1
|
Sweeney N, Merrick B, Pedro Galão R, Pickering S, Botgros A, Wilson HD, Signell AW, Betancor G, Tan MKI, Ramble J, Kouphou N, Acors S, Graham C, Seow J, MacMahon E, Neil SJD, Malim MH, Doores K, Douthwaite S, Batra R, Nebbia G, Edgeworth JD. Clinical utility of targeted SARS-CoV-2 serology testing to aid the diagnosis and management of suspected missed, late or post-COVID-19 infection syndromes: Results from a pilot service implemented during the first pandemic wave. PLoS One 2021; 16:e0249791. [PMID: 33826651 PMCID: PMC8026061 DOI: 10.1371/journal.pone.0249791] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 03/24/2021] [Indexed: 01/15/2023] Open
Abstract
During the first wave of the global COVID-19 pandemic the clinical utility and indications for SARS-CoV-2 serological testing were not clearly defined. The urgency to deploy serological assays required rapid evaluation of their performance characteristics. We undertook an internal validation of a CE marked lateral flow immunoassay (LFIA) (SureScreen Diagnostics) using serum from SARS-CoV-2 RNA positive individuals and pre-pandemic samples. This was followed by the delivery of a same-day named patient SARS-CoV-2 serology service using LFIA on vetted referrals at central London teaching hospital with clinical interpretation of result provided to the direct care team. Assay performance, source and nature of referrals, feasibility and clinical utility of the service, particularly benefit in clinical decision-making, were recorded. Sensitivity and specificity of LFIA were 96.1% and 99.3% respectively. 113 tests were performed on 108 participants during three-week pilot. 44% participants (n = 48) had detectable antibodies. Three main indications were identified for serological testing; new acute presentations potentially triggered by recent COVID-19 e.g. pulmonary embolism (n = 5), potential missed diagnoses in context of a recent COVID-19 compatible illness (n = 40), and making infection control or immunosuppression management decisions in persistently SARS-CoV-2 RNA PCR positive individuals (n = 6). We demonstrate acceptable performance characteristics, feasibility and clinical utility of using a LFIA that detects anti-spike antibodies to deliver SARS-CoV-2 serology service in adults and children. Greatest benefit was seen where there is reasonable pre-test probability and results can be linked with clinical advice or intervention. Experience from this pilot can help inform practicalities and benefits of rapidly implementing new tests such as LFIAs into clinical service as the pandemic evolves.
Collapse
Affiliation(s)
- Nicola Sweeney
- Department of Infectious Diseases, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Blair Merrick
- Department of Infectious Diseases, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
- Department of Infectious Diseases, Centre for Clinical Infection and Diagnostics Research, School of Immunology and Microbial Sciences, King’s College London, London, United Kingdom
| | - Rui Pedro Galão
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King’s College London, London, United Kingdom
| | - Suzanne Pickering
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King’s College London, London, United Kingdom
| | - Alina Botgros
- Department of Infectious Diseases, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Harry D. Wilson
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King’s College London, London, United Kingdom
| | - Adrian W. Signell
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King’s College London, London, United Kingdom
| | - Gilberto Betancor
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King’s College London, London, United Kingdom
| | - Mark Kia Ik Tan
- Department of Infectious Diseases, Centre for Clinical Infection and Diagnostics Research, School of Immunology and Microbial Sciences, King’s College London, London, United Kingdom
| | - John Ramble
- Infection Sciences, Viapath LLP, St Thomas’ Hospital, London, United Kingdom
| | - Neophytos Kouphou
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King’s College London, London, United Kingdom
| | - Sam Acors
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King’s College London, London, United Kingdom
| | - Carl Graham
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King’s College London, London, United Kingdom
| | - Jeffrey Seow
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King’s College London, London, United Kingdom
| | - Eithne MacMahon
- Department of Infectious Diseases, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
- Department of Infectious Diseases, Centre for Clinical Infection and Diagnostics Research, School of Immunology and Microbial Sciences, King’s College London, London, United Kingdom
| | - Stuart J. D. Neil
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King’s College London, London, United Kingdom
| | - Michael H. Malim
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King’s College London, London, United Kingdom
| | - Katie Doores
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King’s College London, London, United Kingdom
| | - Sam Douthwaite
- Department of Infectious Diseases, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
- Department of Infectious Diseases, Centre for Clinical Infection and Diagnostics Research, School of Immunology and Microbial Sciences, King’s College London, London, United Kingdom
| | - Rahul Batra
- Department of Infectious Diseases, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
- Department of Infectious Diseases, Centre for Clinical Infection and Diagnostics Research, School of Immunology and Microbial Sciences, King’s College London, London, United Kingdom
| | - Gaia Nebbia
- Department of Infectious Diseases, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
- Department of Infectious Diseases, Centre for Clinical Infection and Diagnostics Research, School of Immunology and Microbial Sciences, King’s College London, London, United Kingdom
| | - Jonathan D. Edgeworth
- Department of Infectious Diseases, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
- Department of Infectious Diseases, Centre for Clinical Infection and Diagnostics Research, School of Immunology and Microbial Sciences, King’s College London, London, United Kingdom
| |
Collapse
|
2
|
Braun P, Delgado R, Drago M, Fanti D, Fleury H, Izopet J, Lombardi A, Mancon A, Marcos MA, Sauné K, O Shea S, Pérez-Rivilla A, Ramble J, Trimoulet P, Vila J, Whittaker D, Artus A, Rhodes D. A European multicenter study on the analytical performance of the VERIS HBV assay. J Clin Virol 2017; 99-100:50-56. [PMID: 29328964 DOI: 10.1016/j.jcv.2017.12.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 12/15/2017] [Accepted: 12/18/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Hepatitis B viral load monitoring is an essential part of managing patients with chronic Hepatits B infection. Beckman Coulter has developed the VERIS HBV Assay for use on the fully automated Beckman Coulter DxN VERIS Molecular Diagnostics System.1 OBJECTIVES: To evaluate the analytical performance of the VERIS HBV Assay at multiple European virology laboratories. STUDY DESIGN Precision, analytical sensitivity, negative sample performance, linearity and performance with major HBV genotypes/subtypes for the VERIS HBV Assay was evaluated. RESULTS Precision showed an SD of 0.15 log10 IU/mL or less for each level tested. Analytical sensitivity determined by probit analysis was between 6.8-8.0 IU/mL. Clinical specificity on 90 unique patient samples was 100.0%. Performance with 754 negative samples demonstrated 100.0% not detected results, and a carryover study showed no cross contamination. Linearity using clinical samples was shown from 1.23-8.23 log10 IU/mL and the assay detected and showed linearity with major HBV genotypes/subtypes. CONCLUSIONS The VERIS HBV Assay demonstrated comparable analytical performance to other currently marketed assays for HBV DNA monitoring.
Collapse
Affiliation(s)
- Patrick Braun
- Laboratory Dr. Knechten, Medical Center for HIV and Hepatitis, Aachen, Germany
| | - Rafael Delgado
- Microbiology Department, Hospital Universitario 12 de Octubre and Insituto de Investigation, Hospital 12 de Octubre (i + 12), Madrid, Spain
| | - Monica Drago
- Clinical Chemistry and Microbiology laboratories, Niguarda Ca' Granda Hospital, Milan, Italy
| | - Diana Fanti
- Clinical Chemistry and Microbiology laboratories, Niguarda Ca' Granda Hospital, Milan, Italy
| | - Hervé Fleury
- Virology Department, Hôpital Pellegrin, CHU, Bordeaux, France
| | - Jacques Izopet
- Department of Virology, Federative Institute of Biology, CHU, Toulouse, France
| | - Alessandra Lombardi
- Clinical Microbiology, Virology and Bioemergence Diagnosis, L. Sacco University Hospital, Milan, Italy
| | - Alessandro Mancon
- Clinical Microbiology, Virology and Bioemergence Diagnosis, L. Sacco University Hospital, Milan, Italy
| | - Maria Angeles Marcos
- Department of Clinical Microbiology, Hospital Clinic, School of Medicine, University of Barcelona, Centre for International Health Research (CRESIB), Barcelona, Spain
| | - Karine Sauné
- Department of Virology, Federative Institute of Biology, CHU, Toulouse, France
| | - Siobhan O Shea
- Viapath Analytics, Infection Sciences, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom
| | - Alfredo Pérez-Rivilla
- Microbiology Department, Hospital Universitario 12 de Octubre and Insituto de Investigation, Hospital 12 de Octubre (i + 12), Madrid, Spain
| | - John Ramble
- Viapath Analytics, Infection Sciences, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom
| | | | - Jordi Vila
- Department of Clinical Microbiology, Hospital Clinic, School of Medicine, University of Barcelona, Centre for International Health Research (CRESIB), Barcelona, Spain
| | - Duncan Whittaker
- Laboratory Medicine Building, North Lane, Northern General Hospital, Sheffield, United Kingdom
| | - Alain Artus
- Beckman Coulter, Immunotech, Marseille, France
| | | |
Collapse
|
3
|
Braun P, Delgado R, Drago M, Fanti D, Fleury H, Izopet J, Lombardi A, Marcos M, Sauné K, O'Shea S, Pérez-Rivilla A, Ramble J, Trimoulet P, Vila J, Whittaker D, Artus A, Rhodes D. A European multicientre study on the comparison of HBV viral loads between VERIS HBV assay and Roche COBAS ® TAQMAN ® HBV test, Abbott RealTime HBV assay, Siemens VERSANT HBV assay, and Qiagen artus HBV RG kit. J Clin Virol 2017; 95:76-83. [PMID: 28892764 DOI: 10.1016/j.jcv.2017.08.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 08/31/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Hepatitis B viral load testing is essential to treatment and monitoring decisions in patients with chronic Hepatitis B. Beckman Coulter has developed the VERIS HBV Assay (Veris) for use on the fully automated DxN VERIS Molecular Diagnostics System.1 OBJECTIVES: To evaluate the clinical performance of the Veris HBV Assay at multiple EU laboratories STUDY DESIGN: Method comparison was performed with a total of 344 plasma specimens from HBV infected patients tested with Veris and COBAS® TaqMan® HBV Test (Cobas), 207 specimens tested with Veris and RealTime HBV Assay (RealTime), 86 specimens tested with Veris and VERSANT® HBV Assay (Versant), and 74 specimens tested with Veris and artus® HBV RG PCR kit (artus). RESULTS Bland-Altman analysis showed average bias of -0.46 log10 IU/mL between Veris and Cobas, -0.46 log10IU/mL between Veris and RealTime, -0.36 log10IU/mL between Veris and Versant, and -0.12 log10IU/mL between Veris and artus. Bias was consistent across the assay range. Patient monitoring results using Veris demonstrated similar viral load trends over time to Cobas, RealTime, and artus. CONCLUSIONS The VERIS HBV Assay demonstrated comparable clinical performance, with varying degrees of negative bias, compared to other currently marketed assays for HBV DNA monitoring. This negative bias should be taken into consideration if switching monitoring methods to Veris.
Collapse
Affiliation(s)
- Patrick Braun
- Laboratory Dr. Knechten, Medical Center for HIV and Hepatitis, Aachen, Germany
| | - Rafael Delgado
- Microbiology Department, Hospital Universitario 12 de Octubre and Insituto de Investigation, Hospital 12 de Octubre (i+12), Madrid, Spain
| | - Monica Drago
- Clinical Chemistry and Microbiology laboratories, Niguarda Ca' Granda Hospital, Milan, Italy
| | - Diana Fanti
- Clinical Chemistry and Microbiology laboratories, Niguarda Ca' Granda Hospital, Milan, Italy
| | - Hervé Fleury
- Virology Department, Hôpital Pellegrin, CHU, Bordeaux, France
| | - Jacques Izopet
- Department of Virology, Federative Institute of Biology, CHU, Toulouse, France
| | - Alessandra Lombardi
- Clinical Microbiology, Virology and Bioemergence Diagnosis, L. Sacco University Hospital, Milan, Italy
| | - MaAngeles Marcos
- Department of Clinical Microbiology, Hospital Clinic, School of Medicine, University of Barcelona, Centre for International Health Research (CRESIB), Barcelona, Spain
| | - Karine Sauné
- Department of Virology, Federative Institute of Biology, CHU, Toulouse, France
| | - Siobhan O'Shea
- Viapath Analytics, Infection Sciences, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Alfredo Pérez-Rivilla
- Microbiology Department, Hospital Universitario 12 de Octubre and Insituto de Investigation, Hospital 12 de Octubre (i+12), Madrid, Spain
| | - John Ramble
- Viapath Analytics, Infection Sciences, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | | | - Jordi Vila
- Department of Clinical Microbiology, Hospital Clinic, School of Medicine, University of Barcelona, Centre for International Health Research (CRESIB), Barcelona, Spain
| | - Duncan Whittaker
- Laboratory Medicine Building, North Lane, Northern General Hospital, Sheffield, UK
| | - Alain Artus
- Beckman Coulter, Immunotech, Marseille, France
| | | |
Collapse
|
4
|
Braun P, Delgado R, Drago M, Fanti D, Fleury H, Hofmann J, Izopet J, Kühn S, Lombardi A, Mancon A, Marcos MA, Mileto D, Sauné K, O'Shea S, Pérez-Rivilla A, Ramble J, Trimoulet P, Vila J, Whittaker D, Artus A, Rhodes D. A European multicientre study on the comparison of HIV-1 viral loads between VERIS HIV-1 Assay and Roche COBAS® TAQMAN® HIV-1 test, Abbott RealTime HIV-1 Assay, and Siemens VERSANT HIV-1 Assay. J Clin Virol 2017; 92:75-82. [PMID: 28599228 DOI: 10.1016/j.jcv.2017.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 05/03/2017] [Accepted: 05/06/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Viral load monitoring is essential for patients under treatment for HIV. Beckman Coulter has developed the VERIS HIV-1 Assay for use on the novel, automated DxN VERIS Molecular Diagnostics System.¥ OBJECTIVES: Evaluation of the clinical performance of the new quantitative VERIS HIV-1 Assay at multiple EU laboratories. STUDY DESIGN Method comparison with the VERIS HIV-1 Assay was performed with 415 specimens at 5 sites tested with COBAS® AmpliPrep/COBAS® TaqMan® HIV-1 Test, v2.0, 169 specimens at 3 sites tested with RealTime HIV-1 Assay, and 202 specimens from 2 sites tested with VERSANT HIV-1 Assay. Patient monitoring sample results from 4 sites were also compared. RESULTS Bland-Altman analysis showed the average bias between VERIS HIV-1 Assay and COBAS HIV-1 Test, RealTime HIV-1 Assay, and VERSANT HIV-1 Assay to be 0.28, 0.39, and 0.61 log10 cp/mL, respectively. Bias at low end levels below 1000cp/mL showed predicted bias to be <0.3 log10 cp/mL for VERIS HIV-1 Assay versus COBAS HIV-1 Test and RealTime HIV-1 Assay, and <0.5 log10cp/mL versus VERSANT HIV-1 Assay. Analysis on 174 specimens tested with the 0.175mL volume VERIS HIV-1 Assay and COBAS HIV-1 Test showed average bias of 0.39 log10cp/mL. Patient monitoring results using VERIS HIV-1 Assay demonstrated similar viral load trends over time to all comparators. CONCLUSIONS The VERIS HIV-1 Assay for use on the DxN VERIS System demonstrated comparable clinical performance to COBAS® HIV-1 Test, RealTime HIV-1 Assay, and VERSANT HIV-1 Assay.
Collapse
Affiliation(s)
- Patrick Braun
- Laboratory Dr. Knechten, Medical Center for HIV and Hepatitis, Aachen, Germany
| | - Rafael Delgado
- Microbiology Department, Hospital Universitario 12 de Octubre and Insituto de Investigation, Hospital 12 de Octubre (i+12) Madrid, Spain
| | - Monica Drago
- Clinical Chemistry and Microbiology Laboratories, Niguarda Ca' Granda Hospital, Milan, Italy
| | - Diana Fanti
- Clinical Chemistry and Microbiology Laboratories, Niguarda Ca' Granda Hospital, Milan, Italy
| | - Hervé Fleury
- Virology Department, Hôpital Pellegrin, CHU, Bordeaux, France
| | - Jörg Hofmann
- Virology Department, Labor Berlin - Charité Vivantes GmbH, Berlin, Germany
| | - Jacques Izopet
- Department of Virology, Federative Institute of Biology, CHU, Toulouse, France
| | - Sebastian Kühn
- Virology Department, Labor Berlin - Charité Vivantes GmbH, Berlin, Germany
| | - Alessandra Lombardi
- Clinical Microbiology, Virology and Bioemergence Diagnosis, L. Sacco University Hospital, Milan, Italy
| | - Alessandro Mancon
- Clinical Microbiology, Virology and Bioemergence Diagnosis, L. Sacco University Hospital, Milan, Italy
| | - Mª Angeles Marcos
- Department of Clinical Microbiology, Hospital Clinic, School of Medicine, University of Barcelona, Centre for International Health Research (CRESIB), Barcelona, Spain
| | - Davide Mileto
- Virology Department, Labor Berlin - Charité Vivantes GmbH, Berlin, Germany
| | - Karine Sauné
- Department of Virology, Federative Institute of Biology, CHU, Toulouse, France
| | - Siobhan O'Shea
- Viapath Analytics, Infection Sciences, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom
| | - Alfredo Pérez-Rivilla
- Microbiology Department, Hospital Universitario 12 de Octubre and Insituto de Investigation, Hospital 12 de Octubre (i+12) Madrid, Spain
| | - John Ramble
- Viapath Analytics, Infection Sciences, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom
| | | | - Jordi Vila
- Department of Clinical Microbiology, Hospital Clinic, School of Medicine, University of Barcelona, Centre for International Health Research (CRESIB), Barcelona, Spain
| | - Duncan Whittaker
- Laboratory Medicine Building, North Lane, Northern General Hospital, Sheffield, United Kingdom
| | - Alain Artus
- Beckman Coulter, Immunotech, 130 Ave Lattre de Tassigny, Marseille 13009, France
| | - Daniel Rhodes
- Beckman Coulter, Immunotech, 130 Ave Lattre de Tassigny, Marseille 13009, France.
| |
Collapse
|
5
|
Gupta RK, Ramble J, Tong CYW, Whittaker S, MacMahon E. Cytomegalovirus seroprevalence is not higher in patients with mycosis fungoides/Sezary syndrome. Blood 2006; 107:1241-2. [PMID: 16434498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
|