19 (38.8%) negative samples for COVID-19 IgG. For COVID-19 IgM, 11 (22.4%) samples were positive and 38 (77.6%) samples were negative. Anti-SARS-CoV-2 antibodies were not detected in any of the PCR negative individuals. The best diagnostic performance was demonstrated by Roche IgG and IgM, and Vazyme IgG and IgM antibody tests followed by Panbio. For Roche, the sensitivity and specificity for IgG and IgM were (83.3%, 89.5%) and (72.7%, 81.6%) respectively. Vazyme showed sensitivity and specificity for IgG and IgM were (77.8%, 85.7%) and (75%, 91.7%) respectively. Regards Panbio, the sensitivity and specificity for IgG and IgM were (63.6%, 87.5%) and (50%, 86.7%) respectively. Cohen’s Kappa values revealed a substantial agreement for Roche IgG, Vazyme IgG and IgM of (0.7076, 0.6250, 0.6667) respectively. The worst agreement was reported for Maccura IgG, Wondfo, and Dynamiker IgM with Cohen’s Kappa values of (0.2508, 0.1893, 0.0313) respectively.
Conclusions:
Rapid tests in our study exhibited heterogeneous diagnostic performances. Roche, Vazyme, and Panbio antibody tests showed promising results in concordance with our reference method with the best-reported results. On the other hand, the other tests were inferior and failed in providing valid and reliable results. Further studies are necessary to determine the practicality of these tests in different settings and communities.
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Bartko J, Zehetmayer S, Weseslindtner L, Stiasny K, Schloegl A, Forjan E, Zwettler E, Krauter A, Keil F, Sédille-Mostafaie N. Screening and Confirmatory Testing for SARS-CoV-2 Antibodies: Comparison of Health and Non-Health Workers in a Nationwide Healthcare Organization in Central Europe. J Clin Med 2021; 10:jcm10091909. [PMID: 33924976 PMCID: PMC8124742 DOI: 10.3390/jcm10091909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 04/14/2021] [Accepted: 04/23/2021] [Indexed: 12/02/2022] Open
Abstract
Despite being located close to the European epicenter of the COVID-19 pandemic in Italy, Austria has managed to control the first wave. In Austria, the largest health insurance fund covers 7 million people and has 12,000 employees, including 3700 healthcare workers (HCW). For patient and staff safety, transmission control measures were implemented and mass testing of employees for SARS-CoV-2 antibodies was conducted. An IgG SARS-CoV-2 rapid test on fingerstick blood was used as a screening test (ST), followed by serologic studies with 3 different immunoassays and confirmatory testing by a neutralization test (NT). Among 7858 employees, 144 had a positive ST and 88 were confirmed by a NT (1.12%, CI: 0.9–1.38%). The positive predictive value (PPV) of the ST was 69.3% (CI: 60.5–77.2). Interestingly, 40% of the NT positive serum samples were tested negative in all 3 immunoassays. Of the total sample, 2242 HCW (28.5%) were identified. Unexpectedly, there was no difference in the prevalence of NT positives in HCW compared to non-HCW (23/2242 vs. 65/5301, p = 0.53). SARS-CoV-2 antibody prevalence was not increased among HCW. Although HCW are at potentially increased risk for SARS-CoV-2 infection, transmission control measures in healthcare facilities appear sufficient to limit transmission of infection.
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Affiliation(s)
- Johann Bartko
- Institute for Laboratory Medicine, Hanusch Hospital, 1140 Vienna, Austria; (A.S.); (N.S.-M.)
- Correspondence: ; Tel.: +43-191-0218-6224
| | - Sonja Zehetmayer
- Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, 1140 Vienna, Austria;
| | - Lukas Weseslindtner
- Center for Virology, Medical University of Vienna, 1090 Vienna, Austria; (L.W.); (K.S.)
| | - Karin Stiasny
- Center for Virology, Medical University of Vienna, 1090 Vienna, Austria; (L.W.); (K.S.)
| | - Andrea Schloegl
- Institute for Laboratory Medicine, Hanusch Hospital, 1140 Vienna, Austria; (A.S.); (N.S.-M.)
| | - Ernst Forjan
- Department of Haemato-Oncology, Hanusch Hospital, 1090 Vienna, Austria; (E.F.); (F.K.)
| | | | - Andreas Krauter
- Medical Services, Austrian Health Insurance Fund, 1030 Vienna, Austria;
| | - Felix Keil
- Department of Haemato-Oncology, Hanusch Hospital, 1090 Vienna, Austria; (E.F.); (F.K.)
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