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Sumner KM, Yadav R, Noble EK, Sandford R, Joshi D, Tartof SY, Wernli KJ, Martin ET, Gaglani M, Zimmerman RK, Talbot HK, Grijalva CG, Belongia EA, Chung JR, Rogier E, Coughlin MM, Flannery B. Anti-SARS-CoV-2 Antibody Levels Associated With COVID-19 Protection in Outpatients Tested for SARS-CoV-2, US Flu Vaccine Effectiveness Network, October 2021-June 2022. J Infect Dis 2024; 230:45-54. [PMID: 39052724 PMCID: PMC11272097 DOI: 10.1093/infdis/jiae090] [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: 09/08/2023] [Revised: 02/14/2024] [Accepted: 02/21/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND We assessed associations between binding antibody (bAb) concentration <5 days from symptom onset and testing positive for COVID-19 among patients in a test-negative study. METHODS From October 2021 to June 2022, study sites in 7 states enrolled patients aged ≥6 months presenting with acute respiratory illness. Respiratory specimens were tested for SARS-CoV-2. In blood specimens, we measured concentrations of anti-SARS-CoV-2 antibodies against the spike protein receptor binding domain (RBD) and nucleocapsid antigens from the ancestral strain in standardized bAb units (BAU). Percentage change in odds of COVID-19 by increasing anti-RBD bAb was estimated via logistic regression as (1 - adjusted odds ratio of COVID-19) × 100, adjusting for COVID-19 mRNA vaccine doses, age, site, and high-risk exposure. RESULTS Out of 2018 symptomatic patients, 662 (33%) tested positive for acute SARS-CoV-2 infection. Geometric mean RBD bAb levels were lower among COVID-19 cases than SARS-CoV-2 test-negative controls during the Delta-predominant period (112 vs 498 BAU/mL) and Omicron-predominant period (823 vs 1189 BAU/mL). Acute-phase ancestral spike RBD bAb levels associated with 50% lower odds of COVID-19 were 1968 BAU/mL against Delta and 3375 BAU/mL against Omicron; thresholds may differ in other laboratories. CONCLUSIONS During acute illness, antibody concentrations against ancestral spike RBD were associated with protection against COVID-19.
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Affiliation(s)
- Kelsey M Sumner
- US Centers for Disease Control and Prevention, Atlanta, Georgia
- Epidemic Intelligence Service, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ruchi Yadav
- US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Emma K Noble
- US Centers for Disease Control and Prevention, Atlanta, Georgia
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Ryan Sandford
- US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Devyani Joshi
- US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sara Y Tartof
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
| | - Karen J Wernli
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | - Emily T Martin
- School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Manjusha Gaglani
- Baylor Scott & White Health, Temple, Texas
- Baylor College of Medicine–Temple, Temple, Texas
- College of Medicine, Texas A&M University, Temple, Texas
| | | | - H Keipp Talbot
- Vanderbilt University Medical Center, Nashville, Tennessee
| | | | | | - Jessie R Chung
- US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Eric Rogier
- US Centers for Disease Control and Prevention, Atlanta, Georgia
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Lim E, Mehrotra ML, Lamba K, Kamali A, Lai KW, Meza E, Bertsch-Merbach S, Szeto I, Ley C, Martin AB, Parsonnet J, Robinson P, Gebhart D, Fonseca N, Tsai CT, Seftel D, Nicolici A, Melton D, Jain S. CalScope: methodology and lessons learned for conducting a remote statewide SARS-CoV-2 seroprevalence study in California using an at-home dried blood spot collection kit and online survey. BMC Med Res Methodol 2024; 24:120. [PMID: 38802749 PMCID: PMC11131314 DOI: 10.1186/s12874-024-02245-y] [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: 08/30/2023] [Accepted: 05/14/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND To describe the methodology for conducting the CalScope study, a remote, population-based survey launched by the California Department of Public Health (CDPH) to estimate SARS-CoV-2 seroprevalence and understand COVID-19 disease burden in California. METHODS Between April 2021 and August 2022, 666,857 randomly selected households were invited by mail to complete an online survey and at-home test kit for up to one adult and one child. A gift card was given for each completed survey and test kit. Multiple customized REDCap databases were used to create a data system which provided task automation and scalable data management through API integrations. Support infrastructure was developed to manage follow-up for participant questions and a communications plan was used for outreach through local partners. RESULTS Across 3 waves, 32,671 out of 666,857 (4.9%) households registered, 6.3% by phone using an interactive voice response (IVR) system and 95.7% in English. Overall, 25,488 (78.0%) households completed surveys, while 23,396 (71.6%) households returned blood samples for testing. Support requests (n = 5,807) received through the web-based form (36.3%), by email (34.1%), and voicemail (29.7%) were mostly concerned with the test kit (31.6%), test result (26.8%), and gift card (21.3%). CONCLUSIONS Ensuring a well-integrated and scalable data system, responsive support infrastructure for participant follow-up, and appropriate academic and local health department partnerships for study management and communication allowed for successful rollout of a large population-based survey. Remote data collection utilizing online surveys and at-home test kits can complement routine surveillance data for a state health department.
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Affiliation(s)
- Esther Lim
- California Department of Public Health, Epidemiology, Surveillance, and Modeling Section, COVID-19 Response, Richmond, CA, USA.
| | - Megha L Mehrotra
- California Department of Public Health, Epidemiology, Surveillance, and Modeling Section, COVID-19 Response, Richmond, CA, USA
| | - Katherine Lamba
- California Department of Public Health, Epidemiology, Surveillance, and Modeling Section, COVID-19 Response, Richmond, CA, USA
| | - Amanda Kamali
- California Department of Public Health, Epidemiology, Surveillance, and Modeling Section, COVID-19 Response, Richmond, CA, USA
| | - Kristina W Lai
- California Department of Public Health, Epidemiology, Surveillance, and Modeling Section, COVID-19 Response, Richmond, CA, USA
| | - Erika Meza
- California Department of Public Health, Epidemiology, Surveillance, and Modeling Section, COVID-19 Response, Richmond, CA, USA
| | - Stephanie Bertsch-Merbach
- California Department of Public Health, Epidemiology, Surveillance, and Modeling Section, COVID-19 Response, Richmond, CA, USA
| | - Irvin Szeto
- Research IT, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Catherine Ley
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Andrew B Martin
- Research IT, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Julie Parsonnet
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | | | | | | | | | - David Seftel
- Enable Biosciences, South San Francisco, CA, USA
| | - Allyx Nicolici
- California Department of Public Health, Epidemiology, Surveillance, and Modeling Section, COVID-19 Response, Richmond, CA, USA
| | - David Melton
- California Department of Public Health, Epidemiology, Surveillance, and Modeling Section, COVID-19 Response, Richmond, CA, USA
| | - Seema Jain
- California Department of Public Health, Epidemiology, Surveillance, and Modeling Section, COVID-19 Response, Richmond, CA, USA
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3
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Vloemans D, Van Hileghem L, Ordutowski H, Dal Dosso F, Spasic D, Lammertyn J. Self-Powered Microfluidics for Point-of-Care Solutions: From Sampling to Detection of Proteins and Nucleic Acids. Methods Mol Biol 2024; 2804:3-50. [PMID: 38753138 DOI: 10.1007/978-1-0716-3850-7_1] [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] [Indexed: 05/21/2024]
Abstract
Self-powered microfluidics presents a revolutionary approach to address the challenges of healthcare in decentralized and point-of-care settings where limited access to resources and infrastructure prevails or rapid clinical decision-making is critical. These microfluidic systems exploit physical and chemical phenomena, such as capillary forces and surface tension, to manipulate tiny volumes of fluids without the need for external power sources, making them cost-effective and highly portable. Recent technological advancements have demonstrated the ability to preprogram complex multistep liquid operations within the microfluidic circuit of these standalone systems, which enabled the integration of sensitive detection and readout principles. This chapter first addresses how the accessibility to in vitro diagnostics can be improved by shifting toward decentralized approaches like remote microsampling and point-of-care testing. Next, the crucial role of self-powered microfluidic technologies to enable this patient-centric healthcare transition is emphasized using various state-of-the-art examples, with a primary focus on applications related to biofluid collection and the detection of either proteins or nucleic acids. This chapter concludes with a summary of the main findings and our vision of the future perspectives in the field of self-powered microfluidic technologies and their use for in vitro diagnostics applications.
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Affiliation(s)
- Dries Vloemans
- Department of Biosystems - Biosensors Group, KU Leuven, Leuven, Belgium
| | | | - Henry Ordutowski
- Department of Biosystems - Biosensors Group, KU Leuven, Leuven, Belgium
| | | | - Dragana Spasic
- Department of Biosystems - Biosensors Group, KU Leuven, Leuven, Belgium
| | - Jeroen Lammertyn
- Department of Biosystems - Biosensors Group, KU Leuven, Leuven, Belgium.
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Alexander L, Yang C, Hugo H, Maria H, Stefan J, Åke L, Martin S, Staffan T, Cheng-Ting T, Jeanette W, Johan J. Anxiety, Depression and Quality of Life in Relation to SARS-CoV-2 Antibodies in Individuals Living with Diabetes During the Second Wave of COVID-19. DIABETES EPIDEMIOLOGY AND MANAGEMENT 2024; 13:100194. [PMID: 38463606 PMCID: PMC10923605 DOI: 10.1016/j.deman.2023.100194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Aims The objective was to compare anxiety, depression, and quality of life (QoL) in individuals living with type 1 (T1D) and type 2 (T2D) diabetes with matched controls during the second wave of the COVID-19 pandemic. Methods Via randomization, individuals living with diabetes T1D (n= 203) and T2D (n=413), were identified during February-July 2021 through health-care registers. Population controls (n=282) were matched for age, gender, and residential area. Questionnaires included self-assessment of anxiety, depression, QoL, and demographics in relation to SARS-CoV-2 exposure.Blood was collected through home-capillary sampling, and SARS-CoV-2 Nucleocapsid (NCP) and Spike antibodies (SC2_S1) were determined by multiplex Antibody Detection by Agglutination-PCR (ADAP) assays. Results Younger age and health issues were related to anxiety, depression, and QoL, with no differences between the study groups. Female gender was associated with anxiety, while obesity was associated with lower QoL.The SARS-CoV-2 NCP seroprevalence was higher in T1D (8.9%) compared to T2D (3.9%) and controls (4.0%), while the SARS-CoV-2 SC2_S1 seroprevalence was higher for controls (25.5%) compared to T1D (16.8%) and T2D (14.0%). Conclusions A higher SARS-CoV-2 infection rate in T1D may be explained by younger age and higher employment rate, and the associated increased risk for viral exposure.
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Affiliation(s)
- Lind Alexander
- Department of Clinical Sciences Malmö, Lund University, Sweden
| | - Cao Yang
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Hesser Hugo
- School of Behavioural, Social and Legal Sciences, Center for Health and Medical Psychology, Örebro University, Sweden
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Hårdstedt Maria
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Sweden
- Center for Clinical Research Dalarna, Uppsala University, Falun, Sweden
- Vansbro Primary Health Care Center, Vansbro, Sweden
| | - Jansson Stefan
- School of Medical Sciences, University Health Care Research Centre, Örebro University, Örebro, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Lernmark Åke
- Department of Clinical Sciences Malmö, Lund University, Sweden
| | - Sundqvist Martin
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Sweden
| | - Tevell Staffan
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Sweden
- Department of Infectious Diseases, Karlstad Hospital and Centre for Clinical Research and Education, Region Värmland, Karlstad, Sweden
| | | | - Wahlberg Jeanette
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Sweden
| | - Jendle Johan
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Sweden
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Stern D, Meyer TC, Treindl F, Mages HW, Krüger M, Skiba M, Krüger JP, Zobel CM, Schreiner M, Grossegesse M, Rinner T, Peine C, Stoliaroff-Pépin A, Harder T, Hofmann N, Michel J, Nitsche A, Stahlberg S, Kneuer A, Sandoni A, Kubisch U, Schlaud M, Mankertz A, Schwarz T, Corman VM, Müller MA, Drosten C, de la Rosa K, Schaade L, Dorner MB, Dorner BG. A bead-based multiplex assay covering all coronaviruses pathogenic for humans for sensitive and specific surveillance of SARS-CoV-2 humoral immunity. Sci Rep 2023; 13:21846. [PMID: 38071261 PMCID: PMC10710470 DOI: 10.1038/s41598-023-48581-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/28/2023] [Indexed: 12/18/2023] Open
Abstract
Serological assays measuring antibodies against SARS-CoV-2 are key to describe the epidemiology, pathobiology or induction of immunity after infection or vaccination. Of those, multiplex assays targeting multiple antigens are especially helpful as closely related coronaviruses or other antigens can be analysed simultaneously from small sample volumes, hereby shedding light on patterns in the immune response that would otherwise remain undetected. We established a bead-based 17-plex assay detecting antibodies targeting antigens from all coronaviruses pathogenic for humans: SARS-CoV-2, SARS-CoV, MERS-CoV, HCoV strains 229E, OC43, HKU1, and NL63. The assay was validated against five commercial serological immunoassays, a commercial surrogate virus neutralisation test, and a virus neutralisation assay, all targeting SARS-CoV-2. It was found to be highly versatile as shown by antibody detection from both serum and dried blot spots and as shown in three case studies. First, we followed seroconversion for all four endemic HCoV strains and SARS-CoV-2 in an outbreak study in day-care centres for children. Second, we were able to link a more severe clinical course to a stronger IgG response with this 17-plex-assay, which was IgG1 and IgG3 dominated. Finally, our assay was able to discriminate recent from previous SARS-CoV-2 infections by calculating the IgG/IgM ratio on the N antigen targeting antibodies. In conclusion, due to the comprehensive method comparison, thorough validation, and the proven versatility, our multiplex assay is a valuable tool for studies on coronavirus serology.
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Affiliation(s)
- Daniel Stern
- Biological Toxins (ZBS 3), Centre for Biological Threats and Special Pathogens, Robert Koch Institute, 13353, Berlin, Germany.
| | - Tanja C Meyer
- Biological Toxins (ZBS 3), Centre for Biological Threats and Special Pathogens, Robert Koch Institute, 13353, Berlin, Germany
| | - Fridolin Treindl
- Biological Toxins (ZBS 3), Centre for Biological Threats and Special Pathogens, Robert Koch Institute, 13353, Berlin, Germany
| | - Hans Werner Mages
- Biological Toxins (ZBS 3), Centre for Biological Threats and Special Pathogens, Robert Koch Institute, 13353, Berlin, Germany
| | - Maren Krüger
- Biological Toxins (ZBS 3), Centre for Biological Threats and Special Pathogens, Robert Koch Institute, 13353, Berlin, Germany
| | - Martin Skiba
- Biological Toxins (ZBS 3), Centre for Biological Threats and Special Pathogens, Robert Koch Institute, 13353, Berlin, Germany
| | - Jan Philipp Krüger
- Department of Microbiology and Hospital Hygiene, Bundeswehr Hospital Berlin, Berlin, Germany
| | - Christian M Zobel
- Department of Internal Medicine, Bundeswehr Hospital Berlin, Berlin, Germany
| | | | - Marica Grossegesse
- Highly Pathogenic Viruses (ZBS 1), Centre for Biological Threats and Special Pathogens, Robert Koch Institute, 13353, Berlin, Germany
| | - Thomas Rinner
- Highly Pathogenic Viruses (ZBS 1), Centre for Biological Threats and Special Pathogens, Robert Koch Institute, 13353, Berlin, Germany
| | - Caroline Peine
- Immunization Unit (FG 33), Department for Infectious Disease Epidemiology, Robert Koch Institute, 13353, Berlin, Germany
| | - Anna Stoliaroff-Pépin
- Immunization Unit (FG 33), Department for Infectious Disease Epidemiology, Robert Koch Institute, 13353, Berlin, Germany
| | - Thomas Harder
- Immunization Unit (FG 33), Department for Infectious Disease Epidemiology, Robert Koch Institute, 13353, Berlin, Germany
| | - Natalie Hofmann
- Highly Pathogenic Viruses (ZBS 1), Centre for Biological Threats and Special Pathogens, Robert Koch Institute, 13353, Berlin, Germany
| | - Janine Michel
- Highly Pathogenic Viruses (ZBS 1), Centre for Biological Threats and Special Pathogens, Robert Koch Institute, 13353, Berlin, Germany
| | - Andreas Nitsche
- Highly Pathogenic Viruses (ZBS 1), Centre for Biological Threats and Special Pathogens, Robert Koch Institute, 13353, Berlin, Germany
| | - Silke Stahlberg
- Central Epidemiological Laboratory (FG 22), Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101, Berlin, Germany
| | - Antje Kneuer
- Central Epidemiological Laboratory (FG 22), Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101, Berlin, Germany
| | - Anna Sandoni
- Central Epidemiological Laboratory (FG 22), Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101, Berlin, Germany
| | - Ulrike Kubisch
- Central Epidemiological Laboratory (FG 22), Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101, Berlin, Germany
| | - Martin Schlaud
- Central Epidemiological Laboratory (FG 22), Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101, Berlin, Germany
| | - Annette Mankertz
- Measles, Mumps, Rubella, and Viruses Affecting Immunocompromised Patients (FG 12), Robert Koch Institute, 13353, Berlin, Germany
| | - Tatjana Schwarz
- Institute of Virology, Charité-Universitätsmedizin Berlin, 10117, Berlin, Germany
| | - Victor M Corman
- Institute of Virology, Charité-Universitätsmedizin Berlin, 10117, Berlin, Germany
- Corporate Member, Freie Universität Berlin, 10117, Berlin, Germany
- Corporate Member, Humboldt-Universität zu Berlin, 14195, Berlin, Germany
| | - Marcel A Müller
- Institute of Virology, Charité-Universitätsmedizin Berlin, 10117, Berlin, Germany
| | - Christian Drosten
- Institute of Virology, Charité-Universitätsmedizin Berlin, 10117, Berlin, Germany
| | - Kathrin de la Rosa
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), 13125, Berlin, Germany
- Berlin Institute of Health (BIH), Charité-Universitätsmedizin Berlin, 10117, Berlin, Germany
| | - Lars Schaade
- Centre for Biological Threats and Special Pathogens, Robert Koch Institute, 13353, Berlin, Germany
| | - Martin B Dorner
- Biological Toxins (ZBS 3), Centre for Biological Threats and Special Pathogens, Robert Koch Institute, 13353, Berlin, Germany
| | - Brigitte G Dorner
- Biological Toxins (ZBS 3), Centre for Biological Threats and Special Pathogens, Robert Koch Institute, 13353, Berlin, Germany.
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Keskin BB, Liu SF, Du PX, Tsai PS, Ho TS, Su WY, Lin PC, Shih HC, Weng KP, Yang KD, Huang YH, Kuo KC, Syu GD, Kuo HC. Profiling humoral responses to COVID-19 immunization in Kawasaki disease using SARS-CoV-2 variant protein microarrays. Analyst 2023; 148:4698-4709. [PMID: 37610260 DOI: 10.1039/d3an00802a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
Kawasaki disease (KD) is a form of acute systemic vasculitis syndrome that predominantly occurs in children under the age of 5 years. Its etiology has been postulated due to not only genetic factors but also the presence of foreign antigens or infectious agents. To evaluate possible associations between Kawasaki disease (KD) and COVID-19, we investigated humoral responses of KD patients against S-protein variants with SARS-CoV-2 variant protein microarrays. In this study, plasma from a cohort of KD (N = 90) and non-KD control (non-KD) (N = 69) subjects in categories of unvaccinated-uninfected (pre-pandemic), SARS-CoV-2 infected (10-100 days after infection), and 1-dose, 2-dose, and 3-dose BNT162b2 vaccinated (10-100 days after vaccination) was collected. The principal outcomes were non-KD-KD differences for each category in terms of anti-human/anti-His for binding antibodies and neutralizing percentage for surrogate neutralizing antibodies. Binding antibodies against spikes were lower in the KD subjects with 1-dose of BNT162b2, and mean differences were significant for the P.1 S-protein (non-KD-KD, 3401; 95% CI, 289.0 to 6512; P = 0.0252), B.1.617.2 S-protein (non-KD-KD, 4652; 95% CI, 215.8 to 9087; P = 0.0351) and B.1.617.3 S-protein (non-KD-KD, 4874; 95% CI, 31.41 to 9716; P = 0.0477). Neutralizing antibodies against spikes were higher in the KD subjects with 1-dose of BNT162b2, and mean percentage differences were significant for the 1-dose BNT162b2 B.1.617.3 S-protein (non-KD-KD, -22.89%; 95% CI, -45.08 to -0.6965; P = 0.0399), B.1.1.529 S-protein (non-KD-KD, -25.96%; 95% CI, -50.53 to -1.376; P = 0.0333), BA.2.12.1 S-protein (non-KD-KD, -27.83%; 95% CI, -52.55 to -3.115; P = 0.0195), BA.4 S-protein (non-KD-KD, -28.47%; 95% CI, -53.59 to -3.342; P = 0.0184), and BA.5 S-protein (non-KD-KD, -30.42%; 95% CI, -54.98 to -5.869; P = 0.0077). In conclusion, we have found that KD patients have a comparable immunization response to healthy individuals to SARS-CoV-2 infection and COVID-19 immunization.
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Affiliation(s)
- Batuhan Birol Keskin
- Department of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Room 89A07, No. 1, University Road, Tainan 701, Taiwan.
| | - Shih-Feng Liu
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
- Department of Respiratory Therapy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Pin-Xian Du
- Department of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Room 89A07, No. 1, University Road, Tainan 701, Taiwan.
| | - Pei-Shan Tsai
- Department of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Room 89A07, No. 1, University Road, Tainan 701, Taiwan.
| | - Tzong-Shiann Ho
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan, Republic of China
- Center of Infectious Disease and Signaling Research, National Cheng Kung University, Tainan 701, Taiwan, Republic of China
- Department of Pediatrics, Tainan Hospital, Ministry of Health and Welfare, Tainan 700, Taiwan, Republic of China
| | - Wen-Yu Su
- Department of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Room 89A07, No. 1, University Road, Tainan 701, Taiwan.
| | - Pei-Chun Lin
- Department of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Room 89A07, No. 1, University Road, Tainan 701, Taiwan.
| | - Hsi-Chang Shih
- Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Ken-Pen Weng
- Congenital Structural Heart Disease Center, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
| | | | - Ying-Hsien Huang
- Kawasaki Disease Center and Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan.
| | - Kuang-Che Kuo
- Kawasaki Disease Center and Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan.
| | - Guan-Da Syu
- Department of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Room 89A07, No. 1, University Road, Tainan 701, Taiwan.
- International Center for Wound Repair and Regeneration, National Cheng Kung University, Tainan 701, Taiwan
- Medical Device Innovation Center, National Cheng Kung University, Tainan 701, Taiwan
| | - Ho-Chang Kuo
- Department of Respiratory Therapy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Kawasaki Disease Center and Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan.
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7
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Sumner KM, Yadav R, Noble EK, Sandford R, Joshi D, Tartof SY, Wernli KJ, Martin ET, Gaglani M, Zimmerman RK, Talbot HK, Grijalva CG, Chung JR, Rogier E, Coughlin MM, Flannery B. Anti-SARS-CoV-2 Antibody Levels Associated with COVID-19 Protection in Outpatients Tested for SARS-CoV-2, US Flu VE Network, October 2021-June 2022. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.09.21.23295919. [PMID: 37790578 PMCID: PMC10543239 DOI: 10.1101/2023.09.21.23295919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Background We assessed the association between antibody concentration ≤5 days of symptom onset and COVID-19 illness among patients enrolled in a test-negative study. Methods From October 2021-June 2022, study sites in seven states enrolled and tested respiratory specimens from patients of all ages presenting with acute respiratory illness for SARS-CoV-2 infection using rRT-PCR. In blood specimens, we measured concentration of anti-SARS-CoV-2 antibodies against the ancestral strain spike protein receptor binding domain (RBD) and nucleocapsid (N) antigens in standardized binding antibody units (BAU/mL). Percent reduction in odds of symptomatic COVID-19 by anti-RBD antibody was estimated using logistic regression modeled as (1-adjusted odds ratio of COVID-19)×100, adjusting for COVID-19 vaccination status, age, site, and high-risk exposure. Results A total of 662 (33%) of 2,018 symptomatic patients tested positive for acute SARS-CoV-2 infection. During the Omicron-predominant period, geometric mean anti-RBD binding antibody concentrations measured 823 BAU/mL (95%CI:690-981) among COVID-19 case-patients versus 1,189 BAU/mL (95%CI:1,050-1,347) among SARS-CoV-2 test-negative patients. In the adjusted logistic regression, increasing levels of anti-RBD antibodies were associated with reduced odds of COVID-19 for both Delta and Omicron infections. Conclusion Higher anti-RBD antibodies in patients were associated with protection against symptomatic COVID-19 during emergence of SARS-CoV-2 Delta and Omicron variants.
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Affiliation(s)
- Kelsey M. Sumner
- Centers for Disease Control and Prevention, Atlanta, GA, USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ruchi Yadav
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Emma K. Noble
- Centers for Disease Control and Prevention, Atlanta, GA, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA
| | - Ryan Sandford
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Devyani Joshi
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sara Y. Tartof
- Kaiser Permanente Southern California, Department of Research & Evaluation
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
| | - Karen J. Wernli
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Emily T Martin
- University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Manjusha Gaglani
- Baylor Scott & White Health, Temple, TX, USA
- Texas A&M University College of Medicine, Temple, TX, USA
| | | | | | | | - Jessie R. Chung
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Eric Rogier
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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8
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Roper KJ, Thomas J, Albalawi W, Maddocks E, Dobson S, Alshehri A, Barone FG, Baltazar M, Semple MG, Ho A, Turtle L, Paxton WA, Pollakis G. Quantifying neutralising antibody responses against SARS-CoV-2 in dried blood spots (DBS) and paired sera. Sci Rep 2023; 13:15014. [PMID: 37697014 PMCID: PMC10495436 DOI: 10.1038/s41598-023-41928-2] [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: 04/13/2023] [Accepted: 09/04/2023] [Indexed: 09/13/2023] Open
Abstract
The ongoing SARS-CoV-2 pandemic was initially managed by non-pharmaceutical interventions such as diagnostic testing, isolation of positive cases, physical distancing and lockdowns. The advent of vaccines has provided crucial protection against SARS-CoV-2. Neutralising antibody (nAb) responses are a key correlate of protection, and therefore measuring nAb responses is essential for monitoring vaccine efficacy. Fingerstick dried blood spots (DBS) are ideal for use in large-scale sero-surveillance because they are inexpensive, offer the option of self-collection and can be transported and stored at ambient temperatures. Such advantages also make DBS appealing to use in resource-limited settings and in potential future pandemics. In this study, nAb responses in sera, venous blood and fingerstick blood stored on filter paper were measured. Samples were collected from SARS-CoV-2 acutely infected individuals, SARS-CoV-2 convalescent individuals and SARS-CoV-2 vaccinated individuals. Good agreement was observed between the nAb responses measured in eluted DBS and paired sera. Stability of nAb responses was also observed in sera stored on filter paper at room temperature for 28 days. Overall, this study provides support for the use of filter paper as a viable sample collection method to study nAb responses.
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Affiliation(s)
- Kelly J Roper
- Department of Clinical Infection, Microbiology and Immunology (CIMI), Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, Liverpool, L69 7BE, UK
- Faculty of Health and Life Sciences, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Jordan Thomas
- Department of Clinical Infection, Microbiology and Immunology (CIMI), Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, Liverpool, L69 7BE, UK
- Faculty of Health and Life Sciences, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Wejdan Albalawi
- Department of Clinical Infection, Microbiology and Immunology (CIMI), Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, Liverpool, L69 7BE, UK
- Faculty of Health and Life Sciences, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Emily Maddocks
- Department of Clinical Infection, Microbiology and Immunology (CIMI), Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, Liverpool, L69 7BE, UK
- Faculty of Health and Life Sciences, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Susan Dobson
- Department of Clinical Infection, Microbiology and Immunology (CIMI), Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, Liverpool, L69 7BE, UK
- Faculty of Health and Life Sciences, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Abdullateef Alshehri
- Department of Clinical Infection, Microbiology and Immunology (CIMI), Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, Liverpool, L69 7BE, UK
- Faculty of Health and Life Sciences, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Francesco G Barone
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology (ISMIB), University of Liverpool, Liverpool, L69 3BX, UK
| | - Murielle Baltazar
- Department of Clinical Infection, Microbiology and Immunology (CIMI), Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, Liverpool, L69 7BE, UK
- Faculty of Health and Life Sciences, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Malcolm G Semple
- Department of Clinical Infection, Microbiology and Immunology (CIMI), Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, Liverpool, L69 7BE, UK
- Faculty of Health and Life Sciences, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
- Respiratory Medicine, Alder Hey Children's Hospital, Institute in The Park, University of Liverpool, Liverpool, UK
| | - Antonia Ho
- MRC-University of Glasgow Centre for Virus Research, 464 Bearsden Road, Glasgow, G61 1QH, UK
| | - Lance Turtle
- Department of Clinical Infection, Microbiology and Immunology (CIMI), Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, Liverpool, L69 7BE, UK
- Faculty of Health and Life Sciences, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - William A Paxton
- Department of Clinical Infection, Microbiology and Immunology (CIMI), Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, Liverpool, L69 7BE, UK
- Faculty of Health and Life Sciences, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Liverpool, UK
| | - Georgios Pollakis
- Department of Clinical Infection, Microbiology and Immunology (CIMI), Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, Liverpool, L69 7BE, UK.
- Faculty of Health and Life Sciences, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK.
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Liverpool, UK.
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9
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Sciortino S, Graham S, Fillman T, Kandasamy H, Cooley R, Hanson C, Eckert V, Tang H, Yang J, Seftel D, Tsai CT, Robinson P. Shadow of a Pandemic: Persistence of Prenatal SARS-CoV-2 Antibodies in Newborn Blood Spots. Int J Neonatal Screen 2023; 9:43. [PMID: 37606480 PMCID: PMC10443380 DOI: 10.3390/ijns9030043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 07/25/2023] [Accepted: 07/31/2023] [Indexed: 08/23/2023] Open
Abstract
To investigate COVID-19 surveillance among pregnant women, the California Genetic Disease Screening Program conducted a screening performance and seroprevalence evaluation of maternal SARS-CoV-2 antibodies detected in banked newborn dried blood spots (DBS). We obtained seropositive results for 2890 newborn DBS from cohorts in 2020 and 2021 using Enable Bioscience's Antibody Detection by Agglutination-PCR (ADAP) assay for SARS-CoV-2 antibodies. To infer maternal infection, we linked 312 women with a known laboratory-confirmed COVID-19 episode with their newborn's DBS SARS-CoV02 antibody result. Among 2890 newborns, we detected 453 (15.7%) with SARS-CoV-2 antibodies in their DBS. Monthly snapshot statewide seroprevalence among neonates was 12.2% (95% CI 10.3-14.1%, n =1156) in December 2020 and 33.3% (95% CI 29.1-37.4%, n = 26) in March 2021. The longest time recorded from COVID-19 infection to a seropositive neonatal result was 11.7 months among the 312 mothers who had an available SARS-CoV-2 PCR test result. Approximately 94% (153/163) of DBS were seropositive when a known maternal infection occurred earlier than 19 days before birth. The estimated relative sensitivity of DBS to identify prevalent maternal infection was 85.1%, specificity 98.5% and PPV 99.2% (n = 312); the sensitivity was lowest during the December 2021 surge when many infections occurred within 19 days of birth. Fifty pre-pandemic specimens (100% seronegative) and 23 twin-pair results (100% concordant) support an intrinsic specificity and PPV of ADAP approaching 100%. Maternal infection surveillance is limited by a time lag prior to delivery, especially during pandemic surges.
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Affiliation(s)
- Stanley Sciortino
- Genetic Disease Screening Program, California Department of Public Health, Richmond, CA 94804, USA (H.K.)
| | - Steve Graham
- Genetic Disease Screening Program, California Department of Public Health, Richmond, CA 94804, USA (H.K.)
| | - Toki Fillman
- Genetic Disease Screening Program, California Department of Public Health, Richmond, CA 94804, USA (H.K.)
| | - Hari Kandasamy
- Genetic Disease Screening Program, California Department of Public Health, Richmond, CA 94804, USA (H.K.)
| | - Robin Cooley
- Genetic Disease Screening Program, California Department of Public Health, Richmond, CA 94804, USA (H.K.)
| | - Carl Hanson
- Viral and Rickettsial Disease Laboratory, California Department of Public Health, Richmond, CA 94804, USA
| | - Valorie Eckert
- Genetic Disease Screening Program, California Department of Public Health, Richmond, CA 94804, USA (H.K.)
| | - Hao Tang
- Genetic Disease Screening Program, California Department of Public Health, Richmond, CA 94804, USA (H.K.)
| | - Juan Yang
- Genetic Disease Screening Program, California Department of Public Health, Richmond, CA 94804, USA (H.K.)
| | - David Seftel
- Enable Biosciences, South San Francisco, CA 94080, USA
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10
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Guttmann S, Bunte S, Eschrig S, Janzen N, Klemens J, Koenemann Y, Münstermann D, Neisse T, Niedergassel T, Steinhagen K, Meyer-Schlinkmann KM. Dried blood spot eluates are suitable for testing of SARS-CoV-2 IgG antibodies targeting Spike protein 1 and Nucleocapsid protein. Biochem Biophys Rep 2023; 34:101479. [PMID: 37125078 PMCID: PMC10126220 DOI: 10.1016/j.bbrep.2023.101479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 04/24/2023] [Indexed: 05/02/2023] Open
Abstract
Dried blood spots (DBS) provide easy handling and are thus a beneficial tool for data collection, e.g. for epidemiological studies. The suitability of DBS for the assessment of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was analyzed with regards to the use in future studies addressing seroprevalence in the population. 121 volunteers gave a venous blood sample and capillary blood samples on two DBS cards (PerkinElmer and Ahlstrom-Munksjö) via self-sampling under supervision. All samples were analyzed using the Anti-SARS-CoV-2 ELISA (IgG) and the Anti-SARS-CoV-2 NCP ELISA (IgG) from EUROIMMUN performed on the EUROIMMUN EUROLabWorkstation ELISA. Correlation coefficients between ELISA results based on the different sampling methods were calculated. Results of DBS analysis for SARS-CoV-2 IgG S1 and NCP highly correlated with the serum values (r = 0.96). In addition, the calculation of the phi coefficient showed no significant difference between the qualitative results of both sampling methods (rφ = 0.98-1.0). Further analysis of DBS eluates after prolonged storage of 6-8 h also showed a high correlation with serum results (r = 0.97 and r = 0.93, respectively). The study results indicate suitability of DBS for the analysis of antibodies against SARS-CoV-2 S1 and NCP. For DBS eluate, a stability of 6-8 h for measurement of SARS-CoV-2 antibodies can be assumed.
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Affiliation(s)
- Sarah Guttmann
- MVZ Labor Krone GbR, Studienzentrum Immunologie, Bad Salzuflen, Germany
| | | | | | - Nils Janzen
- Screening-Labor Hannover, Hannover, Germany
- Department of Clinical Chemistry, Hannover Medical School, Hannover, Germany
- Division of Laboratory Medicine, Centre for Children and Adolescents, Kinder- und Jugendkrankenhaus Auf der Bult, Hannover, Germany
| | - Julia Klemens
- Insitute for Experimental Immunology, Affiliated to EUROIMMUN Medizinische Labordiagnostika AG, Lübeck, Germany
| | - Yara Koenemann
- Insitute for Experimental Immunology, Affiliated to EUROIMMUN Medizinische Labordiagnostika AG, Lübeck, Germany
| | | | - Thomas Neisse
- MVZ Labor Krone GbR, Studienzentrum Immunologie, Bad Salzuflen, Germany
- Screening-Labor Hannover, Hannover, Germany
| | | | - Katja Steinhagen
- Insitute for Experimental Immunology, Affiliated to EUROIMMUN Medizinische Labordiagnostika AG, Lübeck, Germany
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11
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Schuurmans Stekhoven SJ, Winkel KGT, Souverein D, Sondermeijer BM, van Houten MA, Euser SM, van Lelyveld SFL. Clinical validation of novel dried blood spot based collecting device using serum separation for measuring SARS-CoV-2 antibodies. J Med Virol 2023; 95:e28765. [PMID: 37212273 DOI: 10.1002/jmv.28765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 04/03/2023] [Accepted: 04/09/2023] [Indexed: 05/23/2023]
Abstract
Accurate surveillance of coronavirus disease 2019 (COVID-19) incidence includes large-scale antibody testing of the population. Current testing methods require collection of venous blood samples by a healthcare worker, or dried blood spot (DBS) collection using finger prick, however this might have some logistic and processing limitations. We investigated the performance of the Ser-Col device for detecting severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) antibodies using a finger prick: DBS-like collection system that includes a lateral flow paper for serum separation and allows for automated large scale analysis. For this prospective study, adult patients with moderate to severe COVID-19 were included 6 weeks post-symptom onset. Healthy, adult volunteers were included as a negative control group. Venous blood and capillary blood using the Ser-Col device were collected and the Wantai SARS-CoV-2 total antibody ELISA was performed on all samples. We included 50 subjects in the study population and 49 in the control group. Results obtained with venous blood versus Ser-Col capillary blood showed 100% sensitivity (95% CI: 0.93-1.00) and 100% specificity (95% CI: 0.93-1.00). Our study shows the feasibility of SARS-CoV-2 total antibody screening using a standardized DBS technique with semiautomated processing for large scale analysis.
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Affiliation(s)
| | | | - Dennis Souverein
- Regional Public Health Laboratory Kennemerland, Haarlem, The Netherlands
| | | | | | - Sjoerd M Euser
- Regional Public Health Laboratory Kennemerland, Haarlem, The Netherlands
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12
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A pilot study: Validation of dried blood spots (DBS) to assess SARS-CoV2 IgG antibody immunoassays in underserved minority population. Heliyon 2023; 9:e14729. [PMID: 36974321 PMCID: PMC10029335 DOI: 10.1016/j.heliyon.2023.e14729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 03/14/2023] [Accepted: 03/15/2023] [Indexed: 03/24/2023] Open
Abstract
Underserved, low-income, rural and certain migrant populations have greater risks and higher incidences of Coronavirus disease 2019 (COVID-19) than more privileged populations. Current in-person testing methods have limitations, namely exposure risk, a requirement of accessible transportation to healthcare facilities, and economic barriers. Dried blood spots (DBS) samples are widely used for diagnostics in many infectious diseases including Rabies, HIV, Ebola viruses and newborn screening. Our goal was to determine the accuracy and reliability of measuring COVID-19 IgG in DBS compared to paired plasma samples in a population with known infection status and then apply this method to screen an underserved minority population with high risk for COVID-9 infection (unvaccinated, pregnant, low income, Hispanic women). To optimize the assay, we tested 22 nonpregnant women, 12 with positive prior PCR testing for SARS-CoV2 infection and 10 with negative PCR results. After the assay was optimized, we tested the assay in a vulnerable population with a high risk for infection, who were 52 Hispanic pregnant women without prior PCR testing or vaccination. DBS assay results in both groups showed an agreement of 100% with paired plasma samples. The availability of a DBS assay could enable people who may not have access or transportation to healthcare facilities to use DBS as a COVID-19 testing vehicle.
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13
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Meza E, Cummings KJ, Vergara XP, Lai KW, Lim E, Lamba K, Kamali A, Bibbins-Domingo K, Jain S, Mehrotra ML. Evaluating the association between in-person work and the risk of SARS-CoV-2 infection through June 2021. Am J Ind Med 2023; 66:222-232. [PMID: 36645337 DOI: 10.1002/ajim.23458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 12/09/2022] [Accepted: 12/27/2022] [Indexed: 01/17/2023]
Abstract
OBJECTIVES Recent studies have evaluated COVID-19 outbreaks and excess mortality by occupation sectors. Studies on SARS-CoV-2 infection across occupation and occupation-related factors remain lacking. In this study, we estimate the effect of in-person work on SARS-CoV-2 infection risk and describe SARS-CoV-2 seroprevalence among working adults. METHODS We used Wave 1 data (May to June 2021) from CalScope, a population-based seroprevalence study in California. Occupation data were coded using the National Institute for Occupational Safety and Health Industry and Occupation Computerized Coding System. Dried blood spot specimens were tested for antibodies to establish evidence of prior infection. We estimated the causal effect of in-person work on SARS-CoV-2 infection risk using the g-formula and describe SARS-CoV-2 seroprevalence across occupation-related factors. RESULTS Among 4335 working adults, 53% worked in person. In-person work was associated with increased risk of prior SARS-CoV-2 infection (risk difference: 0.03; [95% CI: 0.02-0.04]) compared with working remotely. Workers that reported job loss or who were without medical insurance had higher evidence of prior infection. Amongst in-person workers, evidence of prior infection was highest within farming, fishing, and forestry (55%; [95% CI: 26%-81%]); installation, maintenance, and repair (23%; [12%-39%]); building and grounds cleaning and maintenance (23%; [13%-36%]); food preparation and serving related (22% [13%-35%]); and healthcare support (22%; [13%-34%]) occupations. Workers who identified as Latino, reported a household income of <$25K, or who were without a bachelor's degree also had higher evidence of prior infection. CONCLUSIONS SARS-CoV-2 infection risk varies by occupation. Future vaccination strategies may consider prioritizing in-person workers.
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Affiliation(s)
- Erika Meza
- California Department of Public Health, Richmond, California, USA.,Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
| | | | - Ximena P Vergara
- California Department of Public Health, Richmond, California, USA.,Heluna Health, City of Industry, California, USA
| | - Kristina W Lai
- California Department of Public Health, Richmond, California, USA
| | - Esther Lim
- California Department of Public Health, Richmond, California, USA
| | - Katherine Lamba
- California Department of Public Health, Richmond, California, USA
| | - Amanda Kamali
- California Department of Public Health, Richmond, California, USA
| | - Kirsten Bibbins-Domingo
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
| | - Seema Jain
- California Department of Public Health, Richmond, California, USA
| | - Megha L Mehrotra
- California Department of Public Health, Richmond, California, USA
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14
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Kuo HC, Kuo KC, Du PX, Keskin BB, Su WY, Ho TS, Tsai PS, Pau CH, Shih HC, Huang YH, Weng KP, Syu GD. Profiling humoral immunity after mixing and matching COVID-19 vaccines using SARS-CoV-2 variant protein microarrays. Mol Cell Proteomics 2023; 22:100507. [PMID: 36787877 PMCID: PMC9922205 DOI: 10.1016/j.mcpro.2023.100507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 02/02/2023] [Accepted: 02/06/2023] [Indexed: 02/16/2023] Open
Abstract
In November 2022, 68% of the population received at least one dose of COVID-19 vaccines. Due to the ongoing mutations, especially for the variants of concern (VOCs), it is important to monitor the humoral immune responses after different vaccination strategies. In this study, we developed a SARS-CoV-2 variant protein microarray that contained the spike proteins from the VOCs, e.g., alpha, beta, gamma, delta, and omicron, to quantify the binding antibody and surrogate neutralizing antibody. Plasmas were collected after two doses of matching AZD1222 (AZx2), two doses of matching mRNA-1273 (Mx2), or mixing AZD1222 and mRNA-1273 (AZ+M). The results showed a significant decrease of surrogate neutralizing antibodies against the receptor-binding domain in all VOCs in AZx2 and Mx2 but not AZ+M. A similar but minor reduction pattern of surrogate neutralizing antibodies against the extracellular domain was observed. While Mx2 exhibited a higher surrogate neutralizing level against all VOCs compared to AZx2, AZ+M showed an even higher surrogate neutralizing level in gamma and omicron compared to Mx2. It is worth noting that the binding antibody displayed a low correlation to the surrogate neutralizing antibody (R-square 0.130-0.382). This study delivers insights into humoral immunities, SARS-CoV-2 mutations, and mixing and matching vaccine strategies, which may provide a more effective vaccine strategy especially in preventing omicron.
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Affiliation(s)
- Ho-Chang Kuo
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan,Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan,College of Medicine, Chang Gung University, Taoyuan, Taiwan 33302
| | - Kuang-Che Kuo
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
| | - Pin-Xian Du
- Department of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Tainan 701, Taiwan
| | - Batuhan Birol Keskin
- Department of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Tainan 701, Taiwan
| | - Wen-Yu Su
- Department of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Tainan 701, Taiwan
| | - Tzong-Shiann Ho
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan R.O.C.,Center of Infectious Disease and Signaling Research, National Cheng Kung University, Tainan 701, Taiwan R.O.C.,Department of Pediatrics, Tainan Hospital, Ministry of Health and Welfare, Tainan 700, Taiwan R.O.C
| | - Pei-Shan Tsai
- Department of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Tainan 701, Taiwan
| | - Chi Ho Pau
- Department of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Tainan 701, Taiwan
| | - Hsi-Chang Shih
- Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Ying-Hsien Huang
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan,Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan,College of Medicine, Chang Gung University, Taoyuan, Taiwan 33302
| | - Ken-Pen Weng
- Congenital Structural Heart Disease Center, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan,School of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
| | - Guan-Da Syu
- Department of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Tainan 701, Taiwan; International Center for Wound Repair and Regeneration, National Cheng Kung University, Tainan 701, Taiwan; Medical Device Innovation Center, National Cheng Kung University, Tainan 701, Taiwan.
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15
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Rong G, Zheng Y, Chen Y, Zhang Y, Zhu P, Sawan M. COVID-19 Diagnostic Methods and Detection Techniques. ENCYCLOPEDIA OF SENSORS AND BIOSENSORS 2023. [PMCID: PMC8409760 DOI: 10.1016/b978-0-12-822548-6.00080-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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16
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Zhao H, Wang M, Muthelo P, Löf L, Sterky F, Gallini R, Kumar NV, Monsen T, Nilsson K, Åberg M, Kamali-Moghaddam M, Mei YF, Landegren U. Detection of SARS-CoV-2 antibodies in serum and dried blood spot samples of vaccinated individuals using a sensitive homogeneous proximity extension assay. N Biotechnol 2022; 72:139-148. [PMID: 36423830 PMCID: PMC9676162 DOI: 10.1016/j.nbt.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 10/26/2022] [Accepted: 11/20/2022] [Indexed: 11/22/2022]
Abstract
A homogeneous PCR-based assay for sensitive and specific detection of antibodies in serum or dried blood spots (DBS) is presented and the method is used to monitor individuals infected with or vaccinated against SARS-CoV-2. Detection probes were prepared by conjugating the recombinant spike protein subunit 1 (S1), containing the receptor binding domain (RBD) of SARS-CoV-2, to each of a pair of specific oligonucleotides. The same was done for the nucleocapsid protein (NP). Upon incubation with serum or DBS samples, the bi- or multivalency of the antibodies (IgG, IgA or IgM) brings pairs of viral proteins with their conjugated oligonucleotides in proximity, allowing the antibodies to be detected by a modified proximity extension assay (PEA). Anti-S1 and anti-NP antibodies could be detected simultaneously from one incubation reaction. This Antibody PEA (AbPEA) test uses only 1 µl of neat or up to 100,000-fold diluted serum or one ø1.2 mm disc cut from a DBS. All 100 investigated sera and 21 DBS collected prior to the COVID-19 outbreak were negative, demonstrating a 100% specificity. The area under the curve, as evaluated by Receiver Operating Characteristic (ROC) analysis reached 0.998 (95%CI: 0.993-1) for samples taken from 11 days after symptoms onset. The kinetics of antibody responses were monitored after a first and second vaccination using serially collected DBS from 14 individuals. AbPEA offers highly specific and sensitive solution-phase antibody detection without requirement for secondary antibodies, no elution step when using DBS sample in a simple procedure that lends itself to multiplex survey of antibody responses.
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Affiliation(s)
- Hongxing Zhao
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Sweden,Unit of Affinity Proteomics Uppsala, Science for Life Laboratory, Sweden,Correspondence to: Department of Immunology, Genetics and Pathology, SciLifeLab, Uppsala Biomedical Center, Uppsala University, Husargatan 3, Uppsala, Sweden
| | - Mengqi Wang
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Sweden
| | - Phathutshedzo Muthelo
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Sweden
| | - Liza Löf
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Sweden,Unit of Affinity Proteomics Uppsala, Science for Life Laboratory, Sweden
| | - Fredrik Sterky
- Department of Laboratory Medicine, University of Gothenburg, Sweden,Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Sweden,Department of Clinical Chemistry, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Radiosa Gallini
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Sweden,Unit of Affinity Proteomics Uppsala, Science for Life Laboratory, Sweden
| | - Nallani Vijay Kumar
- Mammalian Protein Expression core facility, University of Gothenburg, Sweden
| | - Tor Monsen
- Department of Clinical Microbiology, Umeå University, Sweden
| | - Kenneth Nilsson
- Department of Medical Sciences, Section of Clinical Microbiology, Uppsala University, Sweden
| | - Mikael Åberg
- Unit of Affinity Proteomics Uppsala, Science for Life Laboratory, Sweden,Department of Medical Sciences, Section of Clinical Microbiology, Uppsala University, Sweden
| | - Masood Kamali-Moghaddam
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Sweden
| | - Ya-Fang Mei
- Department of Clinical Microbiology, Umeå University, Sweden
| | - Ulf Landegren
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Sweden,Correspondence to: Department of Immunology, Genetics and Pathology, SciLifeLab, Uppsala Biomedical Center, Uppsala University, Husargatan 3, Uppsala, Sweden
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17
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Modified ARCHITECT ® serologic assays enable plasma-level performance from dried blood spot samples. Biotechniques 2022; 73:193-203. [PMID: 36240056 DOI: 10.2144/btn-2022-0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Dried blood spots (DBSs) provide an alternative sample input for serologic testing. We evaluated DBSs for the ARCHITECT® hepatitis B surface antigen (HBsAg) NEXT, hepatitis B e-antigen (HBeAg), anti-hepatitis B core antigen (anti-HBc II), HIV antigen/antibody (Ag/Ab) Combo and AdviseDx SARS-CoV-2 IgG II assays. Assay performance with DBSs was assessed with or without assay modification and compared with on-market assay with plasma samples. DBS stability was also determined. HBsAg NEXT and HIV Ag/Ab Combo assays using DBSs showed sensitivity and specificity comparable to that of on-market assays. Modified HBeAg, anti-HBc II and SARS-CoV-2 IgG II DBS assays achieved performance comparable to on-market assays. Use of DBSs as input for high-throughput serologic assays is expected to have significant implications for improving population surveillance and increasing access to diagnostic testing.
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18
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Cramer EY, Snyder T, Ravenhurst J, Lover AA. Optimizing the implementation of a participant-collected, mail-based SARS-CoV-2 serological survey in university-affiliated populations: lessons learned and practical guidance. BMC Public Health 2022; 22:1907. [PMID: 36224583 PMCID: PMC9556138 DOI: 10.1186/s12889-022-14234-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 09/25/2022] [Indexed: 11/25/2022] Open
Abstract
The rapid spread of SARS-CoV-2 is largely driven by pre-symptomatic or mildly symptomatic individuals transmitting the virus. Serological tests to identify antibodies against SARS-CoV-2 are important tools to characterize subclinical infection exposure. During the summer of 2020, a mail-based serological survey with self-collected dried blood spot (DBS) samples was implemented among university affiliates and their household members in Massachusetts, USA. Described are challenges faced and novel procedures used during the implementation of this study to assess the prevalence of SARS-CoV-2 antibodies amid the pandemic. Important challenges included user-friendly remote and contact-minimized participant recruitment, limited availability of some commodities and laboratory capacity, a potentially biased sample population, and policy changes impacting the distribution of clinical results to study participants. Methods and lessons learned to surmount these challenges are presented to inform design and implementation of similar sero-studies. This study design highlights the feasibility and acceptability of self-collected bio-samples and has broad applicability for other serological surveys for a range of pathogens. Key lessons relate to DBS sampling, supply requirements, the logistics of packing and shipping packages, data linkages to enrolled household members, and the utility of having an on-call nurse available for participant concerns during sample collection. Future research might consider additional recruitment techniques such as conducting studies during academic semesters when recruiting in a university setting, partnerships with supply and shipping specialists, and using a stratified sampling approach to minimize potential biases in recruitment.
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Affiliation(s)
- Estee Y Cramer
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, USA
| | - Teah Snyder
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, USA
| | - Johanna Ravenhurst
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, USA
| | - Andrew A Lover
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, USA.
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19
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Cholette F, Fabia R, Harris A, Ellis H, Cachero K, Schroeder L, Mesa C, Lacap P, Arnold C, Galipeau Y, Langlois MA, Colwill K, Gingras AC, McGeer A, Giles E, Day J, Osiowy C, Durocher Y, Hankins C, Mazer B, Drebot M, Kim J. Comparative performance data for multiplex SARS-CoV-2 serological assays from a large panel of dried blood spot specimens. Heliyon 2022; 8:e10270. [PMID: 36060461 PMCID: PMC9420314 DOI: 10.1016/j.heliyon.2022.e10270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 08/06/2022] [Accepted: 08/09/2022] [Indexed: 11/02/2022] Open
Abstract
The extent of the COVID-19 pandemic will be better understood through serosurveys and SARS-CoV-2 antibody testing. Dried blood spot (DBS) samples will play a central role in large scale serosurveillance by simplifying biological specimen collection and transportation, especially in Canada. Direct comparative performance data on multiplex SARS-CoV-2 assays resulting from identical DBS samples are currently lacking. In our study, we aimed to provide performance data for the BioPlex 2200 SARS-CoV-2 IgG (Bio-Rad), V-PLEX SARS-CoV-2 Panel 2 IgG (MSD), and Elecsys Anti-SARS-CoV-2 (Roche) commercial assays, as well as for two highly scalable in-house assays (University of Ottawa and Mount Sinai Hospital protocols) to assess their suitability for DBS-based SARS-CoV-2 DBS serosurveillance. These assays were evaluated against identical panels of DBS samples collected from convalescent COVID-19 patients (n = 97) and individuals undergoing routine sexually transmitted and bloodborne infection (STBBI) testing prior to the COVID-19 pandemic (n = 90). Our findings suggest that several assays are suitable for serosurveillance (sensitivity >97% and specificity >98%). In contrast to other reports, we did not observe an improvement in performance using multiple antigen consensus-based rules to establish overall seropositivity. This may be due to our DBS panel which consisted of samples collected from convalescent COVID-19 patients with significant anti-spike, -receptor binding domain (RBD), and -nucleocapsid antibody titers. This study demonstrates that biological specimens collected as DBS coupled with one of several readily available assays are useful for large-scale COVID-19 serosurveillance.
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20
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Diagnostic performance of the SARS-CoV-2 S1RBD IgG ELISA (ImmunoDiagnostics) for the quantitative detection of SARS-CoV-2 antibodies on dried blood spots. J Clin Virol 2022; 155:105270. [PMID: 36027822 PMCID: PMC9388275 DOI: 10.1016/j.jcv.2022.105270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 08/02/2022] [Accepted: 08/17/2022] [Indexed: 11/21/2022]
Abstract
Dried Blood Spots (DBS) are broadly used in SARS-CoV-2 surveillance studies, reporting either the presence or absence of SARS-CoV-2 antibodies. However, quantitative follow-up has become increasingly important to monitor humoral vaccine responses. Therefore, we aimed to evaluate the performance of DBS for the detection of anti-spike SARS-CoV-2 antibody concentrations using a commercially available assay, reporting in a standardised unitage (International Units/mL; IU/mL). To assess the sensitivity and specificity of the ImmunoDiagnostics ELISA on serum and DBS for SARS-CoV-2 antibody detection, we analysed 72 paired DBS and serum samples. The SARS-CoV-2 S1 IgG ELISA kit (EUROIMMUN) on serum was used as the reference method. We performed a statistical assessment to optimise the cut-off value for DBS and serum and assessed the correlation between DBS and serum antibody concentrations. We found that anti-spike SARS-CoV-2 antibody concentrations detected in DBS are highly correlated to those detected in paired serum (Pearson correlation 0.98; p-value < 0.0001), allowing to assess serum antibody concentration using DBS. The optimal cut-off for antibody detection on DBS was found to be 26 IU/mL, with 98.1% sensitivity and 100% specificity. For serum, the optimal cut-off was 14 IU/mL, with 100% sensitivity and 100% specificity. Therefore, we conclude that the ImmunoDiagnostics ELISA kit has optimal performance in the detection of SARS-CoV-2 antibodies on both DBS and serum. This makes DBS ideal for large-scale follow-up of humoral SARS-CoV-2 immune responses, as it is an easy but valuable sampling method for quantification of SARS-CoV-2 antibodies, compared to serum.
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21
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Damjanovic A, Styer LM, Nemeth K, Yauney E, Rock JM, Bievenue R, Hoen R, Ehrbar D, Kay DM, Caggana M, Parker MM. Utility of Newborn Dried Blood Spots to Ascertain Seroprevalence of SARS-CoV-2 Antibodies Among Individuals Giving Birth in New York State, November 2019 to November 2021. JAMA Netw Open 2022; 5:e2227995. [PMID: 35994287 PMCID: PMC9396364 DOI: 10.1001/jamanetworkopen.2022.27995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
IMPORTANCE Serosurveys can be used to monitor population-level dynamics of COVID-19 and vaccination. Dried blood spots (DBSs) collected from infants contain maternal IgG antibodies and are useful for serosurveys of individuals recently giving birth. OBJECTIVES To examine SARS-CoV-2 antibody prevalence in pregnant individuals in New York State, identify associations between SARS-CoV-2 antibody status and maternal and infant characteristics, and detect COVID-19 vaccination among this population. DESIGN, SETTING, AND PARTICIPANTS A population-based, repeated cross-sectional study was conducted to detect SARS-CoV-2 nucleocapsid (N) and spike (S) IgG antibodies. Deidentified DBS samples and data submitted to the New York State Newborn Screening Program between November 1, 2019, and November 30, 2021, were analyzed. EXPOSURES Prenatal exposure to SARS-CoV-2 antibodies. MAIN OUTCOMES AND MEASURES The presence of IgG antibodies to SARS-CoV-2 N and S antigens was measured using a microsphere immunoassay. Data were analyzed by geographic region and compared with reported COVID-19 cases and vaccinations among reproductive-aged females (15-44 years of age). Data were stratified by infant birth weight, gestational age, maternal age, and multiple birth status. RESULTS Dried blood spot samples from 415 293 infants (median [IQR] age, 1.04 [1.00-1.20] days; 210 805 [51.1%] male) were analyzed for SARS-CoV-2 antibodies. The first known antibody-positive infant in New York State was born on March 29, 2020. SARS-CoV-2 seroprevalence reflected statewide and regional COVID-19 cases among reproductive-aged females in the prevaccine period. From February through November 2021, S seroprevalence was strongly correlated with cumulative vaccinations in each New York State region and in the state overall (rs = 0.92-1.00, P ≤ .001). S and N seroprevalences were significantly lower in newborns with very low birth weight (720 [14.8%] for S and 138 [2.8%] for N, P < .001) and low birth weight (5160 [19.3%] for S and 1233 [4.6%] for N, P = .009) compared with newborns with normal birth weight (77 116 [20.1%] for S and 19 872 [5.2%] for N). Lower N and higher S seroprevalences were observed in multiple births (odds ratio [OR], 0.84; 95% CI, 0.75-0.94; P = .002 for N and OR, 1.24; 95% CI, 1.18-1.31; P < .001 for S) vs single births and for maternal age older than 30 years (OR, 0.87; 95% CI, 0.80-0.94; P < .001 for N and OR, 1.17; 95% CI, 1.11-1.23; P < .001 for S) vs younger than 20 years. CONCLUSIONS AND RELEVANCE In this study, seroprevalence in newborn DBS samples reflected COVID-19 case fluctuations and vaccinations among reproductive-aged women during the study period. These results demonstrate the utility of using newborn DBS testing to estimate SARS-CoV-2 seroprevalence in pregnant individuals.
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Affiliation(s)
| | - Linda M. Styer
- Wadsworth Center, New York State Department of Health, Albany
- Department of Biomedical Sciences, School of Public Health, University at Albany, Albany, New York
| | | | - Erica Yauney
- Wadsworth Center, New York State Department of Health, Albany
| | - Jean M. Rock
- Wadsworth Center, New York State Department of Health, Albany
| | - Rachel Bievenue
- Wadsworth Center, New York State Department of Health, Albany
| | - Rebecca Hoen
- Bureau of Surveillance and Data Systems, New York State Department of Health, Albany
| | - Dylan Ehrbar
- Wadsworth Center, New York State Department of Health, Albany
| | - Denise M. Kay
- Wadsworth Center, New York State Department of Health, Albany
- Department of Biomedical Sciences, School of Public Health, University at Albany, Albany, New York
| | - Michele Caggana
- Wadsworth Center, New York State Department of Health, Albany
- Department of Biomedical Sciences, School of Public Health, University at Albany, Albany, New York
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22
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Baggio S, Togni G, Eckerle I, Vuillemier N, Kaiser L, Gétaz L. Feasibility of home-based ELISA capillary blood self-testing for anti-SARS-CoV-2 antibodies. Pract Lab Med 2022; 31:e00290. [PMID: 35846110 PMCID: PMC9273287 DOI: 10.1016/j.plabm.2022.e00290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 06/17/2022] [Accepted: 07/08/2022] [Indexed: 11/28/2022] Open
Abstract
Objectives Serological assays for the presence of anti-SARS-CoV-2 antibodies are crucially needed for research and monitoring of the SARS-CoV-2 pandemic. Antibodies are reliability detected in capillary blood, a minimally invasive and cost-effective alternative to venous blood testing. However, there is a limited knowledge on feasibility of capillary blood self-sampling. This study compared the feasibility of capillary blood self-testing in people aged less than 65 vs. people aged 65 or more. A secondary aim was to investigate the performance of the Hem-Col® (no additive) device compared to venous blood testing. Design and methods Data were collected in a prospective study in Switzerland (n = 106). Capillary blood was collected using the Hem-Col® (no additive) device. Feasibility was assessed using 1) collecting the recommended amount of capillary blood and 2) achieving all steps of capillary blood collection. A sample of 5 ml of venous blood was also collected. Results For the primary objective, 86.2%/62.1% of patients aged less than 65 collected the recommended amount of capillary blood/achieved all steps vs. 62.5%/39.6% of patients aged 65 or more (p = .006/p = .022). For the secondary objective, the correlation between capillary and venous blood was r = 0.992 and kappa = 1. Conclusions Capillary blood self-testing appeared as a feasible and reliable alternative to venous blood testing. Such alternative would improve access to serological testing and spare health care resources. However, the difference between age groups should be considered when using self-sampling devices. Help should be developed for older people, such as phone counseling or encouraging asking younger family members for help. Evidence of the feasibility of capillary blood self-testing is scarce. Capillary blood self-testing appeared as reliable and feasible alternative. Older people (aged 65 or more) were more likely to fail than younger people.
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Affiliation(s)
- Stéphanie Baggio
- Division of Prison Health, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.,Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | | | - Isabella Eckerle
- Department of Molecular Medicine and Microbiology, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Center for Emerging Viral Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.,Division of Infectious Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.,Laboratory of Virology, Division of Laboratory Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Nicolas Vuillemier
- Division of Laboratory Medicine, Department of Diagnostics, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.,Division of Laboratory Medicine, Department of Medical Specialties, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Laurent Kaiser
- Center for Emerging Viral Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.,Division of Infectious Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.,Department of Medicine, Faculty of Medicine, University of Geneva, Switzerland
| | - Laurent Gétaz
- Division of Prison Health, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.,Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland
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23
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Catlett B, Starr M, Machalek DA, Danwilai T, Palmer M, Kelly A, Kaldor J, Dore GJ, Darley D, Matthews G, Cunningham PH. Evaluation of serological assays for SARS-CoV-2 antibody testing from dried blood spots collected from cohorts with prior SARS-CoV-2 infection. JOURNAL OF CLINICAL VIROLOGY PLUS 2022; 2:100093. [PMID: 35765384 PMCID: PMC9225964 DOI: 10.1016/j.jcvp.2022.100093] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 06/01/2022] [Accepted: 06/23/2022] [Indexed: 11/26/2022] Open
Abstract
Background Dried blood spot (DBS) specimens are a useful serosurveillance tool particularly in hard-to-reach populations but their application for detecting SARS-CoV-2 infection is poorly characterised. Objectives To compare detection of naturally acquired SARS-CoV-2 antibodies in paired DBS and serum specimens using commercially available serological immunoassays. Study Design Specimens were collected through St Vincent's Hospital observational post COVID-19 cohort study (ADAPT). Laboratory spotted DBS from venepuncture were initially tested on seven assays, a DBS validation completed on three with clinically collected fingerstick DBSs tested on one. Results Sensitivity for Euroimmun nucleocapsid (NCP) IgG ELISA from laboratory spotted DBS (n=145), Euroimmun spike, IgG ELISA from laboratory spotted DBS (n=161), and Binding Site total antibody ELISA from clinically collected fingerstick DBS (n=391) was 100% (95% CI: 95.8-100%), 100% (95% CI: 95.8-100%) and 92.9% (95% CI: 89.5-95.5%), respectively. Specificity was 66.2% (95% CI: 53.6-77.0%), 96% (95% CI: 88.7-99.1%) and 98.8% (95% CI: 93.3-99.9%), respectively. All three assays’ results displayed a strong positive correlation between DBS compared to paired serum. Conclusions The Binding Site™ spike total antibody and Euroimmun™ spike IgG ELISAs provided good analytical performance, demonstrating that DBS specimens could facilitate specimen collection in the epidemiological surveillance of SARS-CoV-2 infection. This is highly applicable in populations and settings where venepuncture is problematic (including community based regional/remote settings, nursing homes, prisons, and schools).
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24
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Detection of neutralizing antibodies against multiple SARS-CoV-2 strains in dried blood spots using cell-free PCR. Nat Commun 2022; 13:4212. [PMID: 35864104 PMCID: PMC9302227 DOI: 10.1038/s41467-022-31796-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 07/04/2022] [Indexed: 11/17/2022] Open
Abstract
An easily implementable serological assay to accurately detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) neutralizing antibodies is urgently needed to better track herd immunity, vaccine efficacy and vaccination rates. Herein, we report the Split-Oligonucleotide Neighboring Inhibition Assay (SONIA) which uses real-time qPCR to measure the ability of neutralizing antibodies to block binding between DNA-barcoded viral spike protein subunit 1 and the human angiotensin-converting enzyme 2 receptor protein. The SONIA neutralizing antibody assay using finger-prick dried blood spots displays 91–97% sensitivity and 100% specificity in comparison to the live-virus neutralization assays using matched serum specimens for multiple SARS-CoV-2 variants-of-concern. The multiplex version of this neutralizing antibody assay, using easily collectable finger-prick dried blood spots, can be a valuable tool to help reveal the impact of age, pre-existing health conditions, waning immunity, different vaccination schemes and the emergence of new variants-of-concern. Neutralizing antibodies are critical for conferring immunity against SARS-CoV-2. Here, Dahn et al. report a PCR assay termed SONIA (Split-Oligonucleotide Neighboring Inhibition Assay) for measuring neutralizing antibodies against multiple SARS-CoV-2 strains in fingerprick dried blood spot samples.
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25
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Dutta D, Naiyer S, Mansuri S, Soni N, Singh V, Bhat KH, Singh N, Arora G, Mansuri MS. COVID-19 Diagnosis: A Comprehensive Review of the RT-qPCR Method for Detection of SARS-CoV-2. Diagnostics (Basel) 2022; 12:diagnostics12061503. [PMID: 35741313 PMCID: PMC9221722 DOI: 10.3390/diagnostics12061503] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 12/15/2022] Open
Abstract
The world is grappling with the coronavirus disease 2019 (COVID-19) pandemic, the causative agent of which is severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 symptoms are similar to the common cold, including fever, sore throat, cough, muscle and chest pain, brain fog, dyspnoea, anosmia, ageusia, and headache. The manifestation of the disease can vary from being asymptomatic to severe life-threatening conditions warranting hospitalization and ventilation support. Furthermore, the emergence of mutecated variants of concern (VOCs) is paramount to the devastating effect of the pandemic. This highly contagious virus and its emergent variants challenge the available advanced viral diagnostic methods for high-accuracy testing with faster result yields. This review is to shed light on the natural history, pathology, molecular biology, and efficient diagnostic methods of COVID-19, detecting SARS-CoV-2 in collected samples. We reviewed the gold standard RT-qPCR method for COVID-19 diagnosis to confer a better understanding and application to combat the COVID-19 pandemic. This comprehensive review may further develop awareness about the management of the COVID-19 pandemic.
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Affiliation(s)
- Debashis Dutta
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
- Correspondence: (D.D.); (M.S.M.)
| | - Sarah Naiyer
- Department of Microbiology and Immunology, University of Illinois at Chicago, Chicago, IL 60616, USA;
| | | | - Neeraj Soni
- Department of Cell and Developmental Biology, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Vandana Singh
- Department of Pathology and Microbiology, College of Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA;
| | - Khalid Hussain Bhat
- SKUAST Kashmir, Division of Basic Science and Humanities, Faculty of Agriculture, Wadura Sopore 193201, JK, India;
| | - Nishant Singh
- Cell and Gene Therapy Absorption System, Exton, PA 19335, USA;
| | - Gunjan Arora
- Section of Infectious Diseases, Yale University School of Medicine, New Haven, CT 06520, USA;
| | - M. Shahid Mansuri
- Molecular Biophysics and Biochemistry, Yale University, New Haven, CT 06511, USA
- Correspondence: (D.D.); (M.S.M.)
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26
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Development and Implementation of Dried Blood Spot-Based COVID-19 Serological Assays for Epidemiologic Studies. Microbiol Spectr 2022; 10:e0247121. [PMID: 35612315 PMCID: PMC9241704 DOI: 10.1128/spectrum.02471-21] [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] [Indexed: 11/20/2022] Open
Abstract
Serological surveillance studies of infectious diseases provide population-level estimates of infection and antibody prevalence, generating crucial insight into population-level immunity, risk factors leading to infection, and effectiveness of public health measures. These studies traditionally rely on detection of pathogen-specific antibodies in samples derived from venipuncture, an expensive and logistically challenging aspect of serological surveillance. During the COVID-19 pandemic, guidelines implemented to prevent the spread of SARS-CoV-2 infection made collection of venous blood logistically difficult at a time when SARS-CoV-2 serosurveillance was urgently needed. Dried blood spots (DBS) have generated interest as an alternative to venous blood for SARS-CoV-2 serological applications due to their stability, low cost, and ease of collection; DBS samples can be self-generated via fingerprick by community members and mailed at ambient temperatures. Here, we detail the development of four DBS-based SARS-CoV-2 serological methods and demonstrate their implementation in a large serological survey of community members from 12 cities in the East Bay region of the San Francisco metropolitan area using at-home DBS collection. We find that DBS perform similarly to plasma/serum in enzyme-linked immunosorbent assays and commercial SARS-CoV-2 serological assays. In addition, we show that DBS samples can reliably detect antibody responses months postinfection and track antibody kinetics after vaccination. Implementation of DBS enabled collection of valuable serological data from our study population to investigate changes in seroprevalence over an 8-month period. Our work makes a strong argument for the implementation of DBS in serological studies, not just for SARS-CoV-2, but any situation where phlebotomy is inaccessible. IMPORTANCE Estimation of community-level antibody responses to SARS-CoV-2 from infection or vaccination is critical to inform public health responses. Traditional studies of antibodies rely on collection of blood via venipuncture, an invasive procedure not amenable to pandemic-related social-distancing measures. Dried blood spots (DBS) are an alternative to venipuncture, since they can be self-collected by study participants at home and do not require refrigeration for shipment or storage. However, DBS-based assays to measure antibody levels to SARS-CoV-2 have not been widely utilized. Here, we show that DBS are comparable to blood as a sampling method for antibody responses to SARS-CoV-2 infection and vaccination over time measured using four distinct serological assays. The DBS format enabled antibody surveillance in a longitudinal cohort where study participants self-collected samples, ensuring the participants’ safety during an ongoing pandemic. Our work demonstrates that DBS are an excellent sampling method for measuring antibody responses whenever venipuncture is impractical.
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27
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Mehrotra ML, Lim E, Lamba K, Kamali A, Lai KW, Meza E, Szeto I, Robinson P, Tsai CT, Gebhart D, Fonseca N, Martin AB, Ley C, Scherf S, Watt J, Seftel D, Parsonnet J, Jain S. CalScope: Monitoring SARS-CoV-2 Seroprevalence from Vaccination and Prior Infection in Adults and Children in California May 2021– July 2021. Open Forum Infect Dis 2022; 9:ofac246. [PMID: 35855959 PMCID: PMC9129171 DOI: 10.1093/ofid/ofac246] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 05/11/2022] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Understanding the distribution of SARS-CoV-2 antibodies from vaccination and/or prior infection is critical to the public health response to the pandemic. CalScope is a population-based serosurvey in 7 counties in California.
Methods
We invited 200,000 randomly sampled households to enroll up to 1 adult and 1 child between April 20, 2021 and June 16, 2021. We tested all specimen for antibodies against SARS-CoV-2 nucleocapsid and spike proteins, and each participant completed an online survey. We classified participants into categories: seronegative, antibodies from infection only, antibodies from infection and vaccination, and antibodies from vaccination only.
Results
11,161 households enrolled (5.6%), with 7,483 adults and 1,375 children completing antibody testing. As of June 2021, 33% (95%CI [28%, 37%]) of adults and 57% (95%CI[48%, 66%]) of children were seronegative; 18% (95%CI[14%, 22%]) of adults and 26% (95%CI[19%, 32%]) of children had antibodies from infection alone; 9% (95%CI[6%,11%]) of adults and 5% (95%CI[1%, 8%]) of children had antibodies from infection and vaccination; and 41% (95%CI[37%, 45%]) of adults and 13% (95%CI [7%, 18%]) of children had antibodies from vaccination alone.
Conclusions
As of June 2021, a third of adults and most children in California were seronegative. Serostatus varied regionally and by demographic group.
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Affiliation(s)
| | - Esther Lim
- California Department of Public Health, Richmond, CA, United States
| | - Katherine Lamba
- California Department of Public Health, Richmond, CA, United States
| | - Amanda Kamali
- California Department of Public Health, Richmond, CA, United States
| | - Kristina W. Lai
- California Department of Public Health, Richmond, CA, United States
| | - Erika Meza
- California Department of Public Health, Richmond, CA, United States
| | - Irvin Szeto
- Stanford University, School of Medicine, Palo Alto, CA, United States
| | - Peter Robinson
- Enable Biosciences, South San Francisco, CA, United States
| | | | - David Gebhart
- Enable Biosciences, South San Francisco, CA, United States
| | - Noemi Fonseca
- Enable Biosciences, South San Francisco, CA, United States
| | - Andrew B. Martin
- Stanford University, School of Medicine, Palo Alto, CA, United States
| | - Catherine Ley
- Stanford University, School of Medicine, Palo Alto, CA, United States
| | | | - James Watt
- California Department of Public Health, Richmond, CA, United States
| | - David Seftel
- Enable Biosciences, South San Francisco, CA, United States
| | - Julie Parsonnet
- Stanford University, School of Medicine, Palo Alto, CA, United States
| | - Seema Jain
- California Department of Public Health, Richmond, CA, United States
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Khan M, Rosadas C, Katsanovskaja K, Weber ID, Shute J, Ijaz S, Marchesin F, McClure E, Elias S, Flower B, Gao H, Quinlan R, Short C, Rosa A, Roustan C, Moshe M, Taylor GP, Elliott P, Cooke GS, Cherepanov P, Parker E, McClure MO, Tedder RS. Simple, sensitive, specific self-sampling assay secures SARS-CoV-2 antibody signals in sero-prevalence and post-vaccine studies. Sci Rep 2022; 12:1885. [PMID: 35115570 PMCID: PMC8814240 DOI: 10.1038/s41598-022-05640-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 01/10/2022] [Indexed: 12/20/2022] Open
Abstract
At-home sampling is key to large scale seroprevalence studies. Dried blood spot (DBS) self-sampling removes the need for medical personnel for specimen collection but facilitates specimen referral to an appropriately accredited laboratory for accurate sample analysis. To establish a highly sensitive and specific antibody assay that would facilitate self-sampling for prevalence and vaccine-response studies. Paired sera and DBS eluates collected from 439 sero-positive, 382 sero-negative individuals and DBS from 34 vaccine recipients were assayed by capture ELISAs for IgG and IgM antibody to SARS-CoV-2. IgG and IgM combined on DBS eluates achieved a diagnostic sensitivity of 97.9% (95%CI 96.6 to 99.3) and a specificity of 99.2% (95% CI 98.4 to 100) compared to serum, displaying limits of detection equivalent to 23 and 10 WHO IU/ml, respectively. A strong correlation (r = 0.81) was observed between serum and DBS reactivities. Reactivity remained stable with samples deliberately rendered inadequate, (p = 0.234) and when samples were accidentally damaged or 'invalid'. All vaccine recipients were sero-positive. This assay provides a secure method for self-sampling by DBS with a sensitivity comparable to serum. The feasibility of DBS testing in sero-prevalence studies and in monitoring post-vaccine responses was confirmed, offering a robust and reliable tool for serological monitoring at a population level.
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Affiliation(s)
- Maryam Khan
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Carolina Rosadas
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Ksenia Katsanovskaja
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Isaac D Weber
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Justin Shute
- Public Health England, 61 Colindale Ave, London, NW9 5EQ, UK
| | - Samreen Ijaz
- Public Health England, 61 Colindale Ave, London, NW9 5EQ, UK
| | - Federica Marchesin
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Eleanor McClure
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Salem Elias
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Barnaby Flower
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - He Gao
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Rachael Quinlan
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Charlotte Short
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Annachiara Rosa
- Francis Crick Institute, 1 Midland Rd, Somers Town, London, NW1 1AT, UK
| | - Chloe Roustan
- Francis Crick Institute, 1 Midland Rd, Somers Town, London, NW1 1AT, UK
| | - Maya Moshe
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Graham P Taylor
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK.,Imperial College Healthcare NHS Trust, St Mary's Hospital, Praed St, Paddington, London, W2 1NY, UK
| | - Paul Elliott
- Imperial College Healthcare NHS Trust, St Mary's Hospital, Praed St, Paddington, London, W2 1NY, UK.,Department of Epidemiology and Biostatistics, School of Public Health, MRC Centre for Environment and Health, Imperial College London, London, UK.,NIHR Imperial Biomedical Research Centre, Imperial College London, Exhibition Rd, London, SW7 2AZ, UK
| | - Graham S Cooke
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK.,Imperial College Healthcare NHS Trust, St Mary's Hospital, Praed St, Paddington, London, W2 1NY, UK
| | - Peter Cherepanov
- Francis Crick Institute, 1 Midland Rd, Somers Town, London, NW1 1AT, UK
| | - Eleanor Parker
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Myra O McClure
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Richard S Tedder
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK.
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Du J, Zhang D, Pathakamuri JA, Kuebler D, Yang Y, Loginova Y, Chu E, Madej R, Neves JV, Singer B, Radke H, Spencer N, Rizk E, Zhang A, Lu CM, Sha MY. A New Testing Platform Using Fingerstick Blood for Quantitative Antibody Response Evaluation after SARS-CoV-2 Vaccination. Emerg Microbes Infect 2021; 11:250-259. [PMID: 34951566 PMCID: PMC8745372 DOI: 10.1080/22221751.2021.2023328] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Testing and vaccination have been major components of the strategy for combating the ongoing COVID-19 pandemic. In this study, we have developed a quantitative anti-SARS-CoV-2 spike (S1) IgG antibody assay using a fingerstick dried blood sample. We evaluated the feasibility of using this high-throughput and quantitative anti-SARS-CoV-2 spike (S1) IgG antibody testing assay in vaccinated individuals. Fingerstick blood samples were collected and analyzed from 137 volunteers before and after receiving the Moderna or Pfizer mRNA vaccine. Anti-SARS-CoV-2 S1 IgG antibody could not be detected within the first 7 days after receiving the first vaccine dose, however, the assay reliably detected antibodies from day 14 onwards. In addition, no anti-SARS-CoV-2 nucleocapsid (N) protein IgG antibody was detected in any of the vaccinated or healthy participants, indicating that the anti-SARS-CoV-2 S1 IgG assay is specific for the mRNA vaccine-induced antibodies. The S1 IgG levels detected in fingerstick samples correlated with the levels found in venous blood plasma samples and with the efficacy of venous blood plasma samples in the plaque reduction neutralization test (PRNT). The assay displayed a limit of quantification (LOQ) of 0.59 μg/mL and was found to be linear in the range of 0.51-1000 μg/mL. Finally, its clinical performance displayed a Positive Percent Agreement (PPA) of 100% (95% CI: 0.89-1.00) and a Negative Percent Agreement (NPA) of 100% (95% CI: 0.93-1.00). In summary, the assay described here represents a sensitive, precise, accurate, and simple method for the quantitative detection and monitoring of post-vaccination anti-SARS-CoV-2 spike IgG responses.
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Affiliation(s)
- Jinwei Du
- DiaCarta Inc., 4385 Hopyard Rd. suite 100, Pleasanton, CA 94588, US
| | - Dayu Zhang
- DiaCarta Inc., 4385 Hopyard Rd. suite 100, Pleasanton, CA 94588, US
| | | | - Daniel Kuebler
- Franciscan University of Steubenville, Steubenville, OH. 43952
| | - Ying Yang
- DiaCarta Inc., 4385 Hopyard Rd. suite 100, Pleasanton, CA 94588, US
| | - Yulia Loginova
- DiaCarta Inc., 4385 Hopyard Rd. suite 100, Pleasanton, CA 94588, US
| | - Eric Chu
- DiaCarta Inc., 4385 Hopyard Rd. suite 100, Pleasanton, CA 94588, US
| | - Roberta Madej
- DiaCarta Inc., 4385 Hopyard Rd. suite 100, Pleasanton, CA 94588, US
| | - Jocelyn V Neves
- Franciscan University of Steubenville, Steubenville, OH. 43952
| | - Brianna Singer
- Franciscan University of Steubenville, Steubenville, OH. 43952
| | - Holly Radke
- Franciscan University of Steubenville, Steubenville, OH. 43952
| | - Naomi Spencer
- Franciscan University of Steubenville, Steubenville, OH. 43952
| | - Elizabeth Rizk
- Franciscan University of Steubenville, Steubenville, OH. 43952
| | - Aiguo Zhang
- DiaCarta Inc., 4385 Hopyard Rd. suite 100, Pleasanton, CA 94588, US
| | - Chuanyi M Lu
- University of California and VA Health Care System, San Francisco, CA
| | - Michael Y Sha
- DiaCarta Inc., 4385 Hopyard Rd. suite 100, Pleasanton, CA 94588, US
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30
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Dried blood spot specimens for SARS-CoV-2 antibody testing: A multi-site, multi-assay comparison. PLoS One 2021; 16:e0261003. [PMID: 34874948 PMCID: PMC8651133 DOI: 10.1371/journal.pone.0261003] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 11/23/2021] [Indexed: 11/19/2022] Open
Abstract
The true severity of infection due to COVID-19 is under-represented because it is based on only those who are tested. Although nucleic acid amplifications tests (NAAT) are the gold standard for COVID-19 diagnostic testing, serological assays provide better population-level SARS-CoV-2 prevalence estimates. Implementing large sero-surveys present several logistical challenges within Canada due its unique geography including rural and remote communities. Dried blood spot (DBS) sampling is a practical solution but comparative performance data on SARS-CoV-2 serological tests using DBS is currently lacking. Here we present test performance data from a well-characterized SARS-CoV-2 DBS panel sent to laboratories across Canada representing 10 commercial and 2 in-house developed tests for SARS-CoV-2 antibodies. Three commercial assays identified all positive and negative DBS correctly corresponding to a sensitivity, specificity, positive predictive value, and negative predictive value of 100% (95% CI = 72.2, 100). Two in-house assays also performed equally well. In contrast, several commercial assays could not achieve a sensitivity greater than 40% or a negative predictive value greater than 60%. Our findings represent the foundation for future validation studies on DBS specimens that will play a central role in strengthening Canada's public health policy in response to COVID-19.
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31
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Lofgren SM, Okafor EC, Colette AA, Pastick KA, Skipper CP, Pullen MF, Nicol MR, Bold TD, Bangdiwala AS, Engen NW, Collins LB, Williams DA, Axelrod ML, Thielen BK, Hullsiek KH, Boulware DR, Rajasingham R. Feasibility of SARS-CoV-2 Antibody Testing in Remote Outpatient Trials. Open Forum Infect Dis 2021; 8:ofab506. [PMID: 35548171 PMCID: PMC8522439 DOI: 10.1093/ofid/ofab506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 10/04/2021] [Indexed: 11/12/2022] Open
Abstract
Background During the coronavirus disease 2019 (COVID-19) pandemic, clinical trials necessitated rapid testing to be performed remotely. Dried blood spot (DBS) techniques have enabled remote HIV virologic testing globally, and more recently, antibody testing as well. We evaluated DBS testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody testing in outpatients to assess seropositivity. Methods In 2020, we conducted 3 internet-based randomized clinical trials and offered serologic testing via self-collected DBS as a voluntary substudy. COVID-19 diagnosis was based on the Centers for Disease Control and Prevention case definition with epidemiological link to cases. A minority reported polymerase chain reaction (PCR) testing at an outside facility. We tested for anti-SARS-CoV-2 immunoglobulin via antibody detection by agglutination-PCR (ADAP) and compared the results with enzyme-linked immunosorbent assay (ELISA). Results Of 2727 participants in the primary studies, 60% (1648/2727) consented for serology testing; 56% (931/1648) returned a usable DBS sample. Of those who were asymptomatic, 5% (33/707) had positive ADAP serology. Of participants with a positive PCR, 67% (36/54) had positive SARS-CoV-2 antibodies. None of those who were PCR-positive and asymptomatic were seropositive (0/7). Of 77 specimens tested for concordance via ELISA, 83% (64/77) were concordant. The challenges of completing a remote testing program during a pandemic included sourcing and assembling collection kits, delivery and return of the kits, and troubleshooting testing. Self-collection was successful for >95% of participants. Delays in US mail with possible sample degradation and timing of DBS collection complicated the analysis. Conclusions We found remote antibody testing during a global pandemic feasible although challenging. We identified an association between symptomatic COVID-19 and positive antibody results at a similar prevalence as other outpatient cohorts.
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Affiliation(s)
- Sarah M Lofgren
- Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Elizabeth C Okafor
- School of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Alanna A Colette
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | - Katelyn A Pastick
- School of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Caleb P Skipper
- Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Matthew F Pullen
- Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Melanie R Nicol
- Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Tyler D Bold
- Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Ananta S Bangdiwala
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | - Nicole W Engen
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | - Lindsey B Collins
- Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Darlisha A Williams
- Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Margaret L Axelrod
- School of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Beth K Thielen
- Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Kathy H Hullsiek
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | - David R Boulware
- Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Radha Rajasingham
- Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
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32
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Meyers E, Heytens S, Formukong A, Vercruysse H, De Sutter A, Geens T, Hofkens K, Janssens H, Nys E, Padalko E, Deschepper E, Cools P. Comparison of Dried Blood Spots and Venous Blood for the Detection of SARS-CoV-2 Antibodies in a Population of Nursing Home Residents. Microbiol Spectr 2021; 9:e0017821. [PMID: 34549995 PMCID: PMC8557917 DOI: 10.1128/spectrum.00178-21] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 07/27/2021] [Indexed: 11/20/2022] Open
Abstract
In the current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, testing for SARS-CoV-2-specific antibodies is paramount for monitoring immune responses in postauthorization vaccination and seroepidemiological studies. However, large-scale and iterative serological testing by venipuncture in older persons can be challenging. Capillary blood sampling using a finger prick and collection on protein saver cards, i.e., dried blood spots (DBSs), has already proven to be a promising alternative. However, elderly persons have reduced cutaneous microvasculature, which may affect DBS-based antibody testing. Therefore, we aimed to evaluate the performance of DBS tests for the detection of SARS-CoV-2 antibodies among nursing homes residents. We collected paired venous blood and DBS samples on two types of protein saver cards (Whatman and EUROIMMUN) from nursing home residents, as well as from staff members as a reference population. Venous blood samples were analyzed for the presence of SARS-CoV-2 IgG antibodies using the Abbott chemiluminescent microparticle immunoassay (CMIA). DBS samples were analyzed by the EUROIMMUN enzyme-linked immunosorbent assay (ELISA) for SARS-CoV-2 IgG antibodies. We performed a statistical assessment to optimize the ELISA cutoff value for the DBS testing using Youden's J index. A total of 273 paired DBS-serum samples were analyzed, of which 129 were positive, as assessed by the reference test. The sensitivities and specificities of DBS testing ranged from 95.0% to 97.1% and from 97.1% to 98.8%, respectively, depending on the population (residents or staff members) and the DBS card type. Therefore, we found that DBS sampling is a valid alternative to venipuncture for the detection of SARS-CoV-2 antibodies among elderly subjects. IMPORTANCE Since the implementation of newly developed SARS-CoV-2 vaccines in the general population, serological tests are of increasing importance. Because DBS samples can be obtained with a finger prick and can be shipped and stored at room temperature, they are optimal for use in large-scale SARS-CoV-2 serosurveillance or postauthorization vaccination studies, even in an elderly study population.
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Affiliation(s)
- Eline Meyers
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Stefan Heytens
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Asangwing Formukong
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Hanne Vercruysse
- Research and Analytics, Liantis Occupational Health Services, Bruges, Belgium
| | - An De Sutter
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Tom Geens
- Research and Analytics, Liantis Occupational Health Services, Bruges, Belgium
| | - Kenneth Hofkens
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Heidi Janssens
- Research and Analytics, Liantis Occupational Health Services, Bruges, Belgium
| | - Eveline Nys
- Laboratory of Medical Microbiology, Ghent University Hospital, Ghent, Belgium
| | - Elizaveta Padalko
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Laboratory of Medical Microbiology, Ghent University Hospital, Ghent, Belgium
| | - Ellen Deschepper
- Biostatistics Unit, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Piet Cools
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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33
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Itell HL, Weight H, Fish CS, Logue JK, Franko N, Wolf CR, McCulloch DJ, Galloway J, Matsen FA, Chu HY, Overbaugh J. SARS-CoV-2 Antibody Binding and Neutralization in Dried Blood Spot Eluates and Paired Plasma. Microbiol Spectr 2021; 9:e0129821. [PMID: 34668728 PMCID: PMC8528110 DOI: 10.1128/spectrum.01298-21] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 09/17/2021] [Indexed: 11/20/2022] Open
Abstract
Wide-scale assessment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific antibodies is critical to understanding population seroprevalence, correlates of protection, and the longevity of vaccine-elicited responses. Most SARS-CoV-2 studies characterize antibody responses in plasma/sera. While reliable and broadly used, these samples pose several logistical restrictions, such as requiring venipuncture for collection and a cold chain for transportation and storage. Dried blood spots (DBS) overcome these barriers as they can be self-collected by fingerstick and mailed and stored at ambient temperature. Here, we evaluate the suitability of DBS for SARS-CoV-2 antibody assays by comparing several antibody responses between paired plasma and DBS from SARS-CoV-2 convalescent and vaccinated individuals. We found that DBS not only reflected plasma antibody binding by enzyme-linked immunosorbent assay (ELISA) and epitope profiles using phage display, but also yielded SARS-CoV-2 neutralization titers that highly correlated with paired plasma. Neutralization measurement was further streamlined by adapting assays to a high-throughput 384-well format. This study supports the adoption of DBS for numerous SARS-CoV-2 binding and neutralization assays. IMPORTANCE Plasma and sera isolated from venous blood represent conventional sample types used for the evaluation of SARS-CoV-2 antibody responses after infection or vaccination. However, collection of these samples is invasive and requires trained personnel and equipment for immediate processing. Once collected, plasma and sera must be stored and shipped at cold temperatures. To define the risk of emerging SARS-CoV-2 variants and the longevity of immune responses to natural infection and vaccination, it will be necessary to measure various antibody features in populations around the world, including in resource-limited areas. A sampling method that is compatible with these settings and is suitable for a variety of SARS-CoV-2 antibody assays is therefore needed to continue to understand and curb the COVID-19 pandemic.
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Affiliation(s)
- Hannah L. Itell
- Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- Molecular and Cellular Biology Graduate Program, University of Washington and Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Haidyn Weight
- Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Carolyn S. Fish
- Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Jennifer K. Logue
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Nicholas Franko
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Caitlin R. Wolf
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | | | - Jared Galloway
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Frederick A. Matsen
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Helen Y. Chu
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Julie Overbaugh
- Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
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Hendelman T, Chaudhary A, LeClair AC, van Leuven K, Chee J, Fink SL, Welch EJ, Berthier E, Quist BA, Wald A, Wener MH, Hoofnagle AN, Morishima C. Self-collection of capillary blood using Tasso-SST devices for Anti-SARS-CoV-2 IgG antibody testing. PLoS One 2021; 16:e0255841. [PMID: 34473717 PMCID: PMC8412246 DOI: 10.1371/journal.pone.0255841] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 07/24/2021] [Indexed: 12/02/2022] Open
Abstract
Background Efforts to minimize COVID-19 exposure during the current SARS-CoV-2 pandemic have led to limitations in access to medical care and testing. The Tasso-SST kit includes all of the components necessary for remote, capillary blood self-collection. In this study, we sought to investigate the accuracy and reliability of the Tasso-SST device as a self-collection device for measurement of SARS-CoV-2 IgG antibodies. Methods Capillary blood was obtained via unsupervised and supervised application of the Tasso-SST device, and venous blood was collected by standard venipuncture. Unsupervised self-collected blood samples underwent either extreme summer or winter-simulated shipping conditions prior to testing. Sera obtained by all three methods were tested concurrently using the EuroImmun anti-SARS-CoV-2 S1 IgG assay in a CLIA-certified clinical laboratory. Results Successful Tasso-SST capillary blood collection by unsupervised and supervised administration was completed by 93.4% and 94.5% of participants, respectively. Sera from 56 participants, 55 with documented (PCR+) COVID-19, and 33 healthy controls were then tested for anti-SARS-CoV-2 IgG antibodies. Compared to venous blood results, Tasso-SST-collected (unstressed) and the summer- and winter-stressed blood samples demonstrated Deming regression slopes of 1.00 (95% CI: 0.99–1.02), 1.00 (95% CI: 0.98–1.01), and 0.99 (95% CI: 0.97–1.01), respectively, with an overall accuracy of 98.9%. Conclusions Capillary blood self-collection using the Tasso-SST device had a high success rate. Moreover, excellent concordance was found for anti-SARS-CoV-2 IgG results between Tasso-SST capillary and standard venous blood-derived sera. The Tasso-SST device should enable widespread collection of capillary blood for testing without medical supervision, facilitating epidemiologic studies.
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Affiliation(s)
- Tess Hendelman
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, United States of America
| | - Anu Chaudhary
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, United States of America
| | - Angela C. LeClair
- Department of Medicine, University of Washington, Seattle, WA, United States of America
| | - Kimberly van Leuven
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, United States of America
| | - Jacqueline Chee
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, United States of America
| | - Susan L. Fink
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, United States of America
| | | | | | | | - Anna Wald
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, United States of America
- Department of Medicine, University of Washington, Seattle, WA, United States of America
- Department of Epidemiology, University of Washington, Seattle, WA, United States of America
- Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States of America
| | - Mark H. Wener
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, United States of America
- Department of Medicine, University of Washington, Seattle, WA, United States of America
| | - Andrew N. Hoofnagle
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, United States of America
| | - Chihiro Morishima
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, United States of America
- * E-mail:
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35
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Styer LM, Hoen R, Rock J, Yauney E, Nemeth K, Bievenue R, Parker MM. High-Throughput Multiplex SARS-CoV-2 IgG Microsphere Immunoassay for Dried Blood Spots: A Public Health Strategy for Enhanced Serosurvey Capacity. Microbiol Spectr 2021; 9:e0013421. [PMID: 34319133 PMCID: PMC8552730 DOI: 10.1128/spectrum.00134-21] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 07/02/2021] [Indexed: 12/23/2022] Open
Abstract
Early in the pandemic when diagnostic testing was not widely available, serosurveys played an important role in estimating the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in different populations. Dried blood spots (DBS), which can be collected in nonclinical settings, provide a minimally invasive alternative to serum for serosurveys. We developed a Luminex-based SARS-CoV-2 microsphere immunoassay (MIA) for DBS that detects IgG antibodies to nucleocapsid (N) and spike subunit 1 (S1) antigens. The assay uses a 384-well plate format and automated liquid handlers for high-throughput capacity. Specificity was assessed using a large collection of prepandemic DBS and well-characterized sera. Sensitivity was analyzed using serology data from New York State SARS-CoV-2 serosurvey testing and matched diagnostic test results. For DBS, the specificity was 99.5% for the individual N and S1 antigens. Median fluorescence intensity (MFI) values for DBS and paired sera showed a strong positive correlation for N (R2 = 0.91) and S1 (R2 = 0.93). Sensitivity, assessed from 1,134 DBS with prior laboratory-confirmed SARS-CoV-2 infection, ranged from 83% at 0 to 20 days to 95% at 61 to 90 days after a positive test. When stratified using coronavirus disease 2019 (COVID-19) symptom data, sensitivity ranged from 90 to 96% for symptomatic and 77 to 91% for asymptomatic individuals. For 8,367 health care workers reporting detailed symptom data, MFI values were significantly higher for all symptom categories. Our results indicate that the SARS-CoV-2 IgG DBS MIA is sensitive, specific, and well-suited for large population-based serosurveys. The ability to readily modify and multiplex antigens is important for ongoing assessment of SARS-CoV-2 antibody responses to emerging variants and vaccines. IMPORTANCE Testing for antibodies to SARS-CoV-2 has been used to estimate the prevalence of COVID-19 in different populations. Seroprevalence studies, or serosurveys, were especially useful during the early phase of the pandemic when diagnostic testing was not widely available, and the resulting seroprevalence estimates played an important role in public health decision making. To achieve meaningful results, antibody tests used for serosurveys should be accurate and accessible to diverse populations. We developed a test that detects antibodies to two different SARS-CoV-2 proteins in dried blood spots (DBS). DBS require only a simple fingerstick and can be collected in nonclinical settings. We conducted a robust validation study and have demonstrated that our test is both sensitive and specific. Furthermore, we demonstrated that our test is suitable for large-scale serosurveys by testing over 56,000 DBS collected in a variety of community-based venues in New York State during the spring of 2020.
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Affiliation(s)
- Linda M. Styer
- Wadsworth Center, New York State Department of Health, Albany, New York, USA
- Department of Biomedical Sciences, School of Public Health, University at Albany, Albany, New York, USA
| | - Rebecca Hoen
- Bureau of Surveillance and Data Systems, New York State Department of Health, Albany, New York, USA
| | - Jean Rock
- Wadsworth Center, New York State Department of Health, Albany, New York, USA
| | - Erica Yauney
- Wadsworth Center, New York State Department of Health, Albany, New York, USA
| | - Katherine Nemeth
- Wadsworth Center, New York State Department of Health, Albany, New York, USA
| | - Rachel Bievenue
- Wadsworth Center, New York State Department of Health, Albany, New York, USA
| | - Monica M. Parker
- Wadsworth Center, New York State Department of Health, Albany, New York, USA
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Affiliation(s)
- Elizabeth Smerczak
- Detroit Medical Center University Laboratories, Sinai-Grace Hospital, Detroit, Michigan, USA
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Snyder T, Ravenhurst J, Cramer EY, Reich NG, Balzer L, Alfandari D, Lover AA. Serological surveys to estimate cumulative incidence of SARS-CoV-2 infection in adults (Sero-MAss study), Massachusetts, July-August 2020: a mail-based cross-sectional study. BMJ Open 2021; 11:e051157. [PMID: 34404716 PMCID: PMC8375452 DOI: 10.1136/bmjopen-2021-051157] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES To estimate the seroprevalence of anti-SARS-CoV-2 IgG and IgM among Massachusetts residents and to better understand asymptomatic SARS-CoV-2 transmission during the summer of 2020. DESIGN Mail-based cross-sectional survey. SETTING Massachusetts, USA. PARTICIPANTS Primary sampling group: sample of undergraduate students at the University of Massachusetts, Amherst (n=548) and a member of their household (n=231).Secondary sampling group: sample of graduate students, faculty, librarians and staff (n=214) and one member of their household (n=78). All participants were residents of Massachusetts without prior COVID-19 diagnosis. PRIMARY AND SECONDARY OUTCOME MEASURES Prevalence of SARS-CoV-2 seropositivity. Association of seroprevalence with variables including age, gender, race, geographic region, occupation and symptoms. RESULTS Approximately 27 000 persons were invited via email to assess eligibility. 1001 households were mailed dried blood spot sample kits, 762 returned blood samples for analysis. In the primary sample group, 36 individuals (4.6%) had IgG antibodies detected for an estimated weighted prevalence in this population of 5.3% (95% CI: 3.5 to 8.0). In the secondary sampling group, 10 participants (3.4%) had IgG antibodies detected for an estimated adjusted prevalence of 4.0% (95% CI: 2.2 to 7.4). No samples were IgM positive. No association was found in either group between seropositivity and self-reported work duties or customer-facing hours. In the primary sampling group, self-reported febrile illness since February 2020, male sex and minority race (Black or American Indian/Alaskan Native) were associated with seropositivity. No factors except geographic regions within the state were associated with evidence of prior SARS-CoV-2 infection in the secondary sampling group. CONCLUSIONS This study fills a critical gap in estimating the levels of subclinical and asymptomatic infection. Estimates can be used to calibrate models estimating levels of population immunity over time, and these data are critical for informing public health interventions and policy.
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Affiliation(s)
- Teah Snyder
- Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | - Johanna Ravenhurst
- Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | - Estee Y Cramer
- Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | - Nicholas G Reich
- Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | - Laura Balzer
- Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | - Dominique Alfandari
- Veterinary and Animal Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | - Andrew A Lover
- Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA
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Baker D, Asardag AN, Quinn OA, Efimov A, Kang AS. Anti-drug antibodies to antibody-based therapeutics in multiple sclerosis. Hum Antibodies 2021; 29:255-262. [PMID: 34397407 DOI: 10.3233/hab-210453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Multiple sclerosis is the major demyelinating autoimmune disease of the central nervous system. Relapsing MS can be treated by a number of approved monoclonal antibodies that currently target: CD20, CD25 (withdrawn), CD49d and CD52. These all target potentially pathogenic memory B cell subsets and perhaps functionally inhibit pathogenic T cell function. These consist of chimeric, humanized and fully human antibodies. However, despite humanization it is evident that all of these monoclonal antibodies can induce binding and neutralizing antibodies ranging from < 1% to over 80% within a year of treatment. Importantly, it is evident that monitoring these allow prediction of future treatment-failure in some individuals and treatment cessation and switching therefore potentially limiting disease breakthrough and disability accumulation. In response to the COVID-19 pandemic and the need to avoid hospitals, shortened infusion times and extended dose intervals have been implemented, importantly, subcutaneous delivery of alternative treatments or formulations have been developed to allow for home treatment. Therefore, hospital-based and remote monitoring of ADA could therefore be advantageous to optimize patient responses in the future.
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Affiliation(s)
- David Baker
- Blizard Institute, Barts and London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - A Nazli Asardag
- Blizard Institute, Barts and London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Olivia A Quinn
- Blizard Institute, Barts and London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Alex Efimov
- Camstech Limited, Daresbury Laboratory Science and Technology Facilities Council Sci-Tech, Keckwick, Cheshire, UK
| | - Angray S Kang
- Blizard Institute, Barts and London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Centre for Oral Immunobiology and Regenerative Medicine, Dental Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Maritz L, Woudberg NJ, Bennett AC, Soares A, Lapierre F, Devine J, Kimberg M, Bouic PJ. Validation of high-throughput, semiquantitative solid-phase SARS coronavirus-2 serology assays in serum and dried blood spot matrices. Bioanalysis 2021; 13:1183-1193. [PMID: 34114884 PMCID: PMC8202508 DOI: 10.4155/bio-2021-0065] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 05/26/2021] [Indexed: 12/12/2022] Open
Abstract
Aim: Serological assays for the detection of anti-SARS coronavirus-2 (SARS-CoV-2) antibodies are essential to the response to the global pandemic. A ligand binding-based serological assay was validated for the semiquantitative detection of IgG, IgM, IgA and neutralizing antibodies (nAb) against SARS-CoV-2 in serum. Results: The assay demonstrated high levels of diagnostic specificity and sensitivity (85-99% for all analytes). Serum IgG, IgM, IgA and nAb correlated positively (R2 = 0.937, R2 = 0.839, R2 = 0.939 and R2 = 0.501, p < 0.001, respectively) with those measured in dried blood spot samples collected using the hemaPEN® microsampling device (Trajan Scientific and Medical, Victoria, Australia). In vitro SARS-CoV-2 pseudotype neutralization correlated positively with the solid phase nAb signals in convalescent donors (R2 = 0.458, p < 0.05). Conclusion: The assay is applicable in efficacy studies, infection monitoring and postmarketing surveillance following vaccine rollout.
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Affiliation(s)
- Leo Maritz
- Synexa Life Sciences, 4 Kunene Circle, Montague Gardens, Cape Town, 7441, South Africa
| | - Nicholas J Woudberg
- Synexa Life Sciences, 4 Kunene Circle, Montague Gardens, Cape Town, 7441, South Africa
| | - Amber C Bennett
- Synexa Life Sciences, 4 Kunene Circle, Montague Gardens, Cape Town, 7441, South Africa
| | - Andreia Soares
- Synexa Life Sciences, 4 Kunene Circle, Montague Gardens, Cape Town, 7441, South Africa
| | - Florian Lapierre
- Trajan Scientific & Medical, 7 Argent Place, Ringwood, Victoria, 3134, Australia
| | - Justin Devine
- Synexa Life Sciences, 4 Kunene Circle, Montague Gardens, Cape Town, 7441, South Africa
| | - Matti Kimberg
- Synexa Life Sciences, 4 Kunene Circle, Montague Gardens, Cape Town, 7441, South Africa
| | - Patrick J Bouic
- Synexa Life Sciences, 4 Kunene Circle, Montague Gardens, Cape Town, 7441, South Africa
- Division of Medical Microbiology, Faculty of Medicine & Health Sciences, University of Stellenbosch, Cape Town, 7505, South Africa
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Salamin O, Nicoli R, Xu C, Boccard J, Rudaz S, Pitteloud N, Saugy M, Kuuranne T. Steroid profiling by UHPLC-MS/MS in dried blood spots collected from healthy women with and without testosterone gel administration. J Pharm Biomed Anal 2021; 204:114280. [PMID: 34340018 DOI: 10.1016/j.jpba.2021.114280] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/24/2021] [Accepted: 07/21/2021] [Indexed: 11/27/2022]
Abstract
The quantification of a large panel of endogenous steroids in serum by LC-MS/MS represents a powerful clinical tool for the screening or diagnosis of diverse endocrine disorders. This approach has also demonstrated excellent sensitivity for the detection of testosterone misuse in the anti-doping field, especially in female athlete population. In both situations, the use of dried blood spots (DBS) could provide a viable alternative to invasive venous blood collection. Here, the evaluation of DBS sampling for the quantification of a panel of endogenous steroids using UHPLC-MS/MS is described. The UHPLC-MS/MS method was validated for quantitative analysis of eleven free and eight conjugated steroids and was then used for the analysis of DBS samples collected in 14 healthy women during a normal menstrual cycle (control phase) followed by a 28-days testosterone gel treatment (treatment phase). Results were compared with those obtained from serum matrix. Satisfactory performance was obtained for all compounds in terms of selectivity, linearity, accuracy, precision, combined uncertainty, stability as well as extraction recovery and matrix effects. In control phase, high correlation was observed between DBS and serum concentrations for most compounds. In treatment phase, higher testosterone concentrations were observed in capillary than in venous DBS, suggesting a possible interference resulting from testosterone contamination on finger(s) used for gel application. Steroid profiling in capillary DBS represents a simple and efficient strategy for monitoring endogenous steroid concentrations and their fluctuation in clinical context of steroid-related disorders, or for the detection of testosterone abuse in anti-doping.
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Affiliation(s)
- Olivier Salamin
- Center of Research and Expertise in Anti-Doping Sciences - REDs, Institute of Sport Sciences, University of Lausanne, 1015, Lausanne, Switzerland; Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Lausanne and Geneva, Lausanne University Hospital and University of Lausanne, Switzerland.
| | - Raul Nicoli
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Lausanne and Geneva, Lausanne University Hospital and University of Lausanne, Switzerland
| | - Cheng Xu
- Service of Endocrinology, Diabetology, and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
| | - Julien Boccard
- School of Pharmaceutical Sciences, University of Geneva, University Medical Centre, 1 Rue Michel-Servet, 1211, Geneva 4, Switzerland; Institute of Pharmaceutical Sciences of Western Switzerland (ISPSO), University of Geneva, Switzerland; Division of Biomedical and Metabolomic Analyses, Swiss Centre for Applied Human Toxicology (SCAHT), Basel, Switzerland
| | - Serge Rudaz
- School of Pharmaceutical Sciences, University of Geneva, University Medical Centre, 1 Rue Michel-Servet, 1211, Geneva 4, Switzerland; Institute of Pharmaceutical Sciences of Western Switzerland (ISPSO), University of Geneva, Switzerland; Division of Biomedical and Metabolomic Analyses, Swiss Centre for Applied Human Toxicology (SCAHT), Basel, Switzerland
| | - Nelly Pitteloud
- Service of Endocrinology, Diabetology, and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
| | - Martial Saugy
- Center of Research and Expertise in Anti-Doping Sciences - REDs, Institute of Sport Sciences, University of Lausanne, 1015, Lausanne, Switzerland
| | - Tiia Kuuranne
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Lausanne and Geneva, Lausanne University Hospital and University of Lausanne, Switzerland
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Turgeon CT, Sanders KA, Rinaldo P, Granger D, Hilgart H, Matern D, Theel ES. Validation of a multiplex flow immunoassay for detection of IgG antibodies against SARS-CoV-2 in dried blood spots. PLoS One 2021; 16:e0252621. [PMID: 34048503 PMCID: PMC8162624 DOI: 10.1371/journal.pone.0252621] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 05/18/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Dried blood spots (DBS) are an established specimen type for clinical testing given their low cost, ease of collection and storage, and convenient shipping capabilities through the postal system. These attributes are complementary to the expansion of SARS-CoV-2 serologic testing, which may be used to inform community seroprevalence rates. METHODS The Luminex xMAP SARS-CoV-2 Multi-Antigen assay utilizes magnetic beads labeled with three viral antigens (nucleocapsid [NC], receptor binding domain [RBD], spike S1 subunit) to detect anti-viral IgG-class antibodies, and has Food and Drug Administration (FDA) Emergency Use Authorization (EUA) for use in serum and plasma. This assay was modified for use with DBS and validated against paired sera tested by one of two reference assays: the Roche Diagnostics Elecsys anti-SARS-CoV-2 ECLIA or the Euroimmun anti-SARS-CoV-2 IgG ELISA. RESULTS 159 paired DBS and serum specimens analyzed using the modified Luminex xMAP assay on DBS and the reference methods on serum showed an overall concordance of 96.9% (154/159). Use of multivariate pattern recognition software (CLIR) for post-analytical interpretation of the Luminex xMAP DBS assay results, instead of manufacturer provided interpretive thresholds, increased overall qualitative result concordance to 99.4% (158/159) between the modified Luminex xMAP DBS and reference results. CONCLUSIONS Use of DBS for detection of antibodies against SARS-CoV-2 provides comparable results to those obtained using serum. DBS concordance was improved with multivariate pattern recognition software (CLIR). We demonstrate that DBS are a reliable specimen type for SARS-CoV-2 antibody detection using the modified Luminex xMAP assay.
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Affiliation(s)
- Coleman T. Turgeon
- Divisions of Laboratory Genetics and Genomics and Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Karen A. Sanders
- Divisions of Laboratory Genetics and Genomics and Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Piero Rinaldo
- Divisions of Laboratory Genetics and Genomics and Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Dane Granger
- Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Heather Hilgart
- Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Dietrich Matern
- Divisions of Laboratory Genetics and Genomics and Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Elitza S. Theel
- Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, United States of America
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Brinc D, Biondi MJ, Li D, Sun H, Capraru C, Smookler D, Zahoor MA, Casey J, Kulasingam V, Feld JJ. Evaluation of Dried Blood Spot Testing for SARS-CoV-2 Serology Using a Quantitative Commercial Assay. Viruses 2021; 13:962. [PMID: 34067361 PMCID: PMC8224688 DOI: 10.3390/v13060962] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 05/10/2021] [Accepted: 05/19/2021] [Indexed: 12/22/2022] Open
Abstract
Dried blood spots (DBS) are commonly used for serologic testing for viruses and provide an alternative collection method when phlebotomy and/or conventional laboratory testing are not readily available. DBS collection could be used to facilitate widespread testing for SARS-CoV-2 antibodies to document past infection, vaccination, and potentially immunity. We investigated the characteristics of Roche's Anti-SARS-CoV-2 (S) assay, a quantitative commercial assay for antibodies against the spike glycoprotein. Antibody levels were reduced relative to plasma following elution from DBS. Quantitative results from DBS samples were highly correlated with values from plasma (r2 = 0.98), allowing for extrapolation using DBS results to accurately estimate plasma antibody levels. High concordance between plasma and fingerpick DBS was observed in PCR-confirmed COVID-19 patients tested 90 days or more after the diagnosis (45/46 matched; 1/46 mismatched plasma vs. DBS). The assessment of antibody responses to SARS-CoV-2 using DBS may be feasible using a quantitative anti-S assay, although false negatives may rarely occur in those with very low antibody levels.
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Affiliation(s)
- Davor Brinc
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada; (D.B.); (V.K.)
- Department of Clinical Biochemistry, University Health Network, Toronto, ON M5G 2C4, Canada;
| | - Mia J. Biondi
- Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON M5G 2C, Canada; (M.J.B.); (C.C.); (D.S.); (M.A.Z.); (J.C.)
| | - Daniel Li
- Institute of Medical Science, University of Toronto, Toronto, ON M5S 1A8, Canada;
| | - Heng Sun
- Department of Clinical Biochemistry, University Health Network, Toronto, ON M5G 2C4, Canada;
| | - Camelia Capraru
- Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON M5G 2C, Canada; (M.J.B.); (C.C.); (D.S.); (M.A.Z.); (J.C.)
| | - David Smookler
- Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON M5G 2C, Canada; (M.J.B.); (C.C.); (D.S.); (M.A.Z.); (J.C.)
| | - Muhammad Atif Zahoor
- Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON M5G 2C, Canada; (M.J.B.); (C.C.); (D.S.); (M.A.Z.); (J.C.)
| | - Julia Casey
- Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON M5G 2C, Canada; (M.J.B.); (C.C.); (D.S.); (M.A.Z.); (J.C.)
| | - Vathany Kulasingam
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada; (D.B.); (V.K.)
- Department of Clinical Biochemistry, University Health Network, Toronto, ON M5G 2C4, Canada;
| | - Jordan J. Feld
- Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON M5G 2C, Canada; (M.J.B.); (C.C.); (D.S.); (M.A.Z.); (J.C.)
- Institute of Medical Science, University of Toronto, Toronto, ON M5S 1A8, Canada;
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Development and Validation of a Multiplex Microsphere Immunoassay Using Dried Blood Spots for SARS-CoV-2 Seroprevalence: Application in First Responders in Colorado, USA. J Clin Microbiol 2021; 59:JCM.00290-21. [PMID: 33795412 PMCID: PMC8315929 DOI: 10.1128/jcm.00290-21] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 03/26/2021] [Indexed: 01/19/2023] Open
Abstract
Serological testing of large representative populations for antibodies to SARS-CoV-2 is needed to estimate seroprevalence, transmission dynamics, and the duration of antibody responses from natural infection and vaccination. In this study, a high-throughput SARS-CoV-2 multiplex microsphere immunoassay (MMIA) was developed for the receptor binding domain (RBD) and nucleocapsid (N) that was more sensitive than enzyme-linked immunosorbent assay (ELISA) (98% versus 87%). The MMIA was then applied and validated in 264 first responders in Colorado using serum and dried blood spot (DBS) eluates, compared to ELISA, and evaluated for neutralizing antibodies. Four percent (11/264) of first responders were seropositive in July to August 2020. Serum and DBS were highly correlated for anti-RBD and anti-N antibodies (R = 0.83, P < 0.0001 and R = 0.87, P < 0.0001, respectively) by MMIA. The MMIA accurately predicted SARS-CoV-2 neutralizing antibodies using DBS (R = 0.76, P = 0.037). On repeat antibody testing 3 months later, anti-RBD IgG decreased less rapidly than anti-N IgG measured by MMIA, with a median change in geometric median fluorescence intensity of 62% versus 79% (P < 0.01) for anti-RBD and anti-N IgG, respectively. This novel MMIA using DBS could be scalable for rapid and affordable SARS-CoV-2 serosurveillance in the United States and globally.
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Detection of SARS-CoV-2 IgG antibodies in dried blood spots. Diagn Microbiol Infect Dis 2021; 101:115425. [PMID: 34116343 PMCID: PMC8116316 DOI: 10.1016/j.diagmicrobio.2021.115425] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/14/2021] [Accepted: 04/27/2021] [Indexed: 01/07/2023]
Abstract
The COVID-19 pandemic led to development of numerous serologic tests. To obviate the need for phlebotomy services, we validated dried blood spots (DBS) for anti-SARS-CoV-2 serologic testing. Immunoglobulins were extracted from 3 mm DBS punches and the extracts were analyzed using the Euroimmun anti-SARS-CoV-2 IgG ELISA. Various pre-analytical factors were studied. Results were favorable for DBS stored for at least 67 days at or below 37°C. Comparison between paired serum and DBS specimens tested by the Euroimmun ELISA showed 96.8% and 81.3% positive and negative agreement, respectively, indicating that confirmatory testing of positive Euroimmun results on DBS extracts is necessary to achieve clinical accuracy. Our findings suggest that any SARS-CoV-2 antibody assay that requires pre-dilution of serum is amenable to DBS as an alternate specimen type that is relatively low cost, self-collectable, stable, can be shipped by standard mail and could be used to establish the seroprevalence of large populations.
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Fontaine E, Saez C. Analysis of SARS-CoV-2 antibodies from dried blood spot samples with the Roche Elecsys Immunochemistry method. Pract Lab Med 2021; 25:e00234. [PMID: 33942023 PMCID: PMC8080505 DOI: 10.1016/j.plabm.2021.e00234] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 04/23/2021] [Indexed: 11/20/2022] Open
Abstract
Objectives The aim of this study was to evaluate the application of the Roche Elecsys anti-SARS-CoV-2 assay to capillary dried blood samples for high throughput analyses on Roche COBAS 6000 systems. Design and methods The performance of the of the Elecsys anti-SARS-CoV-2 assay was assessed using three sets of dried blood spot samples. Method correlation was performed using spiked blood samples. Sensitivity and specificity were calculated using paired donor samples. An additional cohort of 50 individuals, including COVID-19 convalescent cases, was used for the evaluation of at-home collection for mail transport, and stability studies. Results The Elecsys anti-SARS-CoV-2 assay using dried blood spot samples showed an excellent agreement of 98.9% with results obtained using their paired serum samples, and 86.7% accuracy with dried blood spots collected after 9 days from diagnostic (PCR) tests. Conclusions Capillary dried blood spot samples can be confidently used on Roche COBAS automated analyzers to monitor the epidemiology of COVID-19, and are suitable for use in large-scale screening programs.
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Affiliation(s)
| | - Cristian Saez
- Corresponding author. CoreMedica Laboratories, Inc., 200 NE Missouri Road, Lee’s Summit, MO, 64086, USA.
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Brown L, Byrne RL, Fraser A, Owen SI, Cubas-Atienzar AI, Williams CT, Kay GA, Cuevas LE, Fitchett JRA, Fletcher T, Garrod G, Kontogianni K, Krishna S, Menzies S, Planche T, Sainter C, Staines HM, Turtle L, Adams ER. Self-sampling of capillary blood for SARS-CoV-2 serology. Sci Rep 2021; 11:7754. [PMID: 33833246 PMCID: PMC8032656 DOI: 10.1038/s41598-021-86008-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 01/18/2021] [Indexed: 01/06/2023] Open
Abstract
Serological testing is emerging as a powerful tool to progress our understanding of COVID-19 exposure, transmission and immune response. Large-scale testing is limited by the need for in-person blood collection by staff trained in venepuncture, and the limited sensitivity of lateral flow tests. Capillary blood self-sampling and postage to laboratories for analysis could provide a reliable alternative. Two-hundred and nine matched venous and capillary blood samples were obtained from thirty nine participants and analysed using a COVID-19 IgG ELISA to detect antibodies against SARS-CoV-2. Thirty eight out of thirty nine participants were able to self-collect an adequate sample of capillary blood (≥ 50 µl). Using plasma from venous blood collected in lithium heparin as the reference standard, matched capillary blood samples, collected in lithium heparin-treated tubes and on filter paper as dried blood spots, achieved a Cohen’s kappa coefficient of > 0.88 (near-perfect agreement, 95% CI 0.738–1.000). Storage of capillary blood at room temperature for up to 7 days post sampling did not affect concordance. Our results indicate that capillary blood self-sampling is a reliable and feasible alternative to venepuncture for serological assessment in COVID-19.
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Affiliation(s)
- Lottie Brown
- Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Rachel L Byrne
- Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Alice Fraser
- Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Sophie I Owen
- Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Ana I Cubas-Atienzar
- Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Christopher T Williams
- Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Grant A Kay
- Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Luis E Cuevas
- Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | | | - Tom Fletcher
- Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK.,Tropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust (Member of Liverpool Health Partners), Liverpool, UK
| | - Gala Garrod
- Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Konstantina Kontogianni
- Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Sanjeev Krishna
- Centre for Diagnostics and Antimicrobial Resistance, Institute for Infection and Immunity, St George's University of London, London, UK
| | - Stefanie Menzies
- Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Tim Planche
- Centre for Diagnostics and Antimicrobial Resistance, Institute for Infection and Immunity, St George's University of London, London, UK
| | - Chris Sainter
- Mologic COVID-19 Diagnostics Development Team, Thurleigh, Bedfordshire, UK
| | - Henry M Staines
- Centre for Diagnostics and Antimicrobial Resistance, Institute for Infection and Immunity, St George's University of London, London, UK
| | - Lance Turtle
- Tropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust (Member of Liverpool Health Partners), Liverpool, UK.,Department of Clinical Infection, Microbiology and Immunology, University of Liverpool, Liverpool, L69 7BE, UK
| | - Emily R Adams
- Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK.
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The Evolving Role of Microsampling in Therapeutic Drug Monitoring of Monoclonal Antibodies in Inflammatory Diseases. Molecules 2021; 26:molecules26061787. [PMID: 33810104 PMCID: PMC8004874 DOI: 10.3390/molecules26061787] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 03/18/2021] [Accepted: 03/19/2021] [Indexed: 12/17/2022] Open
Abstract
Monoclonal antibodies (mAbs) have been extensively developed over the past few years, for the treatment of various inflammatory diseases. They are large molecules characterized by complex pharmacokinetic and pharmacodynamic properties. Therapeutic drug monitoring (TDM) is routinely implemented in the therapy with mAbs, to monitor patients’ treatment response and to further guide dose adjustments. Serum has been the matrix of choice in the TDM of mAbs and its sampling requires the visit of the patients to laboratories that are not always easily accessible. Therefore, dried blood spots (DBS) and various microsampling techniques have been suggested as an alternative. DBS is a sampling technique in which capillary blood is deposited on a special filter paper. It is a relatively simple procedure, and the patients can perform the home-sampling. The convenience it offers has enabled its use in the quantification of small-molecule drugs, whilst in the recent years, studies aimed to develop microsampling methods that will facilitate the TDM of mAbs. Nevertheless, hematocrit still remains an obstacle that hinders a more widespread implementation of DBS in clinical practice. The introduction of novel analytical techniques and contemporary microsampling devices can be considered the steppingstone to the attempts made addressing this issue.
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48
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Adaptation of Elecsys ® anti-severe acute respiratory syndrome coronavirus-2 immunoassay to dried blood spots: proof of concept. Bioanalysis 2021; 13:161-167. [PMID: 33538622 DOI: 10.4155/bio-2020-0318] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Aim: Several automated immunoassays have been validated on serum/plasma to evaluate the presence of significant levels of anti-severe acute respiratory syndrome coronavirus 2 (anti-SARS-CoV-2) antibodies, signs of a present or past infection, but the use of dried blood spots (DBS) would facilitate sampling, shipping and storage. Objective: The aim of this project was to give proof of concept of the possibility to use of the automatized Elecsys® anti-SARS-CoV-2 immunoassay with a volumetric DBS device. Results: Linearity and correlation were satisfactory between volumetric DBS and plasma. A cut-off value was suggested and should be validated with more samples. Conclusion: this study strongly support the possibility to work with volumetric DBS instead of serum/plasma to test for anti-SARS-CoV-2 antibodies.
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49
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Use of dried blood spot samples for SARS-CoV-2 antibody detection using the Roche Elecsys ® high throughput immunoassay. J Clin Virol 2021; 136:104739. [PMID: 33588354 PMCID: PMC7817498 DOI: 10.1016/j.jcv.2021.104739] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 12/24/2020] [Accepted: 01/14/2021] [Indexed: 02/06/2023]
Abstract
Dried blood spot samples (DBS) provide an alternative sample type to venous blood samples for antibody testing. DBS are used by NHS for diagnosing Hepatitis C and by Public Health England for large scale HIV and Hepatitis C serosurveillance; the applicability of DBS based approaches for SARS-CoV-2 antibody detection is uncertain. The study aimed to compare antibody detection in DBS eluates using the Roche Elecsys ® immunoassay with antibody detection in paired plasma samples, using the same assay. The study was in one Police and one Fire & Rescue facility in England; it comprised of 195 participants within a larger sample COVID-19 serodiagnostics study of keyworkers, EDSAB-HOME. Outcome measures were sensitivity and specificity of DBS (the index test) relative to plasma (the reference test), at an experimental cut-off; quality of DBS sample collected; estimates of relative sensitivity of DBS vs. plasma immunoassay in a larger population. 18/195 (9.2%) participants tested positive using plasma samples. DBS sample quality varied markedly by phlebotomist, and low sample volume significantly reduced immunoassay signals. Using an experimental cut-off, sensitivity and specificity of DBS were 89.0% (95% CI 67.2, 96.9%) and 100.0% (95% CI 97.9, 100%) respectively compared with using plasma. The limit of detection for DBS is about 30 times higher than for plasma. DBS use for SARS-CoV-2 serology, though feasible, is insensitive relative to immunoassays on plasma. Sample quality impacts on assay performance. Alternatives, including the collection of capillary blood samples, should be considered for screening programs.
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