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Zhang P, Li B, Wang Y, Min W, Wang X, Zhou Y, Li Z, Zhao Y, Zhang H, Jiang M, Zheng H, Yang C, Zhang W, Zuo L, Gao Q, Yang Z, Li Y, Feng T, Lin C, Hu Q, Song T, Yang R. Development and multi-center clinical trials of an up-converting phosphor technology-based point-of-care (UPT-POCT) assay for rapid COVID-19 diagnosis and prediction of protective effects. BMC Microbiol 2022; 22:42. [PMID: 35114938 PMCID: PMC8811342 DOI: 10.1186/s12866-022-02450-z] [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: 07/13/2021] [Accepted: 01/17/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Quantitative point-of-care testing assay for detecting antibodies is critical to COVID-19 control. In this study, we established an up-conversion phosphor technology-based point-of-care testing (UPT-POCT), a lateral flow assay, for rapid COVID-19 diagnosis, as well as prediction of seral neutralizing antibody (NAb) activity and protective effects. METHODS UPT-POCT was developed targeting total antibodies against the receptor-binding domain (RBD) of SARS-CoV-2 spike protein. Using ELISA as a contrast method, we evaluated the quantitation accuracy with NAb and serum samples. Cutoff for serum samples was determined through 70 healthy and 140 COVID-19 patients. We evaluated the cross-reactions with antibodies against other viruses. Then, we performed multi-center clinical trials of UPT-POCT, including 782 patients with 387 clinically confirmed COVID-19 cases. Furthermore, RBD-specific antibody levels were detected using UPT-POCT and microneutralization assay for samples from both patients and vaccinees. Specifically, the antibodies of recovered patients with recurrent positive (RP) reverse transcriptase-polymerase chain reaction test results were discussed. RESULTS The ratios of signal intensities between the test and control bands on the lateral flow strip, namely, T/C ratios, was defined as the results of UPT-POCT. T/C ratios had excellent correlations with concentrations of NAb, as well as OD values of ELISA for serum samples. The sensitivity and specificity of UPT-POCT were 89.15% and 99.75% for 782 cases in seven hospitals in China, respectively. We evaluated RBD-specific antibodies for 528 seral samples from 213 recovered and 99 RP COVID-19 patients, along with 35 seral samples from inactivated SARS-CoV-2 vaccinees, and we discovered that the total RBD-specific antibody level indicated by T/C ratios of UPT-POCT was significantly related to the NAb titers in both COVID-19 patients (r = 0.9404, n = 527; ρ = 0.6836, n = 528) and the vaccinees (r = 0.9063, ρ = 0.7642, n = 35), and it was highly relevant to the protection rate against RP (r = 0.9886, n = 312). CONCLUSION This study reveals that the UPT-POCT for quantitative detection of total RBD-specific antibody could be employed as a surrogate method for rapid COVID-19 diagnosis and prediction of protective effects.
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Affiliation(s)
- Pingping Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, 100071, People's Republic of China.,Beijing Key Laboratory of POCT for Bioemergency and Clinic (No. BZ0329), Beijing, 100071, People's Republic of China
| | - Baisheng Li
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, People's Republic of China
| | - Yao Wang
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100032, People's Republic of China
| | - Wei Min
- Beijing Key Laboratory of POCT for Bioemergency and Clinic (No. BZ0329), Beijing, 100071, People's Republic of China
| | - Xiaohui Wang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China
| | - Yugui Zhou
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, 100071, People's Republic of China.,Beijing Key Laboratory of POCT for Bioemergency and Clinic (No. BZ0329), Beijing, 100071, People's Republic of China.,Guizhou Medical University, Guiyang, People's Republic of China
| | - Zhencui Li
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, People's Republic of China
| | - Yong Zhao
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, 100071, People's Republic of China
| | - Huan Zhang
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, People's Republic of China
| | - Min Jiang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China
| | - Huanying Zheng
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, People's Republic of China
| | - Chao Yang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China
| | - Wei Zhang
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, People's Republic of China
| | - Le Zuo
- Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China
| | - Qi Gao
- Beijing Key Laboratory of POCT for Bioemergency and Clinic (No. BZ0329), Beijing, 100071, People's Republic of China
| | - Zhengrong Yang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China
| | - Yanzhao Li
- Beijing Key Laboratory of POCT for Bioemergency and Clinic (No. BZ0329), Beijing, 100071, People's Republic of China
| | - Tiejian Feng
- Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China
| | - Changqing Lin
- Beijing Key Laboratory of POCT for Bioemergency and Clinic (No. BZ0329), Beijing, 100071, People's Republic of China.
| | - Qinghua Hu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China.
| | - Tie Song
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, People's Republic of China.
| | - Ruifu Yang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, 100071, People's Republic of China. .,Beijing Key Laboratory of POCT for Bioemergency and Clinic (No. BZ0329), Beijing, 100071, People's Republic of China.
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