Laboratory evaluation of SARS-CoV-2 in the COVID-19 pandemic

SARS-CoV-2 serological findings and exposure risk among employees in school and retail after first and second wave COVID-19 pandemic in Oslo, Norway: a cohort study

OBJECTIVES

The objective was to characterize and compare SARS-CoV-2 serology among Norwegian school employees and retail employees, and describe preventive measures taken at the workplaces.

MATERIAL AND METHODS

A cohort of 238 school and retail employees was enrolled to an ambidirectional cohort study after the first COVID-19 pandemic wave. Self-reported exposure history and serum samples were collected at 10 schools and 15 retail stores in Oslo, Norway, sampled at 2 time-points: baseline (May-July 2020); and follow-up (January-March 2021). SARS-CoV-2 antibodies targeting both spike and nucleocapsid were detected by multiplex microsphere-based serological methods.

RESULTS

At baseline, 6 enrolled workers (5 in retail) presented with positive SARS-CoV-2 serology, higher than the expected 1% prevalence (3%, 95% CI: 1-6, p = 0.019). At followup, school and retail groups presented 11 new seropositive cases altogether, but groups were not significantly different, although exposure and preventive measures against viral transmission at workplaces were different between groups. Self-reported medical history of COVID-19 infection showed that all but one positive SARS-CoV-2 serological findings arising between baseline and follow-up had been diagnosed with virus testing.

CONCLUSIONS

Distribution of SARS-CoV-2 positive serology after the first wave was slightly higher than expected. Distribution of infection was not significantly different between the groups at baseline nor at follow-up, despite difference in exposure and protective measures. Nearly all new seropositive cases discovered between baseline and follow-up, had already been diagnosed, highlighting the importance of extensive viral testing among workers. Int J Occup Med Environ Health. 2022;35(5):537-47.

Evaluation of the Clinical Performance of 7 Serological Assays for SARS-CoV-2 for Use in Clinical Laboratories

Background

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serological assays have emerged as a response to the global pandemic, warranting studies evaluating their clinical performance. This study investigated seven commercially available SARS-CoV-2 serological assays in samples from non-infected individuals and hospitalized patients.

Methods

SARS-CoV-2 qualitative serological assays by Abbott (IgG), Beckman (IgG), DiaSorin (IgG), EUROIMMUN (IgG and IgA), Roche and Bio-Rad (Total) were evaluated using specimens collected pre-December 2019 (n=393), from nucleic acid amplification testing (NAAT) negative patients (n=40), and from 53 patients with COVID-19 by NAAT collected 3-21 days post-onset of symptoms (POS) (N=83). Negative agreement (NA), positive agreement (PA), and positive and negative predictive values (PPV and NPV) at prevalences of 5% and 10% were calculated.

Results

The overall %NA;95% CI in the negative samples were: Roche 99.8%; 99.3-100.2, Beckman 99.8%; 98.7-100.0, Abbott and Bio-Rad 99.3%; 98.0-99.9, DiaSorin 98.4; 97.2-99.6, EUROIMMUN IgG 97.5%; 95.5-98.7, and EUROIMMUN IgA 79.7%; 75.9-83.5), accounting for positive/equivocal results as false positives. The %PA; 95% CI in samples collected 14+days POS (n=24) were: Bio-Rad 83.3%; 68.4-98.2, Abbott and Roche 79.2%; 62.9-95.4, EUROIMMUN IgA 70.8%; 52.6-89.0, Beckman 58.3%; 38.6-78.1, DiaSorin 54.2; 34.2-74.1, and EUROIMMUN IgG 50.0%; 30.0-70.0, accounting for negative/equivocal results as false negatives. NPVs ranged from 97.4-98.9% and 94.7-97.7% for prevalences 5% and 10%, respectively. PPVs ranged from 15.5-94.8% and 27.9-97.4% for prevalences 5% and 10%, respectively.

Conclusions

The Roche and Beckman assays resulted in fewer false positives followed by the Bio-Rad and Abbott assays. While the Bio-Rad assay demonstrated higher antibody detection in COVID-19-positive patients, PA claims cannot be established with a high level of confidence in our sample population.