1
|
Fujii Y, Ishigaki H, Miyairi I, Niizeki N, Nagura O, Yamashita K, Maekawa M, Furuhashi K. Age dependent discrepancy between SARS-CoV-2 anti-nucleoprotein antibody and anti-RBD spike protein antibody in children reflects vaccine coverage. J Infect Chemother 2024; 30:646-650. [PMID: 38309499 DOI: 10.1016/j.jiac.2024.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/23/2023] [Accepted: 01/31/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND COVID-19 has become widespread in Japanese children. However, the impact of varying immunization coverage on the seroprevalence of SARS-CoV-2 in children is unknown. METHODS We examined the SARS-CoV-2 antibody in children aged 0 to 18 who were hospitalized at a university hospital from June 2020 through May 2023. The SARS-CoV-2 anti-nucleoprotein (N) antibody and anti-RBD spike (S) protein antibody was measured. RESULTS A total of 586 cases were enrolled. The median age was 4 years old (interquartile range 1-9), and 362 (61.8 %) were male. The seroprevalence of anti-S antibodies gradually increased from October 2021 and reached 60 percent by early 2023. The anti-N antibody increased starting in January 2022 and reached 50 percent in May 2023. There was a discrepancy in the seroprevalence of anti-S and N antibodies in children 0 years of age or 12 years and older until the fall of 2022. This discrepancy was minimal for children 1-4 years of age and relatively small in the 5-11-year-old group. DISCUSSION The data suggests that approximately half of the children in our cohort had been infected with SARS-CoV-2 by May 2023. The discrepancy in seropositivity between the anti-S and N antibodies corresponded to the reported vaccine uptake of each target age group, which suggested protective effects of immunization. However, this effect appeared to diminish after early 2023. CONCLUSION Age dependent discrepancy between SARS-CoV-2 anti-N and anti-S antibody in children reflected differences in vaccine coverage.
Collapse
Affiliation(s)
- Yasuhito Fujii
- Department of Pediatrics, Hamamatsu University School of Medicine, Japan
| | - Hidetoshi Ishigaki
- Department of Pediatrics, Hamamatsu University School of Medicine, Japan
| | - Isao Miyairi
- Department of Pediatrics, Hamamatsu University School of Medicine, Japan.
| | - Noriyasu Niizeki
- Department of Laboratory Medicine, Hamamatsu University School of Medicine, Japan
| | - Osanori Nagura
- Infection and Prevention Center, Hamamatsu University Hospital, Japan
| | - Keita Yamashita
- Department of Laboratory Medicine, Hamamatsu University School of Medicine, Japan
| | - Masato Maekawa
- Department of Laboratory Medicine, Hamamatsu University School of Medicine, Japan
| | - Kazuki Furuhashi
- Infection and Prevention Center, Hamamatsu University Hospital, Japan
| |
Collapse
|
2
|
Groh AM, Vehreschild MJGT, Diaz D, Kuchta AL, Dodoo C, Alvarado LA, Parkin NT, Robbins EM, Moonsamy P, Toptan T, Ciesek S, Berger A. Kinetics of SARS-CoV-2 infection biomarkers in a household transmission study. Sci Rep 2024; 14:12365. [PMID: 38811590 PMCID: PMC11136983 DOI: 10.1038/s41598-024-62835-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 05/22/2024] [Indexed: 05/31/2024] Open
Abstract
SARS-CoV-2 is the causative agent of COVID-19. Timely and accurate diagnostic testing is vital to contain the spread of infection, reduce delays in treatment and care, and inform patient management. Optimal specimen type (e.g. nasal swabs or saliva), timing of sampling, viral marker assayed (RNA or antigen), and correlation with viral infectivity and COVID-19 symptoms severity remain incompletely defined. We conducted a field study to evaluate SARS-CoV-2 viral marker kinetics starting from very early times after infection. We measured RNA and antigen levels in nasal swabs and saliva, virus outgrowth in cell culture from nasal swabs, and antibody levels in blood in a cohort of 30 households. Nine household contacts (HHC) became infected with SARS-CoV-2 during the study. Viral RNA was detected in saliva specimens approximately 1-2 days before nasal swabs in six HHC. Detection of RNA was more sensitive than of antigen, but antigen detection was better correlated with culture positivity, a proxy for contagiousness. Anti-nucleocapsid antibodies peaked one to three weeks post-infection. Viral RNA and antigen levels were higher in specimens yielding replication competent virus in cell culture. This study provides important data that can inform how to optimally interpret SARS-CoV-2 diagnostic test results.
Collapse
Affiliation(s)
- Ana M Groh
- Goethe University Frankfurt, University Hospital Frankfurt, Department 2 of Internal Medicine, Infectious Diseases, Frankfurt am Main, Germany
| | - Maria J G T Vehreschild
- Goethe University Frankfurt, University Hospital Frankfurt, Department 2 of Internal Medicine, Infectious Diseases, Frankfurt am Main, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt am Main, Germany
| | - Damian Diaz
- Goethe University Frankfurt, University Hospital Frankfurt, Department 2 of Internal Medicine, Infectious Diseases, Frankfurt am Main, Germany
| | | | | | - Luis A Alvarado
- Roche Molecular Systems, Pleasanton, CA, USA
- EP Statistical Consulting, LLC, El Paso, TX, USA
| | | | | | | | - Tuna Toptan
- Institute of Medical Virology, Goethe University Frankfurt, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Sandra Ciesek
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Frankfurt am Main, Germany
- Institute of Medical Virology, Goethe University Frankfurt, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Annemarie Berger
- Institute of Medical Virology, Goethe University Frankfurt, University Hospital Frankfurt, Frankfurt am Main, Germany.
| |
Collapse
|
3
|
Hashimoto T, Yahiro T, Khan S, Kimitsuki K, Suzuki M, Fujimoto T, Tanaka T, Saito N, Hiramatsu K, Nishizono A. Seroprevalence kinetics of SARS-CoV-2 antibodies in pediatric patients visiting a hospital during COVID-19 pandemic in Japan. J Infect Chemother 2024; 30:169-171. [PMID: 37734592 DOI: 10.1016/j.jiac.2023.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/21/2023] [Accepted: 09/18/2023] [Indexed: 09/23/2023]
Abstract
Children infected with SARS-CoV-2 are often asymptomatic or have mild symptoms. The studies on the seroprevalence kinetics of SARS-CoV-2 antibodies in children are limited. We conducted a cross-sectional survey of the positive rate of the SARS-CoV-2 IgG in pediatric patients without suspected COVID-19 infection between January 2007 and March 2022. We defined the serum samples from the pre-pandemic and pandemic groups (1st-6th waves). Totally, 2557 samples were collected and no samples from the pre-pandemic group or the 1st-4th waves were positive for IgG. There were 4/661 and 16/373 positives at the 5th and 6th waves, respectively. At the 5th wave, the prevalence of IgG was 1.3% in children aged 1-4 years. At the 6th wave, in children <1 year of age, the prevalence was 4.0%, and 2.4%, 5.3%, 5.2% and 10% in age groups 1-4, 5-9, 10-14 and 15-18 years, respectively. In conclusions, the pre-pandemic samples were negative, and the IgG positivity increased during the later period of the pandemic.
Collapse
Affiliation(s)
- Takehiro Hashimoto
- Infection Control Center, Oita University Hospital, Oita, Japan; Department of Microbiology, Oita University Faculty of Medicine, Oita, Japan.
| | - Takaaki Yahiro
- Department of Microbiology, Oita University Faculty of Medicine, Oita, Japan; Department of Advanced Medical Sciences, Oita University Faculty of Medicine, Oita, Japan; Research Center for Global and Local Infectious Diseases, Oita, Japan
| | - Sakirul Khan
- Department of Microbiology, Oita University Faculty of Medicine, Oita, Japan
| | - Kazunori Kimitsuki
- Department of Microbiology, Oita University Faculty of Medicine, Oita, Japan
| | | | | | - Toshihiro Tanaka
- Department of Pediatrics, Shizuoka Kosei Hospital, Shizuoka, Japan
| | - Nobuo Saito
- Department of Microbiology, Oita University Faculty of Medicine, Oita, Japan
| | - Kazufumi Hiramatsu
- Infection Control Center, Oita University Hospital, Oita, Japan; Research Center for Global and Local Infectious Diseases, Oita, Japan
| | - Akira Nishizono
- Department of Microbiology, Oita University Faculty of Medicine, Oita, Japan; Research Center for Global and Local Infectious Diseases, Oita, Japan
| |
Collapse
|
4
|
Fox T, Geppert J, Dinnes J, Scandrett K, Bigio J, Sulis G, Hettiarachchi D, Mathangasinghe Y, Weeratunga P, Wickramasinghe D, Bergman H, Buckley BS, Probyn K, Sguassero Y, Davenport C, Cunningham J, Dittrich S, Emperador D, Hooft L, Leeflang MM, McInnes MD, Spijker R, Struyf T, Van den Bruel A, Verbakel JY, Takwoingi Y, Taylor-Phillips S, Deeks JJ. Antibody tests for identification of current and past infection with SARS-CoV-2. Cochrane Database Syst Rev 2022; 11:CD013652. [PMID: 36394900 PMCID: PMC9671206 DOI: 10.1002/14651858.cd013652.pub2] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND The diagnostic challenges associated with the COVID-19 pandemic resulted in rapid development of diagnostic test methods for detecting SARS-CoV-2 infection. Serology tests to detect the presence of antibodies to SARS-CoV-2 enable detection of past infection and may detect cases of SARS-CoV-2 infection that were missed by earlier diagnostic tests. Understanding the diagnostic accuracy of serology tests for SARS-CoV-2 infection may enable development of effective diagnostic and management pathways, inform public health management decisions and understanding of SARS-CoV-2 epidemiology. OBJECTIVES To assess the accuracy of antibody tests, firstly, to determine if a person presenting in the community, or in primary or secondary care has current SARS-CoV-2 infection according to time after onset of infection and, secondly, to determine if a person has previously been infected with SARS-CoV-2. Sources of heterogeneity investigated included: timing of test, test method, SARS-CoV-2 antigen used, test brand, and reference standard for non-SARS-CoV-2 cases. SEARCH METHODS The COVID-19 Open Access Project living evidence database from the University of Bern (which includes daily updates from PubMed and Embase and preprints from medRxiv and bioRxiv) was searched on 30 September 2020. We included additional publications from the Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre) 'COVID-19: Living map of the evidence' and the Norwegian Institute of Public Health 'NIPH systematic and living map on COVID-19 evidence'. We did not apply language restrictions. SELECTION CRITERIA We included test accuracy studies of any design that evaluated commercially produced serology tests, targeting IgG, IgM, IgA alone, or in combination. Studies must have provided data for sensitivity, that could be allocated to a predefined time period after onset of symptoms, or after a positive RT-PCR test. Small studies with fewer than 25 SARS-CoV-2 infection cases were excluded. We included any reference standard to define the presence or absence of SARS-CoV-2 (including reverse transcription polymerase chain reaction tests (RT-PCR), clinical diagnostic criteria, and pre-pandemic samples). DATA COLLECTION AND ANALYSIS We use standard screening procedures with three reviewers. Quality assessment (using the QUADAS-2 tool) and numeric study results were extracted independently by two people. Other study characteristics were extracted by one reviewer and checked by a second. We present sensitivity and specificity with 95% confidence intervals (CIs) for each test and, for meta-analysis, we fitted univariate random-effects logistic regression models for sensitivity by eligible time period and for specificity by reference standard group. Heterogeneity was investigated by including indicator variables in the random-effects logistic regression models. We tabulated results by test manufacturer and summarised results for tests that were evaluated in 200 or more samples and that met a modification of UK Medicines and Healthcare products Regulatory Agency (MHRA) target performance criteria. MAIN RESULTS We included 178 separate studies (described in 177 study reports, with 45 as pre-prints) providing 527 test evaluations. The studies included 64,688 samples including 25,724 from people with confirmed SARS-CoV-2; most compared the accuracy of two or more assays (102/178, 57%). Participants with confirmed SARS-CoV-2 infection were most commonly hospital inpatients (78/178, 44%), and pre-pandemic samples were used by 45% (81/178) to estimate specificity. Over two-thirds of studies recruited participants based on known SARS-CoV-2 infection status (123/178, 69%). All studies were conducted prior to the introduction of SARS-CoV-2 vaccines and present data for naturally acquired antibody responses. Seventy-nine percent (141/178) of studies reported sensitivity by week after symptom onset and 66% (117/178) for convalescent phase infection. Studies evaluated enzyme-linked immunosorbent assays (ELISA) (165/527; 31%), chemiluminescent assays (CLIA) (167/527; 32%) or lateral flow assays (LFA) (188/527; 36%). Risk of bias was high because of participant selection (172, 97%); application and interpretation of the index test (35, 20%); weaknesses in the reference standard (38, 21%); and issues related to participant flow and timing (148, 82%). We judged that there were high concerns about the applicability of the evidence related to participants in 170 (96%) studies, and about the applicability of the reference standard in 162 (91%) studies. Average sensitivities for current SARS-CoV-2 infection increased by week after onset for all target antibodies. Average sensitivity for the combination of either IgG or IgM was 41.1% in week one (95% CI 38.1 to 44.2; 103 evaluations; 3881 samples, 1593 cases), 74.9% in week two (95% CI 72.4 to 77.3; 96 evaluations, 3948 samples, 2904 cases) and 88.0% by week three after onset of symptoms (95% CI 86.3 to 89.5; 103 evaluations, 2929 samples, 2571 cases). Average sensitivity during the convalescent phase of infection (up to a maximum of 100 days since onset of symptoms, where reported) was 89.8% for IgG (95% CI 88.5 to 90.9; 253 evaluations, 16,846 samples, 14,183 cases), 92.9% for IgG or IgM combined (95% CI 91.0 to 94.4; 108 evaluations, 3571 samples, 3206 cases) and 94.3% for total antibodies (95% CI 92.8 to 95.5; 58 evaluations, 7063 samples, 6652 cases). Average sensitivities for IgM alone followed a similar pattern but were of a lower test accuracy in every time slot. Average specificities were consistently high and precise, particularly for pre-pandemic samples which provide the least biased estimates of specificity (ranging from 98.6% for IgM to 99.8% for total antibodies). Subgroup analyses suggested small differences in sensitivity and specificity by test technology however heterogeneity in study results, timing of sample collection, and smaller sample numbers in some groups made comparisons difficult. For IgG, CLIAs were the most sensitive (convalescent-phase infection) and specific (pre-pandemic samples) compared to both ELISAs and LFAs (P < 0.001 for differences across test methods). The antigen(s) used (whether from the Spike-protein or nucleocapsid) appeared to have some effect on average sensitivity in the first weeks after onset but there was no clear evidence of an effect during convalescent-phase infection. Investigations of test performance by brand showed considerable variation in sensitivity between tests, and in results between studies evaluating the same test. For tests that were evaluated in 200 or more samples, the lower bound of the 95% CI for sensitivity was 90% or more for only a small number of tests (IgG, n = 5; IgG or IgM, n = 1; total antibodies, n = 4). More test brands met the MHRA minimum criteria for specificity of 98% or above (IgG, n = 16; IgG or IgM, n = 5; total antibodies, n = 7). Seven assays met the specified criteria for both sensitivity and specificity. In a low-prevalence (2%) setting, where antibody testing is used to diagnose COVID-19 in people with symptoms but who have had a negative PCR test, we would anticipate that 1 (1 to 2) case would be missed and 8 (5 to 15) would be falsely positive in 1000 people undergoing IgG or IgM testing in week three after onset of SARS-CoV-2 infection. In a seroprevalence survey, where prevalence of prior infection is 50%, we would anticipate that 51 (46 to 58) cases would be missed and 6 (5 to 7) would be falsely positive in 1000 people having IgG tests during the convalescent phase (21 to 100 days post-symptom onset or post-positive PCR) of SARS-CoV-2 infection. AUTHORS' CONCLUSIONS Some antibody tests could be a useful diagnostic tool for those in whom molecular- or antigen-based tests have failed to detect the SARS-CoV-2 virus, including in those with ongoing symptoms of acute infection (from week three onwards) or those presenting with post-acute sequelae of COVID-19. However, antibody tests have an increasing likelihood of detecting an immune response to infection as time since onset of infection progresses and have demonstrated adequate performance for detection of prior infection for sero-epidemiological purposes. The applicability of results for detection of vaccination-induced antibodies is uncertain.
Collapse
Affiliation(s)
- Tilly Fox
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Julia Geppert
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Jacqueline Dinnes
- Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK
| | - Katie Scandrett
- Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Jacob Bigio
- Research Institute of the McGill University Health Centre, Montreal, Canada
- McGill International TB Centre, Montreal, Canada
| | - Giorgia Sulis
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | - Dineshani Hettiarachchi
- Department of Anatomy Genetics and Biomedical Informatics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Yasith Mathangasinghe
- Department of Anatomy Genetics and Biomedical Informatics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
- Australian Regenerative Medicine Institute, Monash University, Clayton, Australia
| | - Praveen Weeratunga
- Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | | | | | - Brian S Buckley
- Cochrane Response, Cochrane, London, UK
- Department of Surgery, University of the Philippines, Manila, Philippines
| | | | | | - Clare Davenport
- Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK
| | - Jane Cunningham
- Global Malaria Programme, World Health Organization, Geneva, Switzerland
| | | | | | - Lotty Hooft
- Cochrane Netherlands, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht , Netherlands
| | - Mariska Mg Leeflang
- Epidemiology and Data Science, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health, Amsterdam, Netherlands
| | | | - René Spijker
- Medical Library, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health, Amsterdam, Netherlands
- Cochrane Netherlands, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Thomas Struyf
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Ann Van den Bruel
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Jan Y Verbakel
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Yemisi Takwoingi
- Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK
| | - Sian Taylor-Phillips
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
- Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Jonathan J Deeks
- Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK
| |
Collapse
|
5
|
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] [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.
Collapse
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.
| |
Collapse
|
6
|
Dibernardo A, Toledo NPL, Robinson A, Osiowy C, Giles E, Day J, Robbin Lindsay L, Drebot MA, Booth TF, Pidduck T, Baily A, Charlton CL, Tipples G, Kanji JN, Brochu G, Lang A, Therrien C, Bélanger-Collard M, Beaulac SN, Gilfix BM, Boivin G, Hamelin MÈ, Carbonneau J, Lévesque S, Martin P, Finzi A, Gendron-Lepage G, Goyette G, Benlarbi M, Gasser R, Fortin C, Martel-Lafferrière V, Lavoie M, Guérin R, Haraoui LP, Renaud C, Jenkins C, O'Brien SF, Drews SJ, Conrod V, Tran V, Awrey B, Scheuermann R, DuPuis A, Payne A, Warszycki C, Girardin R, Lee W, Zahariadis G, Jiao L, Needle R, Cordenbach J, Zaharatos J, Taylor K, Teltscher M, Miller M, Elsherif M, Robertson P, Robinson JL. Evaluation of the performance of multiple immunoassay diagnostic platforms on the National Microbiology Laboratory SARS-CoV-2 National Serology Panel. JOURNAL OF THE ASSOCIATION OF MEDICAL MICROBIOLOGY AND INFECTIOUS DISEASE CANADA = JOURNAL OFFICIEL DE L'ASSOCIATION POUR LA MICROBIOLOGIE MEDICALE ET L'INFECTIOLOGIE CANADA 2022; 7:186-195. [PMID: 36337598 PMCID: PMC9629736 DOI: 10.3138/jammi-2021-0026] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 11/05/2021] [Accepted: 03/05/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Serological assays designed to detect SARS-CoV-2 antibodies are being used in serological surveys and other specialized applications. As a result, and to ensure that the outcomes of serological testing meet high quality standards, evaluations are required to assess the performance of these assays and the proficiency of laboratories performing them. METHODS A panel of 60 plasma/serum samples from blood donors who had reverse transcriptase-polymerase chain reaction (RT-PCR) confirmed SARS-CoV-2 infections and 21 SARS-CoV-2 negative samples were secured and distributed to interested laboratories within Canada (n = 30) and the United States (n = 1). Participating laboratories were asked to provide details on the diagnostic assays used, the platforms the assays were performed on, and the results obtained for each panel sample. Laboratories were blinded with respect to the expected outcomes. RESULTS The performance of the different assays evaluated was excellent, with the high-throughput platforms of Roche, Ortho, and Siemens demonstrating 100% sensitivity. Most other high-throughput platforms had sensitivities of >93%, with the exception of the IgG assay using the Abbott ARCHITECT which had an average sensitivity of only 87%. The majority of the high-throughput platforms also demonstrated very good specificities (>97%). CONCLUSION This proficiency study demonstrates that most of the SARS-CoV-2 serological assays utilized by provincial public health or hospital laboratories in Canada have acceptable sensitivity and excellent specificity.
Collapse
Affiliation(s)
- Antonia Dibernardo
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Nikki PL Toledo
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Alyssia Robinson
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Carla Osiowy
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Elizabeth Giles
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Jacqueline Day
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - L Robbin Lindsay
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Michael A Drebot
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Timothy F Booth
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Tamara Pidduck
- BCCDC Public Health Laboratory, Vancouver, British Columbia, Canada
| | - Ashley Baily
- Public Health Laboratory, Alberta Precision Laboratories, University of Alberta Hospital, Edmonton, Alberta, Canada
| | - Carmen L Charlton
- Department of Laboratory Medicine and Pathology, University of Alberta Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada
| | - Graham Tipples
- Department of Medical Microbiology & Immunology, University of Alberta, Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada
- Li Ka Shing Institute for Virology, Edmonton, Alberta, Canada
| | - Jamil N Kanji
- Department of Laboratory Medicine and Pathology, University of Alberta Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada
- Division of Infectious Diseases, Department of Medicine, University of Alberta, Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Gino Brochu
- CIUSSS Mauricie—Centre du Québec, Trois-Rivières, Québec, Canada
| | - Amanda Lang
- Roy Romanow Provincial Laboratory, Saskatchewan Health Authority, Regina, Saskatchewan, Canada
| | - Christian Therrien
- Laboratoire de santé publique du Québec, Institut de santé publique du Québec, Saint-Anne-de-Bellevue, Québec, Canada
| | - Mélina Bélanger-Collard
- Laboratoire de santé publique du Québec, Institut de santé publique du Québec, Saint-Anne-de-Bellevue, Québec, Canada
| | - Sylvie-Nancy Beaulac
- Laboratoire de santé publique du Québec, Institut de santé publique du Québec, Saint-Anne-de-Bellevue, Québec, Canada
| | - Brian M Gilfix
- McGill University Health Centre, Department of Medicine, Montreal, Québec, Canada
| | - Guy Boivin
- Université Laval and CHU de Québec, Québec City, Québec, Canada
| | | | | | - Simon Lévesque
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
- CIUSSSE de l'Estrie—CHUS, Sherbrooke, Québec, Canada
- Département de microbiologie et infectiologie, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Philippe Martin
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
- CIUSSSE de l'Estrie—CHUS, Sherbrooke, Québec, Canada
- Département de microbiologie et infectiologie, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Andrés Finzi
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
- Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montréal, Québec, Canada
- Canada Department of Microbiology and Immunology, McGill University, Montreal, Québec, Canada
| | | | | | | | - Romain Gasser
- Département de Microbiologie, Infectiologie et Immunologie, Université de Montréal, Montréal, Québec, Canada
| | - Claude Fortin
- CHUM: Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | | | - Myriam Lavoie
- CIUSSS du Saguenay Lac-St-Jean, Hôpital de Chicoutimi, Chicoutimi, Québec, Canada
| | - Renée Guérin
- Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Louis-Patrick Haraoui
- Department of Microbiology and Infectious Diseases, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Christian Renaud
- Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Canada
| | | | | | | | | | - Vanessa Tran
- BCCDC Public Health Laboratory, Vancouver, British Columbia, Canada
- Public Health Ontario, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Bill Awrey
- Alpha Laboratories Inc., Toronto, Ontario, Canada
| | | | - Alan DuPuis
- Wadsworth Center, New York State Department of Health (NYSDOH), Albany, New York, United States
| | - Anne Payne
- Wadsworth Center, New York State Department of Health (NYSDOH), Albany, New York, United States
| | - Casey Warszycki
- Wadsworth Center, New York State Department of Health (NYSDOH), Albany, New York, United States
| | - Roxie Girardin
- Wadsworth Center, New York State Department of Health (NYSDOH), Albany, New York, United States
| | - William Lee
- BCCDC Public Health Laboratory, Vancouver, British Columbia, Canada
- Wadsworth Center, New York State Department of Health (NYSDOH), Albany, New York, United States
- Department of Biomedical Sciences, School of Public Health, University at Albany, Albany, New York, United States
| | - George Zahariadis
- Newfoundland and Labrador Public Health Microbiology Laboratory, St. Johns, Newfoundland, Canada
| | - Lei Jiao
- Newfoundland and Labrador Public Health Microbiology Laboratory, St. Johns, Newfoundland, Canada
| | - Robert Needle
- Newfoundland and Labrador Public Health Microbiology Laboratory, St. Johns, Newfoundland, Canada
| | | | | | | | | | - Matthew Miller
- Canadian Centre for Vaccinology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - May Elsherif
- Canadian Centre for Vaccinology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Peter Robertson
- Canadian Centre for Vaccinology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jason L Robinson
- Division of Clinical Chemistry, Provincial Laboratory Services, Health PEI, Charlottetown, Prince Edward Island, Canada
| |
Collapse
|
7
|
Oka S, Higuchi T, Furukawa H, Shimada K, Hashimoto A, Matsui T, Tohma S. False-positive detection of IgM anti-severe acute respiratory syndrome coronavirus 2 antibodies in patients with rheumatoid arthritis: Possible effects of IgM or IgG rheumatoid factors on immunochromatographic assay results. SAGE Open Med 2022; 10:20503121221088090. [PMID: 35342631 PMCID: PMC8949754 DOI: 10.1177/20503121221088090] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 02/24/2022] [Indexed: 12/29/2022] Open
Abstract
Objectives: The severe acute respiratory syndrome coronavirus 2 causes coronavirus disease 2019. A serological test is conducted to determine prior infection by severe acute respiratory syndrome coronavirus 2. We investigated whether the results of anti-severe acute respiratory syndrome coronavirus 2 antibody tests are modified in patients with rheumatoid arthritis. Methods: Patients in Japan with rheumatoid arthritis were recruited at Sagamihara Hospital from July 2014 to October 2015 (n = 38; 2014 cohort) and at Tokyo Hospital from June to October 2020 (n = 93; 2020 cohort). Anti-severe acute respiratory syndrome coronavirus 2 antibodies were measured by electrochemiluminescence immunoassay or immunochromatographic assay. Results: Anti-severe acute respiratory syndrome coronavirus 2 antibodies were not detected in any of the samples from rheumatoid arthritis patients tested by electrochemiluminescence immunoassay. Anti-severe acute respiratory syndrome coronavirus 2 antibodies were detected by immunochromatographic assay in the 3 (7.9%) serum samples in the 2014 cohort and 15 (16.1%) serum samples in the 2020 cohort. The IgM rheumatoid factor levels were increased in rheumatoid arthritis patients with IgM anti-severe acute respiratory syndrome coronavirus 2 antibodies detected by immunochromatographic assay (mean ± standard deviation (IU/ml), 1223.0 ± 1308.7 versus 503.6 ± 1947.2; P = 0.0101). The levels of IgG rheumatoid factor were also upregulated in rheumatoid arthritis patients with IgM anti-severe acute respiratory syndrome coronavirus 2 antibodies detected by immunochromatographic assay (4.0 ± 0.7 versus 2.4 ± 0.9; P = 0.0013). Conclusion: The results of IgM anti-severe acute respiratory syndrome coronavirus 2 antibody testing by immunochromatographic assay are modified by IgM or IgG rheumatoid factors in rheumatoid arthritis patients.
Collapse
Affiliation(s)
- Shomi Oka
- Department of Rheumatology, National Hospital Organization Tokyo National Hospital, Kiyose, Japan.,Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan
| | - Takashi Higuchi
- Department of Rheumatology, National Hospital Organization Tokyo National Hospital, Kiyose, Japan.,Department of Nephrology, Ushiku Aiwa General Hospital, Ushiku, Japan
| | - Hiroshi Furukawa
- Department of Rheumatology, National Hospital Organization Tokyo National Hospital, Kiyose, Japan.,Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan
| | - Kota Shimada
- Department of Rheumatology, National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan.,Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, Fuchu, Japan
| | - Atsushi Hashimoto
- Department of Rheumatology, National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan.,Department of Internal Medicine, Sagami Seikyou Hospital, Sagamihara, Japan
| | - Toshihiro Matsui
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan.,Department of Rheumatology, National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan
| | - Shigeto Tohma
- Department of Rheumatology, National Hospital Organization Tokyo National Hospital, Kiyose, Japan.,Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan
| |
Collapse
|
8
|
Lau CS, Phua SK, Liang YL, Oh MLH, Aw TC. SARS-CoV-2 Spike and Neutralizing Antibody Kinetics 90 Days after Three Doses of BNT162b2 mRNA COVID-19 Vaccine in Singapore. Vaccines (Basel) 2022; 10:331. [PMID: 35214789 PMCID: PMC8879250 DOI: 10.3390/vaccines10020331] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/09/2022] [Accepted: 02/12/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND We evaluated the post-booster (BNT162b2) antibody responses in Singapore. METHODS Participants (n = 43) were tested pre-booster and 20/30/60/90 days post-booster. Participants were boosted 120-240 days (mean 214 days) after their second dose and had no history or serologic evidence of prior COVID-19 infection; all participants had undetectable SARS-CoV-2 nucleocapsid antibodies throughout the study. Total nucleocapsid and spike antibodies (S-Ab) were assessed on the Roche Elecsys e802 and neutralizing antibody (N-Ab) on the Snibe quantitative N-Ab assay. RESULTS Pre-booster median S-Ab/N-Ab titers were 829 BAU/mL/0.83 µg/mL; 2 participants were below manufacturer's N-Ab cut-offs of 0.3 µg/mL (0.192 and 0.229). Both S-Ab and N-Ab titers peaked at 30 days post-booster (median S-Ab 25,220 BAU/mL and N-Ab 30.3 µg/mL) at 30-37× pre-booster median levels. These peak post-booster S-Ab/N-Ab titers were 11× (25,220 vs. 2235 BAU/mL) and 9× (30.3 vs. 3.52 µg/mL) higher than the previously reported peak post-second dose levels. Antibody titers declined to 12,315 BAU/mL (51% decrease) and 14.3 µg/mL (53% decrease) 90 days post-booster. Non-linear regression estimates for S-Ab/N-Ab half-lives were 44/58 days. At 180 days post-booster, S-Ab/N-Ab are estimated to be 2671 BAU/mL/4.83 µg/mL. CONCLUSIONS Both S-Ab and N-Ab show a good response following post-booster vaccination, with half-lives that may provide a prolonged antibody response.
Collapse
Affiliation(s)
- Chin Shern Lau
- Department of Laboratory Medicine, Changi General Hospital, Singapore 529889, Singapore; (S.K.P.); (Y.L.L.); (T.C.A.)
| | - Soon Kieng Phua
- Department of Laboratory Medicine, Changi General Hospital, Singapore 529889, Singapore; (S.K.P.); (Y.L.L.); (T.C.A.)
| | - Ya Li Liang
- Department of Laboratory Medicine, Changi General Hospital, Singapore 529889, Singapore; (S.K.P.); (Y.L.L.); (T.C.A.)
| | - May Lin Helen Oh
- Department of Infectious Diseases, Changi General Hospital, Singapore 529889, Singapore;
| | - Tar Choon Aw
- Department of Laboratory Medicine, Changi General Hospital, Singapore 529889, Singapore; (S.K.P.); (Y.L.L.); (T.C.A.)
- Department of Medicine, National University of Singapore, Singapore 119077, Singapore
- Academic Pathology Program, Duke-NUS Medical School, Singapore 169857, Singapore
| |
Collapse
|
9
|
Chong PY, Iqbal J, Yeong J, Aw TC, Chan KS, Chui P. Immune Response in Myocardial Injury: In Situ Hybridization and Immunohistochemistry Techniques for SARS-CoV-2 Detection in COVID-19 Autopsies. Front Mol Biosci 2021; 8:658932. [PMID: 34765640 PMCID: PMC8576174 DOI: 10.3389/fmolb.2021.658932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 09/28/2021] [Indexed: 01/18/2023] Open
Abstract
Coronavirus disease-19 (COVID-19) is caused by the newly discovered coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). While the lung remains the primary target site of COVID-19 injury, damage to myocardium, and other organs also contribute to the morbidity and mortality of this disease. There is also increasing demand to visualize viral components within tissue specimens. Here we discuss the cardiac autopsy findings of 12 intensive care unit (ICU) naïve and PCR-positive COVID-19 cases using a combination of histological, Immunohistochemical/immunofluorescent and molecular techniques. We performed SARS-CoV-2 qRT-PCR on fresh tissue from all cases; RNA-ISH and IHC for SARS-CoV-2 were performed on selected cases using FFPE tissue from heart. Eight of these patients also had positive post-mortem serology for SARS-CoV-2. Histopathologic changes in the coronary vessels and inflammation of the myocardium as well as in the endocardium were documented which support the reports of a cardiac component to the viral infection. As in the pulmonary reports, widespread platelet and fibrin thrombi were also identified in the cardiac tissue. In keeping with vaccine-induced activation of virus-specific CD4+ and CD8+ T cells, and release of cytokines such as interferon-gamma (IFNγ), we observed similar immune cellular distribution and cytokines in these patients. Immunohistochemical and immunofluorescent localisation for the viral Spike (S-protein) protein and the nucleocapsid protein (NP) were performed; presence of these aggregates may possibly contribute to cardiac ischemia and even remodelling.
Collapse
Affiliation(s)
- Pek Yoon Chong
- Department of Pathology, Sengkang General Hospital, Singapore, Singapore
| | - Jabed Iqbal
- Department of Anatomical Pathology, Singapore General Hospital, Singapore, Singapore
| | - Joe Yeong
- Institute of Molecular and Cell Biology, A-STAR, Singapore, Singapore
| | - Tar Choon Aw
- Department of Pathology, Sengkang General Hospital, Singapore, Singapore
| | - Kian Sing Chan
- Department of Molecular Pathology, Singapore General Hospital, Singapore, Singapore
| | - Paul Chui
- Health Science Authority, Singapore, Singapore
| |
Collapse
|
10
|
Robust SARS-CoV-2 Antibody Responses in Asian COVID-Naïve Subjects 180 Days after Two Doses of BNT162b2 mRNA COVID-19 Vaccine. Vaccines (Basel) 2021; 9:vaccines9111241. [PMID: 34835172 PMCID: PMC8622758 DOI: 10.3390/vaccines9111241] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/20/2021] [Accepted: 10/22/2021] [Indexed: 01/10/2023] Open
Abstract
Background: Subjects with previous COVID-19 have augmented post-vaccination responses. However, the antibody response in COVID-naïve subjects from Southeast Asia is not well known. Methods: 77 COVID-naïve vaccinees were tested with a full antibody panel [spike antibodies (total (T-Ab), IgG, IgM) and neutralizing antibodies (N-Ab)] pre-vaccination, 10 days after dose 1, and 20/40/60/90/120/150/180 days after dose 2. Results: 10 days after dose 1, 67.6% (48/71)/69.0% (49/71) were T-Ab/IgG positive; only 15.5% (11/71)/14.1% (10/71) were N-Ab/IgM positive. While all (100%) subjects had brisk T-Ab, IgG and N-Ab antibody responses 20 days after complete vaccination, only 79.1% (53/67) were IgM positive. At 180 days (n = 8), T-Ab/IgG/N-Ab were still reactive (lowest T-Ab 186 U/mL, IgG 617 AU/mL, N-Ab 0.39 µg/mL), but IgM was negative in all samples. Spike antibody thresholds of T-Ab 74.1 U/mL (r = 0.95) and IgG 916 AU/mL (r = 0.95) corresponded to N-Ab reactivity (>0.3 µg/mL). Non-linear regression analysis showed that N-Ab would decrease to 0.3 µg/mL by 241 days, whereas T-Ab/IgG would need 470/163 days to reach titers of T-Ab/IgG associated with a N-Ab 0.3 µg/mL (76.4 U/mL and 916 AU/mL respectively). Conclusions: The antibody responses of T-Ab, IgG and N-Ab remain high and durable even at 180 days. N-Ab titers are expected to remain reactive up to 241 days post-vaccination.
Collapse
|
11
|
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] [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.
Collapse
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
| |
Collapse
|
12
|
Grove JS, Mayne ES, Burgers WA, Blackburn J, Jugwanth S, Stevens W, Scott L, David A, Gededzha M, Sanne IM, Maphayi MR, Pillay T, George JA. Validation of Roche immunoassay for severe acute respiratory coronavirus 2 in South Africa. S Afr J Infect Dis 2021. [DOI: 10.4102/sajid.v36i1.286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
13
|
Cs L, Sp H, Yl L, Sk P, Tc A. Performance of an automated chemiluminescent immunoassay for SARS-COV-2 IgM and head-to-head comparison of Abbott and Roche COVID-19 antibody assays. Pract Lab Med 2021; 25:e00230. [PMID: 33937471 PMCID: PMC8079267 DOI: 10.1016/j.plabm.2021.e00230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 04/21/2021] [Indexed: 12/29/2022] Open
Abstract
Introduction We evaluated the performance of the new Abbott SARS-CoV-2 IgM assay on the Architect immunoassay analyser and compared it to the Architect IgG/Roche Cobas total antibody assays in both SARS-CoV-2 RT-PCR positive cases and healthy controls. Method 200 healthy control samples and 48 individuals with other antibody-positive disorders (18 hepatitis/18 dengue/11 ANA/1 dsDNA) served to assess for potential cross-reactivity. Anonymised residual leftover sera positive for SARS-CoV-2 on RT-PCR were recruited as cases (N = 133). The sensitivity/specificity/cross-reactivity of the Architect IgM assay were assessed. Concordance between the 3 assays were also analysed. Results There was no cross-reactivity with controls and other antibody positive samples. The Architect IgM assay was 100% specific (95% CI 98.5 to 100) and sensitivity was 77.8% (95% CI 60.8 to 89.9) ≥14 days post-first positive RT-PCR (POS). Sensitivity of the combined Architect IgM and IgG results (30.8%) was significantly better than the Cobas total antibodies (15.4%) in early disease (p = 0.04). While the Architect IgM assay had moderate agreement with the Cobas total antibody result (Cohen’s kappa 0.72), a combined Architect IgM and IgG result had better agreement (Cohen’s kappa 0.83). Conclusion The Architect IgM assay has good specificity and no cross-reactivity with other antibody positive cases. A combined Architect IgM and IgG result has better sensitivity than the individual assays for early COVID-19. The Architect IgM assay is not comparable to the Cobas total antibody assay, but the Architect IgM and IgG combined result has good agreement with the Cobas assay. IgM/IgG may not develop in some cases of COVID-19, even ≥14 days post infection. The sensitivity/PPV of the combined Architect IgG/IgM assays improves ≥14 days POS. The Architect IgM/IgG combined result has good agreement with the Cobas assay. The Architect IgM and IgG combined results slightly outperforms the Cobas assay.
Collapse
Affiliation(s)
- Lau Cs
- Department of Laboratory Medicine, Changi General Hospital, Singapore
| | - Hoo Sp
- Department of Laboratory Medicine, Changi General Hospital, Singapore
| | - Liang Yl
- Department of Laboratory Medicine, Changi General Hospital, Singapore
| | - Phua Sk
- Department of Laboratory Medicine, Changi General Hospital, Singapore
| | - Aw Tc
- Department of Laboratory Medicine, Changi General Hospital, Singapore.,Department of Medicine, National University of Singapore, Singapore.,Academic Pathology Program, Duke-NUS Medical School, Singapore
| |
Collapse
|
14
|
Chvatal-Medina M, Mendez-Cortina Y, Patiño PJ, Velilla PA, Rugeles MT. Antibody Responses in COVID-19: A Review. Front Immunol 2021; 12:633184. [PMID: 33936045 PMCID: PMC8081880 DOI: 10.3389/fimmu.2021.633184] [Citation(s) in RCA: 79] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 03/25/2021] [Indexed: 01/08/2023] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to spread worldwide as a severe pandemic. Although its seroprevalence is highly variable among territories, it has been reported at around 10%, but higher in health workers. Evidence regarding cross-neutralizing response between SARS-CoV and SARS-CoV-2 is still controversial. However, other previous coronaviruses may interfere with SARS-CoV-2 infection, since they are phylogenetically related and share the same target receptor. Further, the seroconversion of IgM and IgG occurs at around 12 days post onset of symptoms and most patients have neutralizing titers on days 14-20, with great titer variability. Neutralizing antibodies correlate positively with age, male sex, and severity of the disease. Moreover, the use of convalescent plasma has shown controversial results in terms of safety and efficacy, and due to the variable immune response among individuals, measuring antibody titers before transfusion is mostly required. Similarly, cellular immunity seems to be crucial in the resolution of the infection, as SARS-CoV-2-specific CD4+ and CD8+ T cells circulate to some extent in recovered patients. Of note, the duration of the antibody response has not been well established yet.
Collapse
Affiliation(s)
- Mateo Chvatal-Medina
- Grupo Inmunovirología, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | | | - Pablo J. Patiño
- Grupo Inmunodeficiencias Primarias, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Paula A. Velilla
- Grupo Inmunovirología, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Maria T. Rugeles
- Grupo Inmunovirología, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| |
Collapse
|
15
|
Abstract
COVID-19, caused by the SARS-CoV-2 virus, has developed into a global health crisis, causing over 2 million deaths and changing people's daily life the world over. Current main-stream diagnostic methods in the laboratory include nucleic acid PCR tests and direct viral antigen tests for detecting active infections, and indirect human antibody tests specific to SARS-CoV-2 to detect prior exposure. In this Perspective, we briefly describe the PCR and antigen tests and then focus mainly on existing antibody tests and their limitations including inaccuracies and possible causes of unreliability. False negatives in antibody immunoassays can arise from assay formats, selection of viral antigens and antibody types, diagnostic testing windows, individual variance, and fluctuation in antibody levels. Reasons for false positives in antibody immunoassays mainly involve antibody cross-reactivity from other viruses, as well as autoimmune disease. The spectrum bias has an effect on both the false negatives and false positives. For assay developers, not only improvement of assay formats but also selection of viral antigens and isotopes of human antibodies need to be carefully considered to improve sensitivity and specificity. For clinicians, the factors influencing the accuracy of assays must be kept in mind to test patients using currently imperfect but available tests with smart tactics and realistic interpretation of the test results.
Collapse
Affiliation(s)
- Guoqiang Liu
- Medical College, Jiaxing
University, 118 Jiahang Road, Jiaxing, Zhejiang Province,
China
- Department of Chemistry, University of
Connecticut, 55 North Eagleville Road, Storrs, Connecticut 06269,
United States
| | - James F. Rusling
- Department of Chemistry, University of
Connecticut, 55 North Eagleville Road, Storrs, Connecticut 06269,
United States
- Department of Surgery and Neag Cancer Center,
UConn Health, Farmington, Connecticut 06232, United
States
- Institute of Materials Science,
University of Connecticut, 97 North Eagleville Road, Storrs,
Connecticut 0626, United States
- School of Chemistry, National University
of Ireland Galway, University Road, Galway,
Ireland
| |
Collapse
|
16
|
Comparative Performance of Five Commercially Available Serologic Assays To Detect Antibodies to SARS-CoV-2 and Identify Individuals with High Neutralizing Titers. J Clin Microbiol 2021; 59:JCM.02257-20. [PMID: 33139419 PMCID: PMC8111143 DOI: 10.1128/jcm.02257-20] [Citation(s) in RCA: 146] [Impact Index Per Article: 48.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 10/29/2020] [Indexed: 12/16/2022] Open
Abstract
Accurate serological assays to detect antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are needed to characterize the epidemiology of SARS-CoV-2 infection and identify potential candidates for coronavirus disease 2019 (COVID-19) convalescent plasma (CCP) donation. This study compared the performances of commercial enzyme immunoassays (EIAs) with respect to detection of IgG or total antibodies to SARS-CoV-2 and neutralizing antibodies (nAbs). The diagnostic accuracy of five commercially available EIAs (Abbott, Euroimmun, EDI, ImmunoDiagnostics, and Roche) for detection of IgG or total antibodies to SARS-CoV-2 was evaluated using cross-sectional samples from potential CCP donors who had prior molecular confirmation of SARS-CoV-2 infection (n = 214) and samples from prepandemic emergency department patients without SARS-CoV-2 infection (n = 1,099). Accurate serological assays to detect antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are needed to characterize the epidemiology of SARS-CoV-2 infection and identify potential candidates for coronavirus disease 2019 (COVID-19) convalescent plasma (CCP) donation. This study compared the performances of commercial enzyme immunoassays (EIAs) with respect to detection of IgG or total antibodies to SARS-CoV-2 and neutralizing antibodies (nAbs). The diagnostic accuracy of five commercially available EIAs (Abbott, Euroimmun, EDI, ImmunoDiagnostics, and Roche) for detection of IgG or total antibodies to SARS-CoV-2 was evaluated using cross-sectional samples from potential CCP donors who had prior molecular confirmation of SARS-CoV-2 infection (n = 214) and samples from prepandemic emergency department patients without SARS-CoV-2 infection (n = 1,099). Of the 214 potential CCP donors, all were sampled >14 days since symptom onset and only a minority (n = 16 [7.5%]) had been hospitalized due to COVID-19; 140 potential CCP donors were tested by all five EIAs and a microneutralization assay. Performed according to the protocols of the manufacturers to detect IgG or total antibodies to SARS-CoV-2, the sensitivity of each EIA ranged from 76.4% to 93.9%, and the specificity of each EIA ranged from 87.0% to 99.6%. Using a nAb titer cutoff value of ≥160 as the reference representing a positive test result (n = 140 CCP donors), the empirical area under the receiver operating curve for each EIA ranged from 0.66 (Roche) to 0.90 (Euroimmun). Commercial EIAs with high diagnostic accuracy to detect SARS-CoV-2 antibodies did not necessarily have high diagnostic accuracy to detect high nAb titers. Some but not all commercial EIAs may be useful in the identification of individuals with high nAb titers among convalescent individuals.
Collapse
|
17
|
Mehdi F, Chattopadhyay S, Thiruvengadam R, Yadav S, Kumar M, Sinha SK, Goswami S, Kshetrapal P, Wadhwa N, Chandramouli Natchu U, Sopory S, Koundinya Desiraju B, Pandey AK, Das A, Verma N, Sharma N, Sharma P, Bhartia V, Gosain M, Lodha R, Lamminmäki U, Shrivastava T, Bhatnagar S, Batra G. Development of a Fast SARS-CoV-2 IgG ELISA, Based on Receptor-Binding Domain, and Its Comparative Evaluation Using Temporally Segregated Samples From RT-PCR Positive Individuals. Front Microbiol 2021; 11:618097. [PMID: 33552028 PMCID: PMC7854536 DOI: 10.3389/fmicb.2020.618097] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 12/24/2020] [Indexed: 12/12/2022] Open
Abstract
SARS-CoV-2 antibody detection assays are crucial for gathering seroepidemiological information and monitoring the sustainability of antibody response against the virus. The SARS-CoV-2 Spike protein's receptor-binding domain (RBD) is a very specific target for anti-SARS-CoV-2 antibodies detection. Moreover, many neutralizing antibodies are mapped to this domain, linking antibody response to RBD with neutralizing potential. Detection of IgG antibodies, rather than IgM or total antibodies, against RBD is likely to play a larger role in understanding antibody-mediated protection and vaccine response. Here we describe a rapid and stable RBD-based IgG ELISA test obtained through extensive optimization of the assay components and conditions. The test showed a specificity of 99.79% (95% CI: 98.82-99.99%) in a panel of pre-pandemic samples (n = 470) from different groups, i.e., pregnancy, fever, HCV, HBV, and autoantibodies positive. Test sensitivity was evaluated using sera from SARS-CoV-2 RT-PCR positive individuals (n = 312) and found to be 53.33% (95% CI: 37.87-68.34%), 80.47% (95% CI: 72.53-86.94%), and 88.24% (95% CI: 82.05-92.88%) in panel 1 (days 0-13), panel 2 (days 14-20) and panel 3 (days 21-27), respectively. Higher sensitivity was achieved in symptomatic individuals and reached 92.14% (95% CI: 86.38-96.01%) for panel 3. Our test, with a shorter runtime, showed higher sensitivity than parallelly tested commercial ELISAs for SARS-CoV-2-IgG, i.e., Euroimmun and Zydus, even when equivocal results in the commercial ELISAs were considered positive. None of the tests, which are using different antigens, could detect anti-SARS-CoV-2 IgGs in 10.5% RT-PCR positive individuals by the fourth week, suggesting the lack of IgG response.
Collapse
Affiliation(s)
- Farha Mehdi
- Translational Health Science and Technology Institute, Faridabad, India
| | | | | | - Sarla Yadav
- Translational Health Science and Technology Institute, Faridabad, India
| | - Manjit Kumar
- Translational Health Science and Technology Institute, Faridabad, India
| | | | - Sandeep Goswami
- Translational Health Science and Technology Institute, Faridabad, India
| | | | - Nitya Wadhwa
- Translational Health Science and Technology Institute, Faridabad, India
| | | | - Shailaja Sopory
- Translational Health Science and Technology Institute, Faridabad, India
| | | | | | - Asim Das
- ESIC Medical College and Hospital, Faridabad, India
| | - Nikhil Verma
- ESIC Medical College and Hospital, Faridabad, India
| | - Nandini Sharma
- Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
| | - Pragya Sharma
- Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
| | - Vandita Bhartia
- Translational Health Science and Technology Institute, Faridabad, India
| | - Mudita Gosain
- Translational Health Science and Technology Institute, Faridabad, India
| | - Rakesh Lodha
- All India Institute of Medical Sciences, New Delhi, India
| | - Urpo Lamminmäki
- Department of Biochemistry/Biotechnology, University of Turku, Turku, Finland
| | | | | | - Gaurav Batra
- Translational Health Science and Technology Institute, Faridabad, India
| |
Collapse
|
18
|
Lau CS, Hoo SP, Liang YL, Phua SK, Aw TC. Performance of two rapid point of care SARS-COV-2 antibody assays against laboratory-based automated chemiluminescent immunoassays for SARS-COV-2 IG-G, IG-M and total antibodies. Pract Lab Med 2021; 24:e00201. [PMID: 33501369 PMCID: PMC7816621 DOI: 10.1016/j.plabm.2021.e00201] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 01/11/2021] [Indexed: 12/23/2022] Open
Abstract
Introduction We evaluated two SARS-CoV-2 antibody point-of-care tests (POCTs) (Abbott Panbio COVID-19 IgG/IgM and Roche SARS-CoV-2 Rapid Antibody tests) and compared the results to their respective chemiluminescent immunoassays (CLIAs) (Abbott Architect IgM, Architect IgG, Roche Cobas total antibody assays). Method 200 pre-pandemic sera and 48 samples positive for various conditions (18 viral hepatitis, 18 dengue, 11 ANA and 1 dsDNA) were used as controls and to assess for cross-reactivity. Anonymised residual leftover sera positive for SARS-CoV-2 on RT-PCR were recruited as cases (n = 133). The sensitivity/specificity/cross-reactivity/positive predictive value (PPV)/negative predictive value (NPV) of the POCTs were assessed. Concordance between the POCTs and chemiluminescent immunoassays (CLIAs) were analysed. Results Abbott/Roche POCT specificity was 98.7%/100% (95% CI 96.5–99.8/98.5–100) and sensitivity was 97.2%/97.2% (95% CI 85.5–99.9/85.5–99.9) in cases ≥14 days post-first positive RT-PCR (POS), PPV was 68.7%/100% (95% CI 41.3–87.2/94.7–100.0), and NPV was 97.4%/97.6% (95% CI 97.0–97.8/97.2–98.0). In cases ≥14 days POS, concordance of Abbott/Roche POCT and CLIAs was 97.2%/100% (35/36 and 36/36 results). The sensitivity of individual IgM-band results on both POCTs did not increase >95% even after 14 days POS (Abbott 2.78%, Roche 44.4%). Conclusion Both POCTs have good specificity, little cross-reactivity with other antibodies, and sensitivity >95% when used in subjects ≥14 days POS. Analysis of individual POCT IgG/IgM-bands did not provide any additional information. POCTs can substitute for CLIAs in cases ≥14 days POS. In low prevalence areas, POCTs would be especially useful when combined with antigen testing in an orthogonal format to increase the PPV of COVID-19 results. The POCT IgM-band is negative in most cases of COVID-19. There is little utility in examining the IgG-IgM bands individually. Like CLIAs, the sensitivity of the POCTs is >95% 14 days after RT-PCR positivity. Combining POCTs with another test orthogonally improves the PPV.
Collapse
Affiliation(s)
- C S Lau
- Department of Laboratory Medicine, Changi General Hospital, Singapore
| | - S P Hoo
- Department of Laboratory Medicine, Changi General Hospital, Singapore
| | - Y L Liang
- Department of Laboratory Medicine, Changi General 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
| |
Collapse
|
19
|
Brown SD, Ottaway KA, Weaving G, Shipman KE. Response to: towards the rational utilization of SARS-CoV-2 serological tests in clinical practice. Clin Chem Lab Med 2021; 59:e227-e229. [PMID: 33554513 DOI: 10.1515/cclm-2020-1762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 12/29/2020] [Indexed: 11/15/2022]
Affiliation(s)
- Samuel D Brown
- School of Pharmacy and Biomolecular Sciences, University of Brighton, Huxley Building, BN2 4HP, Brighton, UK
| | - Kate A Ottaway
- Biochemistry Department, Royal Sussex County Hospital, Brighton, UK
| | - Gary Weaving
- Biochemistry Department, Royal Sussex County Hospital, Brighton, UK
| | - Kate E Shipman
- Biochemistry Department, Western Sussex Hospitals NHS Foundation Trust, Worthing, West Sussex, UK
| |
Collapse
|
20
|
Patel EU, Bloch EM, Clarke W, Hsieh YH, Boon D, Eby Y, Fernandez RE, Baker OR, Keruly M, Kirby CS, Klock E, Littlefield K, Miller J, Schmidt HA, Sullivan P, Piwowar-Manning E, Shrestha R, Redd AD, Rothman RE, Sullivan D, Shoham S, Casadevall A, Quinn TC, Pekosz A, Tobian AA, Laeyendecker O. Comparative performance of five commercially available serologic assays to detect antibodies to SARS-CoV-2 and identify individuals with high neutralizing titers. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020:2020.08.31.20184788. [PMID: 32908987 PMCID: PMC7480035 DOI: 10.1101/2020.08.31.20184788] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Accurate serological assays to detect antibodies to SARS-CoV-2 are needed to characterize the epidemiology of SARS-CoV-2 infection and identify potential candidates for COVID-19 convalescent plasma (CCP) donation. This study compared the performance of commercial enzyme immunoassays (EIAs) to detect IgG or total antibodies to SARS-CoV-2 and neutralizing antibodies (nAb). The diagnostic accuracy of five commercially available EIAs (Abbott, Euroimmun, EDI, ImmunoDiagnostics, and Roche) to detect IgG or total antibodies to SARS-CoV-2 was evaluated from cross-sectional samples of potential CCP donors that had prior molecular confirmation of SARS-CoV-2 infection for sensitivity (n=214) and pre-pandemic emergency department patients for specificity (n=1,102). Of the 214 potential CCP donors, all were sampled >14 days since symptom onset and only a minority had been hospitalized due to COVID-19 (n=16 [7.5%]); 140 potential CCP donors were tested by all five EIAs and a microneutralization assay. When performed according to the manufacturers' protocol to detect IgG or total antibodies to SARS-CoV-2, the sensitivity of each EIA ranged from 76.4% to 93.9%, and the specificity of each EIA ranged from 87.0% to 99.6%. Using a nAb titer cutoff of ≥160 as the reference positive test (n=140 CCP donors), the empirical area under receiver operating curve of each EIA ranged from 0.66 (Roche) to 0.90 (Euroimmun). Commercial EIAs with high diagnostic accuracy to detect SARS-CoV-2 antibodies did not necessarily have high diagnostic accuracy to detect high nAbs. Some but not all commercial EIAs may be useful in the identification of individuals with high nAbs in convalescent individuals.
Collapse
Affiliation(s)
- Eshan U. Patel
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Evan M. Bloch
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - William Clarke
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Yu-Hsiang Hsieh
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Denali Boon
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Yolanda Eby
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Reinaldo E. Fernandez
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Owen R. Baker
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Baltimore, MD, USA
| | - Morgan Keruly
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Charles S. Kirby
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ethan Klock
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kirsten Littlefield
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jernelle Miller
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Haley A. Schmidt
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Philip Sullivan
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Ruchee Shrestha
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Andrew D. Redd
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Baltimore, MD, USA
| | - Richard E. Rothman
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - David Sullivan
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Shmuel Shoham
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Arturo Casadevall
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Thomas C. Quinn
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Baltimore, MD, USA
| | - Andrew Pekosz
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Aaron A.R. Tobian
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Oliver Laeyendecker
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Baltimore, MD, USA
| |
Collapse
|