1
|
Sundell GN, Tao SC. Phage immunoprecipitation and sequencing-a versatile technique for mapping the antibody reactome. Mol Cell Proteomics 2024:100831. [PMID: 39168282 DOI: 10.1016/j.mcpro.2024.100831] [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: 04/10/2024] [Revised: 08/13/2024] [Accepted: 08/16/2024] [Indexed: 08/23/2024] Open
Abstract
Characterizing the antibody reactome for circulating antibodies provide insight into pathogen exposure, allergies and autoimmune diseases. This is important for biomarker discovery, clinical diagnosis, and prognosis of disease progression, as well as population-level insights into the immune system. The emerging technology phage display immunoprecipitation and sequencing (PhIP-seq) is a high-throughput method for identifying antigens/epitopes of the antibody reactome. In PhIP-seq, libraries with sequences of defined lengths and overlapping segments are bioinformatically designed using naturally occurring proteins and cloned into phage genomes to be displayed on the surface. These libraries are used in immunoprecipitation experiments of circulating antibodies. This can be done with parallel samples from multiple sources, and the DNA inserts from the bound phages are barcoded and subjected to next-generation sequencing for hit-determination. PhIP-seq is a powerful technique for characterizing the antibody reactome that has undergone rapid advances in recent years. In this review, we comprehensively describe the history of PhIP-seq and discuss recent advances in library design and applications.
Collapse
Affiliation(s)
- Gustav N Sundell
- Shanghai Center for Systems Biomedicine, Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Jiao Tong University, Shanghai 200240, China
| | - Sheng-Ce Tao
- Shanghai Center for Systems Biomedicine, Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Jiao Tong University, Shanghai 200240, China.
| |
Collapse
|
2
|
Liao L, Luo ZQ, Byeon JH, Park JH. Size-selective sampler combined with an immunochromatographic assay for the rapid detection of airborne Legionella pneumophila. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 927:172085. [PMID: 38554967 DOI: 10.1016/j.scitotenv.2024.172085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 03/04/2024] [Accepted: 03/27/2024] [Indexed: 04/02/2024]
Abstract
Airborne biological aerosols (also called bioaerosols) are found in various environmental and occupational settings. Among these, pathogenic bioaerosols can cause diseases such as legionellosis, influenza, measles, and tuberculosis. To prevent or minimize people's exposure to these pathogenic bioaerosols in the field, a rapid detection method is required. In this study, a size-selective bioaerosol (SSB) sampler was combined with the immunochromatographic assay (ICA). The SSB sampler can collect bioaerosols on the sampling swab and the lateral flow test kit used in ICA can rapidly detect the pathogens in bioaerosols collected on the swab. Before testing the combined method, the lower limit of detection (LOD) of the lateral flow test kit was determined. Legionella pneumophila (L. pneumophila) was used as a target pathogen. The results show that at least 1.3 × 103L. pneumophila cells are required to be detected by the lateral flow test kit. To test the developed method, L. pneumophila suspension was aerosolized in the sampling chamber and collected using two SSB samplers with different sampling times (10 and 20 min). The developed method could detect aerosolized L. pneumophila and also estimate the concentrations from the lower LOD, sampling time, and formation of a positive line on a test strip. When positive results were obtained from sampling for 10 min and 20 min, concentrations of respirable L. pneumophila were estimated ≥5.2 × 104 CFUresp/m3 and ≥2.6 × 104 CFUresp/m3, respectively. The conventional sampler Andersen impactor with colony counting was also used for comparison. In all cases, the estimated concentrations obtained by the developed method were higher than those obtained by the conventional method. These findings confirm that the developed method can overcome the limitations of conventional methods and eventually benefit environmental and occupational health by providing a better method for risk assessment.
Collapse
Affiliation(s)
- Li Liao
- School of Health Sciences, Purdue University, West Lafayette, IN 47906, USA
| | - Zhao-Qing Luo
- Department of Biological Sciences, Purdue University, West Lafayette, IN 47906, USA
| | - Jeong Hoon Byeon
- School of Mechanical Engineering, Yeungnam University, Gyeongsan 38541, Republic of Korea.
| | - Jae Hong Park
- School of Health Sciences, Purdue University, West Lafayette, IN 47906, USA.
| |
Collapse
|
3
|
Ganesh PS, Elugoke SE, Lee SH, Kim SY, Ebenso EE. Smart and emerging point of care electrochemical sensors based on nanomaterials for SARS-CoV-2 virus detection: Towards designing a future rapid diagnostic tool. CHEMOSPHERE 2024; 352:141269. [PMID: 38307334 DOI: 10.1016/j.chemosphere.2024.141269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/08/2024] [Accepted: 01/18/2024] [Indexed: 02/04/2024]
Abstract
In the recent years, researchers from all over the world have become interested in the fabrication of advanced and innovative electrochemical and/or biosensors for respiratory virus detection with the use of nanotechnology. These fabricated sensors demonstrated a number of benefits, including precision, affordability, accessibility, and miniaturization which makes them a promising test method for point-of-care (PoC) screening for SARS-CoV-2 viral infection. In order to comprehend the principles of electrochemical sensing and the role of various types of sensing interfaces, we comprehensively explored the underlying principles of electroanalytical methods and terminologies related to it in this review. In addition, it is addressed how to fabricate electrochemical sensing devices incorporating nanomaterials as graphene, metal/metal oxides, metal organic frameworks (MOFs), MXenes, quantum dots, and polymers. We took an effort to carefully compile current developments, advantages, drawbacks, possible solutions in nanomaterials based electrochemical sensors.
Collapse
Affiliation(s)
- Pattan Siddappa Ganesh
- Interaction Laboratory, Advanced Technology Research Center, Future Convergence Engineering, Korea University of Technology and Education, Cheonan-si, Chungcheongnam-do, 330-708, Republic of Korea.
| | - Saheed Eluwale Elugoke
- Centre for Material Science, College of Science, Engineering and Technology, University of South Africa, Johannesburg 1709, South Africa; Institute for Nanotechnology and Water Sustainability (iNanoWS), College of Science, Engineering and Technology, University of South Africa, Johannesburg 1709, South Africa
| | - Seok-Han Lee
- Interaction Laboratory, Advanced Technology Research Center, Future Convergence Engineering, Korea University of Technology and Education, Cheonan-si, Chungcheongnam-do, 330-708, Republic of Korea
| | - Sang-Youn Kim
- Interaction Laboratory, Advanced Technology Research Center, Future Convergence Engineering, Korea University of Technology and Education, Cheonan-si, Chungcheongnam-do, 330-708, Republic of Korea.
| | - Eno E Ebenso
- Centre for Material Science, College of Science, Engineering and Technology, University of South Africa, Johannesburg 1709, South Africa; Institute for Nanotechnology and Water Sustainability (iNanoWS), College of Science, Engineering and Technology, University of South Africa, Johannesburg 1709, South Africa.
| |
Collapse
|
4
|
Holdenrieder S, Dos Santos Ferreira CE, Izopet J, Theel ES, Wieser A. Clinical and laboratory considerations: determining an antibody-based composite correlate of risk for reinfection with SARS-CoV-2 or severe COVID-19. Front Public Health 2023; 11:1290402. [PMID: 38222091 PMCID: PMC10788057 DOI: 10.3389/fpubh.2023.1290402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/30/2023] [Indexed: 01/16/2024] Open
Abstract
Much of the global population now has some level of adaptive immunity to SARS-CoV-2 induced by exposure to the virus (natural infection), vaccination, or a combination of both (hybrid immunity). Key questions that subsequently arise relate to the duration and the level of protection an individual might expect based on their infection and vaccination history. A multi-component composite correlate of risk (CoR) could inform individuals and stakeholders about protection and aid decision making. This perspective evaluates the various elements that need to be accommodated in the development of an antibody-based composite CoR for reinfection with SARS-CoV-2 or development of severe COVID-19, including variation in exposure dose, transmission route, viral genetic variation, patient factors, and vaccination status. We provide an overview of antibody dynamics to aid exploration of the specifics of SARS-CoV-2 antibody testing. We further discuss anti-SARS-CoV-2 immunoassays, sample matrices, testing formats, frequency of sampling and the optimal time point for such sampling. While the development of a composite CoR is challenging, we provide our recommendations for each of these key areas and highlight areas that require further work to be undertaken.
Collapse
Affiliation(s)
- Stefan Holdenrieder
- Institute of Laboratory Medicine, German Heart Centre Munich, Technical University Munich, Munich, Germany
| | | | - Jacques Izopet
- Laboratory of Virology, Toulouse University Hospital and INFINITY Toulouse Institute for Infections and Inflammatory Diseases, INSERM UMR 1291 CNRS UMR 5051, University Toulouse III, Toulouse, France
| | - Elitza S. Theel
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
| | - Andreas Wieser
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
- German Centre for Infection Research (DZIF), Munich, Germany
- Faculty of Medicine, Max Von Pettenkofer Institute, LMU Munich, Munich, Germany
- Immunology, Infection and Pandemic Research, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Munich, Germany
| |
Collapse
|
5
|
Yari P, Liang S, Chugh VK, Rezaei B, Mostufa S, Krishna VD, Saha R, Cheeran MCJ, Wang JP, Gómez-Pastora J, Wu K. Nanomaterial-Based Biosensors for SARS-CoV-2 and Future Epidemics. Anal Chem 2023; 95:15419-15449. [PMID: 37826859 DOI: 10.1021/acs.analchem.3c01522] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Affiliation(s)
- Parsa Yari
- Department of Electrical and Computer Engineering, Texas Tech University, Lubbock, Texas 79409, United States
| | - Shuang Liang
- Department of Chemical Engineering and Materials Science, University of Minnesota, Minneapolis, Minnesota 55455, United States
| | - Vinit Kumar Chugh
- Department of Electrical and Computer Engineering, University of Minnesota, Minneapolis, Minnesota 55455, United States
| | - Bahareh Rezaei
- Department of Electrical and Computer Engineering, Texas Tech University, Lubbock, Texas 79409, United States
| | - Shahriar Mostufa
- Department of Electrical and Computer Engineering, Texas Tech University, Lubbock, Texas 79409, United States
| | - Venkatramana Divana Krishna
- Department of Veterinary Population Medicine, University of Minnesota, St. Paul, Minnesota 55108, United States
| | - Renata Saha
- Department of Electrical and Computer Engineering, University of Minnesota, Minneapolis, Minnesota 55455, United States
| | - Maxim C-J Cheeran
- Department of Veterinary Population Medicine, University of Minnesota, St. Paul, Minnesota 55108, United States
| | - Jian-Ping Wang
- Department of Chemical Engineering and Materials Science, University of Minnesota, Minneapolis, Minnesota 55455, United States
- Department of Electrical and Computer Engineering, University of Minnesota, Minneapolis, Minnesota 55455, United States
| | - Jenifer Gómez-Pastora
- Department of Chemical Engineering, Texas Tech University, Lubbock, Texas 79409, United States
| | - Kai Wu
- Department of Electrical and Computer Engineering, Texas Tech University, Lubbock, Texas 79409, United States
| |
Collapse
|
6
|
Greenland-Bews C, Byrne RL, Owen SI, Watkins RL, Bengey D, Buist K, Clerkin K, Escadafal C, Finch LS, Gould S, Giorgi E, Hodgkinson A, Mashenko L, Powell D, Savage HR, Thompson CR, Turtle L, Wardale J, Wooding D, Edwards T, Atienzar AC, Adams ER. Evaluation of eight lateral flow tests for the detection of anti-SARS-CoV-2 antibodies in a vaccinated population. BMC Infect Dis 2023; 23:110. [PMID: 36823583 PMCID: PMC9947870 DOI: 10.1186/s12879-023-08033-1] [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: 06/17/2022] [Accepted: 01/27/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Rapid determination of an individual's antibody status can be beneficial in understanding an individual's immune response to SARS-CoV-2 and for initiation of therapies that are only deemed effective in sero-negative individuals. Antibody lateral flow tests (LFTs) have potential to address this need as a rapid, point of care test. METHODS Here we present a proof-of-concept evaluation of eight LFT brands using sera from 95 vaccinated individuals to determine sensitivity for detecting vaccination generated antibodies. Samples were analysed on eight different brands of antibody LFT and an automated chemiluminescent microparticle immunoassay (CMIA) that identifies anti-spike antibodies which was used as our reference standard. RESULTS All 95 (100%) participants tested positive for anti-spike antibodies by the chemiluminescent microparticle immunoassay (CMIA) reference standard post-dose two of their SARS-CoV-2 vaccine: BNT162b2 (Pfizer/BioNTech, n = 60), AZD1222 (AstraZeneca, n = 31), mRNA-1273 (Moderna, n = 2) and Undeclared Vaccine Brand (n = 2). Sensitivity increased from dose one to dose two in six out of eight LFTs with three tests achieving 100% sensitivity at dose two in detecting anti-spike antibodies. CONCLUSIONS These tests are demonstrated to be highly sensitive to detect raised antibody levels in vaccinated individuals. RDTs are low cost and rapid alternatives to ELISA based systems.
Collapse
Affiliation(s)
- Caitlin Greenland-Bews
- grid.48004.380000 0004 1936 9764Liverpool School of Tropical Medicine, Centre for Drugs and Diagnostics, Liverpool, UK
| | - Rachel L. Byrne
- grid.48004.380000 0004 1936 9764Liverpool School of Tropical Medicine, Centre for Drugs and Diagnostics, Liverpool, UK
| | - Sophie I. Owen
- grid.48004.380000 0004 1936 9764Liverpool School of Tropical Medicine, Centre for Drugs and Diagnostics, Liverpool, UK ,Global Access Diagnostics (GADx), Bedfordshire, UK
| | - Rachel L. Watkins
- grid.48004.380000 0004 1936 9764Liverpool School of Tropical Medicine, Centre for Drugs and Diagnostics, Liverpool, UK
| | - Daisy Bengey
- grid.48004.380000 0004 1936 9764Liverpool School of Tropical Medicine, Centre for Drugs and Diagnostics, Liverpool, UK
| | - Kate Buist
- grid.48004.380000 0004 1936 9764Liverpool School of Tropical Medicine, Centre for Drugs and Diagnostics, Liverpool, UK
| | - Karina Clerkin
- grid.48004.380000 0004 1936 9764Liverpool School of Tropical Medicine, Centre for Drugs and Diagnostics, Liverpool, UK
| | - Camille Escadafal
- grid.452485.a0000 0001 1507 3147FIND, Foundation for Innovative New Diagnostics, Geneva, Switzerland
| | - Lorna S. Finch
- grid.48004.380000 0004 1936 9764Liverpool School of Tropical Medicine, Centre for Drugs and Diagnostics, Liverpool, UK
| | - Susan Gould
- grid.48004.380000 0004 1936 9764Liverpool School of Tropical Medicine, Centre for Drugs and Diagnostics, Liverpool, UK
| | - Emanuele Giorgi
- grid.9835.70000 0000 8190 6402Lancaster Medical School, Lancaster University, Lancaster, UK
| | - Andy Hodgkinson
- grid.413582.90000 0001 0503 2798Biochemistry Department, Alder Hey Children’s Hospital, Liverpool, UK
| | - Larysa Mashenko
- grid.48004.380000 0004 1936 9764Liverpool School of Tropical Medicine, Centre for Drugs and Diagnostics, Liverpool, UK
| | - Darren Powell
- grid.413582.90000 0001 0503 2798Biochemistry Department, Alder Hey Children’s Hospital, Liverpool, UK
| | - Helen R. Savage
- grid.48004.380000 0004 1936 9764Liverpool School of Tropical Medicine, Centre for Drugs and Diagnostics, Liverpool, UK
| | - Caitlin R. Thompson
- grid.48004.380000 0004 1936 9764Liverpool School of Tropical Medicine, Centre for Drugs and Diagnostics, Liverpool, UK
| | - Lance Turtle
- grid.10025.360000 0004 1936 8470Department of Clinical Infection, Microbiology and Immunology, University of Liverpool, Liverpool, UK
| | - Jahanara Wardale
- grid.48004.380000 0004 1936 9764Liverpool School of Tropical Medicine, Centre for Drugs and Diagnostics, Liverpool, UK
| | - Dominic Wooding
- grid.48004.380000 0004 1936 9764Liverpool School of Tropical Medicine, Centre for Drugs and Diagnostics, Liverpool, UK
| | - Thomas Edwards
- grid.48004.380000 0004 1936 9764Liverpool School of Tropical Medicine, Centre for Drugs and Diagnostics, Liverpool, UK
| | - Ana Cubas Atienzar
- grid.48004.380000 0004 1936 9764Liverpool School of Tropical Medicine, Centre for Drugs and Diagnostics, Liverpool, UK
| | - Emily R. Adams
- grid.48004.380000 0004 1936 9764Liverpool School of Tropical Medicine, Centre for Drugs and Diagnostics, Liverpool, UK ,Global Access Diagnostics (GADx), Bedfordshire, UK
| |
Collapse
|
7
|
Jiang M, Chen W, Chen Y, Chen J, Zhang Y, Yin H, Li Y, Liu W. Analytical performance of rapid nucleic acid detection assays and routine RT-qPCR assays for detection of SARS-CoV-2 in Shanghai, China in 2022. Diagn Microbiol Infect Dis 2023; 105:115860. [PMID: 36459887 PMCID: PMC9708047 DOI: 10.1016/j.diagmicrobio.2022.115860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/28/2022] [Accepted: 11/08/2022] [Indexed: 11/13/2022]
Abstract
Diagnostic accuracy of COVID-19 varies among different assays. In this study, the analytical performance of 1 rapid nucleic acid detection assay (Coyote assay) and 2 routine RT-qPCR assays (BioGerm assay and DaAn assay) was evaluated, using 1196 clinical samples. Disagreement in the results of 2 paired targets occurred in all 3 assays. The Coyote assay failed to detect 15 samples, and the DaAn assay failed to detect 5 samples. The Cohen's kappa coefficient was 0.970 between the BioGerm and DaAn assays, 0.907 between the Coyote and BioGerm assays, and 0.936 between the Coyote and DaAn assays. The positive percent agreement, and negative percent agreement of the Coyote assay were 84.04%, and 100%, respectively. Our study revealed that the results of the Coyote, BioGerm, and DaAn assays were highly consistent, which provided reference for the application of these assays for diagnosis of COVID-19.
Collapse
Affiliation(s)
- Min Jiang
- Department of Laboratory Medicine, LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Department of Laboratory Medicine and Central Laboratory, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Weiqin Chen
- Department of Laboratory Medicine, LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yong Chen
- Department of Laboratory Medicine, LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jia Chen
- Department of Laboratory Medicine, LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yue Zhang
- Department of Laboratory Medicine, LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hongmei Yin
- Department of Laboratory Medicine, LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yi Li
- Department of Nephropathy, LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
| | - Weiwei Liu
- Department of Laboratory Medicine, LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
| |
Collapse
|
8
|
Bhuiyan NH, Uddin MJ, Lee J, Hong JH, Shim JS. An Internet-of-Disease System for COVID-19 Testing Using Saliva by an AI-Controlled Microfluidic ELISA Device. ADVANCED MATERIALS TECHNOLOGIES 2022; 7:2101690. [PMID: 35942252 PMCID: PMC9349700 DOI: 10.1002/admt.202101690] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 05/04/2022] [Indexed: 06/15/2023]
Abstract
Throughout coronavirus disease (COVID-19) outbreaks, the centers for disease control and prevention (CDCP) of a country require monitoring of particular territories to provide public health guidance. In this work, the Internet of Diseases (IoD) is suggested for continuous real-time monitoring of infectious diseases for public health. Because converging information and communication technologies (ICTs) with point-of-care (POC) devices to enable the IoD for continuous real-time health monitoring and processing of clinical records are crucial, an IoD platform associating a lab-on-a-chip (LOC) device to diagnose severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) from oropharyngeal saliva samples have been developed and uploaded the resulted diagnostic data into a cloud-based system to be connected with CDCP. Moreover, a choropleth IoD map to visualize provincial infection rate is proposed along with the IoD platform. The developed platform is applied for the quantification of SARS-CoV-2 N-protein antigen with a LOD as low as 0.013 ng mL-1 and the infection rate of various provinces is projected with the IoD map successfully. Thus, the proposed IoD system has the potential to become an imperative tool for the disease control and prevention centers to restrain COVID-19 outbreaks by identifying the severity of particular regions.
Collapse
Affiliation(s)
- Nabil Hossain Bhuiyan
- Bio‐IT Convergence LaboratoryDepartment of Electronic Convergence EngineeringKwangWoon UniversitySeoul01897Republic of Korea
| | - Md. Jalal Uddin
- Bio‐IT Convergence LaboratoryDepartment of Electronic Convergence EngineeringKwangWoon UniversitySeoul01897Republic of Korea
- BioGeneSys Inc., 20 Kwangwoon‐roNowon‐guSeoul01897Republic of Korea
| | - Joowon Lee
- Bio‐IT Convergence LaboratoryDepartment of Electronic Convergence EngineeringKwangWoon UniversitySeoul01897Republic of Korea
| | - Jun Hyeok Hong
- Bio‐IT Convergence LaboratoryDepartment of Electronic Convergence EngineeringKwangWoon UniversitySeoul01897Republic of Korea
| | - Joon Sub Shim
- Bio‐IT Convergence LaboratoryDepartment of Electronic Convergence EngineeringKwangWoon UniversitySeoul01897Republic of Korea
- BioGeneSys Inc., 20 Kwangwoon‐roNowon‐guSeoul01897Republic of Korea
| |
Collapse
|
9
|
Qavi AJ, Wu C, Lloyd M, Zaman MMU, Luan J, Ballman C, Leung DW, Crick SL, Farnsworth CW, Amarasinghe GK. Plasmonic Fluor-Enhanced Antigen Arrays for High-Throughput, Serological Studies of SARS-CoV-2. ACS Infect Dis 2022; 8:1468-1479. [PMID: 35867632 PMCID: PMC9344907 DOI: 10.1021/acsinfecdis.2c00086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Serological testing for acute infection or prior exposure is critical for patient management and coordination of public health decisions during outbreaks. Current methods have several limitations, including variable performance, relatively low analytical and clinical sensitivity, and poor detection due to antigenic drift. Serological methods for SARS-CoV-2 detection for the ongoing COVID-19 pandemic suffer from several of these limitations and serves as a reminder of the critical need for new technologies. Here, we describe the use of ultrabright fluorescent reagents, Plasmonic Fluors, coupled with antigen arrays that address a subset of these limitations. We demonstrate its application using patient samples in SARS-CoV-2 serological assays. In our multiplexed assay, SARS-CoV-2 antigens were spotted into 48-plex arrays within a single well of a 96-well plate and used to evaluate remnant laboratory samples of SARS-CoV-2 positive patients. Signal-readout was performed with Auragent Bioscience's Empower microplate reader, and microarray analysis software. Sample volumes of 1 μL were used. High sensitivity of the Plasmonic Fluors combined with the array format enabled us to profile patient serological response to eight distinct SARS-CoV-2 antigens and evaluate responses to IgG, IgM, and IgA. Sensitivities for SARS-CoV-2 antigens during the symptomatic state ranged between 72.5 and 95.0%, specificity between 62.5 and 100%, and the resulting area under the curve values between 0.76 and 0.97. Together, these results highlight the increased sensitivity for low sample volumes and multiplex capability. These characteristics make Plasmonic Fluor-enhanced antigen arrays an attractive technology for serological studies for the COVID-19 pandemic and beyond.
Collapse
Affiliation(s)
- Abraham J. Qavi
- Department
of Pathology & Immunology, Washington
University School of Medicine, St. Louis, Missouri 63110, United States
| | - Chao Wu
- Department
of Pathology & Immunology, Washington
University School of Medicine, St. Louis, Missouri 63110, United States
| | - Matthew Lloyd
- Department
of Pathology & Immunology, Washington
University School of Medicine, St. Louis, Missouri 63110, United States
| | | | - Jingyi Luan
- Auragent
Bioscience, St. Louis, Missouri 63108, United
States
| | - Claire Ballman
- Department
of Pathology & Immunology, Washington
University School of Medicine, St. Louis, Missouri 63110, United States
| | - Daisy W. Leung
- Department
of Internal Medicine, Washington University
School of Medicine, St. Louis, Missouri 63110, United States
| | - Scott L. Crick
- Auragent
Bioscience, St. Louis, Missouri 63108, United
States
| | - Christopher W. Farnsworth
- Department
of Pathology & Immunology, Washington
University School of Medicine, St. Louis, Missouri 63110, United States
| | - Gaya K. Amarasinghe
- Department
of Pathology & Immunology, Washington
University School of Medicine, St. Louis, Missouri 63110, United States
| |
Collapse
|
10
|
Barreira GA, Santos EHD, Pereira MFB, Rodrigues KA, Rocha MC, Kanunfre KA, Marques HHDS, Okay TS. Technical performance of a lateral flow immunoassay for detection of anti-SARS-CoV-2 IgG in the outpatient follow-up of non-severe cases and at different times after vaccination: comparison with enzyme and chemiluminescent immunoassays. Rev Inst Med Trop Sao Paulo 2022; 64:e49. [PMID: 35858039 PMCID: PMC9281580 DOI: 10.1590/s1678-9946202264049] [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: 05/23/2022] [Accepted: 06/09/2022] [Indexed: 11/22/2022] Open
Abstract
This study assessed the technical performance of a rapid lateral flow immunochromatographic assay (LFIA) for the detection of anti-SARS-CoV-2 IgG and compared LFIA results with chemiluminescent immunoassay (CLIA) results and an in-house enzyme immunoassay (EIA). To this end, a total of 216 whole blood or serum samples from three groups were analyzed: the first group was composed of 68 true negative cases corresponding to blood bank donors, healthy young volunteers, and eight pediatric patients diagnosed with other coronavirus infections. The serum samples from these participants were obtained and stored in a pre-COVID-19 period, thus they were not expected to have COVID-19. In the second group of true positive cases, we chose to replace natural cases of COVID-19 by 96 participants who were expected to have produced anti-SARS-CoV-2 IgG antibodies 30-60 days after the vaccine booster dose. The serum samples were collected on the same day that LFIA were tested either by EIA or CLIA. The third study group was composed of 52 participants (12 adults and 40 children) who did or did not have anti-SARS-CoV-2 IgG antibodies due to specific clinical scenarios. The 12 adults had been vaccinated more than seven months before LFIA testing, and the 40 children had non-severe COVID-19 diagnosed using RT-PCR during the acute phase of infection. They were referred for outpatient follow-up and during this period the serum samples were collected and tested by CLIA and LFIA. All tests were performed by the same healthcare operator and there was no variation of LFIA results when tests were performed on finger prick whole blood or serum samples, so that results were grouped for analysis. LFIA's sensitivity in detecting anti-SARS-CoV-2 IgG antibodies was 90%, specificity 97.6%, efficiency 93%, PPV 98.3%, NPV 86.6%, and likelihood ratio for a positive or a negative result were 37.5 and 0.01 respectively. There was a good agreement (Kappa index of 0.677) between LFIA results and serological (EIA or CLIA) results. In conclusion, LFIA analyzed in this study showed a good technical performance and agreement with reference serological assays (EIA or CLIA), therefore it can be recommended for use in the outpatient follow-up of non-severe cases of COVID-19 and to assess anti-SARS-CoV-2 IgG antibody production induced by vaccination and the antibodies decrease over time. However, LFIAs should be confirmed by using reference serological assays whenever possible.
Collapse
Affiliation(s)
- Gabriel Acca Barreira
- Universidade de São Paulo, Faculdade de Medicina, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil.,Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, São Paulo, Brazil
| | - Emilly Henrique Dos Santos
- Universidade de São Paulo, Faculdade de Medicina, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil.,Universidade de São Paulo, Faculdade de Medicina, Departamento de Pediatria, São Paulo, São Paulo, Brazil
| | | | - Karen Alessandra Rodrigues
- Universidade de São Paulo, Faculdade de Medicina, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil
| | - Mussya Cisotto Rocha
- Universidade de São Paulo, Faculdade de Medicina, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil
| | - Kelly Aparecida Kanunfre
- Universidade de São Paulo, Faculdade de Medicina, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil
| | | | - Thelma Suely Okay
- Universidade de São Paulo, Faculdade de Medicina, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil.,Universidade de São Paulo, Faculdade de Medicina, Departamento de Pediatria, São Paulo, São Paulo, Brazil
| | | |
Collapse
|
11
|
Yin H, Tong Z, Shen C, Xu X, Ma H, Wu Z, Qi Y, Mao H. Micro-PCR chip-based multifunctional ultrafast SARS-CoV-2 detection platform. LAB ON A CHIP 2022; 22:2671-2681. [PMID: 35543190 DOI: 10.1039/d2lc00101b] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
When dealing with infectious pathogens, the point-of-care screening and diagnosis strategy should be low-cost, simple, rapid and accurate. Here, we report a multifunctional rapid PCR platform allowing both simultaneous screening of suspected cases and accurate identification and quantification of the virus. Based on the platform, samples suspected of being infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are screened first, after which subsequent precise quantification of the virus (SARS-CoV-2) can be performed if necessary. This fast screening technique offers a detection limit of 10 nucleic acid copies per test during the entire running time of 15 minutes, with a throughput of 9 samples at a time. Besides, depending on a droplet microfluidic chip, this platform could also provide assays of nucleic acids across four orders of magnitude of concentration within less than 15 minutes. Additionally, we successfully use the platform to quickly distinguish between positive and negative cases in clinical samples and rapidly quantify the viral load in each sample, which is consistent with standard RT-qPCR tests. As such, we demonstrate a promising and versatile rapid PCR platform for point-of-care diagnosis of infectious diseases.
Collapse
Affiliation(s)
- Hao Yin
- State Key Laboratory of Transducer Technology, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050, China.
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Zhaoduo Tong
- State Key Laboratory of Transducer Technology, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050, China.
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Chuanjie Shen
- State Key Laboratory of Transducer Technology, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050, China.
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Xin Xu
- State Key Laboratory of Transducer Technology, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050, China.
| | - Hui Ma
- State Key Laboratory of Transducer Technology, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050, China.
| | - Zhenhua Wu
- State Key Laboratory of Transducer Technology, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050, China.
| | - Yong Qi
- Huadong Research Institute for Medicine and Biotechniques, Nanjing, Jiangsu, 210000, China.
| | - Hongju Mao
- State Key Laboratory of Transducer Technology, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050, China.
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing, 100049, China
| |
Collapse
|
12
|
Leonard E, Aller Pellitero M, Juelg B, Spangler JB, Arroyo-Currás N. Antibody-Invertase Fusion Protein Enables Quantitative Detection of SARS-CoV-2 Antibodies Using Widely Available Glucometers. J Am Chem Soc 2022; 144:11226-11237. [PMID: 35675509 PMCID: PMC9199438 DOI: 10.1021/jacs.2c02537] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Indexed: 01/02/2023]
Abstract
Rapid diagnostics that can accurately inform patients of disease risk and protection are critical to mitigating the spread of the current COVID-19 pandemic and future infectious disease outbreaks. To be effective, such diagnostics must rely on simple, cost-effective, and widely available equipment and should be compatible with existing telehealth infrastructure to facilitate data access and remote care. Commercial glucometers are an established detection technology that can overcome the cost, time, and trained personnel requirements of current benchtop-based antibody serology assays when paired with reporter molecules that catalyze glucose conversion. To this end, we developed an enzymatic reporter that, when bound to disease-specific patient antibodies, produces glucose in proportion to the level of antibodies present in the patient sample. Although a straightforward concept, the coupling of enzymatic reporters to secondary antibodies or antigens often results in low yields, indeterminant stoichiometry, reduced target binding, and poor catalytic efficiency. Our enzymatic reporter is a novel fusion protein that comprises an antihuman immunoglobulin G (IgG) antibody genetically fused to two invertase molecules. The resulting fusion protein retains the binding affinity and catalytic activity of the constituent proteins and serves as an accurate reporter for immunoassays. Using this fusion, we demonstrate quantitative glucometer-based measurement of anti-SARS-CoV-2 spike protein antibodies in blinded clinical sample training sets. Our results demonstrate the ability to detect SARS-CoV-2-specific IgGs in patient serum with precise agreement to benchmark commercial immunoassays. Because our fusion protein binds all human IgG isotypes, it represents a versatile tool for detection of disease-specific antibodies in a broad range of biomedical applications.
Collapse
Affiliation(s)
- Elissa
K. Leonard
- Department
of Biomedical Engineering, Johns Hopkins
University, Baltimore, Maryland 21218, United States
- Translational
Tissue Engineering Center, Johns Hopkins
University School of Medicine, Baltimore, Maryland 21231, United States
| | - Miguel Aller Pellitero
- Department
of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, United States
| | - Boris Juelg
- Ragon
Institute of MGH, MIT, and Harvard, Cambridge, Massachusetts 02139, United States
| | - Jamie B. Spangler
- Department
of Biomedical Engineering, Johns Hopkins
University, Baltimore, Maryland 21218, United States
- Department
of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, Maryland 21218, United States
- Translational
Tissue Engineering Center, Johns Hopkins
University School of Medicine, Baltimore, Maryland 21231, United States
- Department
of Oncology, Johns Hopkins University School
of Medicine, Baltimore, Maryland 21205, United
States
- Bloomberg−Kimmel
Institute for Cancer Immunotherapy, Sidney Kimmel Comprehensive Cancer
Center Johns Hopkins University School of
Medicine, Baltimore, Maryland 21231, United
States
- Department
of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231, United States
| | - Netzahualcóyotl Arroyo-Currás
- Department
of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, United States
- Department
of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, Maryland 21218, United States
| |
Collapse
|
13
|
Quantification of a COVID-19 Antibody Assay Using a Lateral Flow Test and a Cell Phone. CHEMOSENSORS 2022. [DOI: 10.3390/chemosensors10070234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although several biomedical assays have been developed to screen for antibodies against SARS-CoV-2, very few can be completed without drawing blood. We developed a rapid lateral flow screening tool that used saliva samples and yielded rapid results that could be quantified using a cell phone. This assay provided the sensitive detection of IgG antibodies against SARS-CoV-2 within 10 min. We started by synthesising, modifying, and characterising gold nanoparticles. Using these particles as a coloured label, we developed a lateral flow strip made of nitrocellulose, glass fibre, and cellulose material. We quantified our visual results using pictures acquired with a cell phone and calculated a limit of detection of 4 ng/mL of antibodies against the SARS-CoV-2 spike protein.
Collapse
|
14
|
Coburn SB, Manabe YC, Laeyendecker O, Sherman SG, Baker OR, Quinn TC, Graham LA, Dennis Thomas F, Southall P, Weedn VW, Ehsani J, Klock E, Li R, Shields WC, Michael JP, Li L, Althoff K. Severe Acute Respiratory Syndrome Coronavirus 2 Antibody Seroprevalence in Decedents Undergoing Forensic Postmortem Examination: Feasibility for
Real-Time Pandemic Surveillance. Open Forum Infect Dis 2022; 9:ofac142. [PMID: 35415200 PMCID: PMC8995069 DOI: 10.1093/ofid/ofac142] [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: 12/20/2021] [Accepted: 03/22/2022] [Indexed: 11/16/2022] Open
Abstract
Background Population-based seroprevalence studies offer comprehensive characterization of coronavirus disease 2019 (COVID-19) spread, but barriers exist and marginalized populations may not be captured. We assessed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody seroprevalence among decedents in Maryland over 6 months in 2020. Methods Data were collected on decedents undergoing forensic postmortem examination in Maryland from 24 May through 30 November 2020 from whom a blood specimen could be collected. Those with available blood specimens were tested with the CoronaCHEK lateral flow antibody assay. We assessed monthly seroprevalence compared to the statewide estimated number of cases and proportion of positive test results (testing positivity). We used Poisson regression with robust variance to estimate adjusted prevalence ratios (aPRs) with 95% confidence intervals (CIs) for associations of demographic characteristics, homelessness, and manner of death with SARS-CoV-2 antibodies. Results Among 1906 decedents, 305 (16%) were positive for SARS-CoV-2 antibodies. Monthly seroprevalence increased from 11% to 22% over time and was consistently higher than state-level estimates of testing positivity. Hispanic ethnicity was associated with 2- to 3.2-fold higher seropositivity (P < .05) irrespective of sex. Deaths due to motor vehicle crash were associated with 62% increased seropositivity (aPR, 1.62 [95% CI, 1.15-2.28]) vs natural manner of death. Though seroprevalence was lower in decedents of illicit drug overdose vs nonoverdose in early months, this shifted, and seroprevalence was comparable by November 2020. Conclusions Decedents undergoing forensic postmortem examination, especially those dying due to motor vehicle trauma, may be a sentinel population for COVID-19 spread in the general population and merits exploration in other states/regions.
Collapse
Affiliation(s)
- Sally B Coburn
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Yukari C Manabe
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Oliver Laeyendecker
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Susan G Sherman
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Owen R Baker
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Thomas C Quinn
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | | | | | - Pamela Southall
- Office of the Chief Medical Examiner, Maryland Department of Health, Baltimore, Maryland, USA
| | - Victor W Weedn
- University of Maryland Baltimore Graduate School, Baltimore, Maryland, USA
| | - Johnathon Ehsani
- Center for Injury Research and Policy, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ethan Klock
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Rong Li
- Office of the Chief Medical Examiner, Maryland Department of Health, Baltimore, Maryland, USA
| | - Wendy C Shields
- Center for Injury Research and Policy, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jeffrey Paul Michael
- Center for Injury Research and Policy, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ling Li
- Office of the Chief Medical Examiner, Maryland Department of Health, Baltimore, Maryland, USA
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Keri N Althoff
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| |
Collapse
|
15
|
Adi W, Biswas D, Shelef MA, Yesilkoy F. Multiplexed COVID-19 antibody quantification from human sera using label-free nanoplasmonic biosensors. BIOMEDICAL OPTICS EXPRESS 2022; 13:2130-2143. [PMID: 35519285 PMCID: PMC9045896 DOI: 10.1364/boe.454919] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/23/2022] [Accepted: 02/24/2022] [Indexed: 05/25/2023]
Abstract
Serological assays that can reveal immune status against COVID-19 play a critical role in informing individual and public healthcare decisions. Currently, antibody tests are performed in central clinical laboratories, limiting broad access to diverse populations. Here we report a multiplexed and label-free nanoplasmonic biosensor that can be deployed for point-of-care antibody profiling. Our optical imaging-based approach can simultaneously quantify antigen-specific antibody response against SARS-CoV-2 spike and nucleocapsid proteins from 50 µL of human sera. To enhance the dynamic range, we employed multivariate data processing and multi-color imaging and achieved a quantification range of 0.1-100 µg/mL. We measured sera from a COVID-19 acute and convalescent (N = 24) patient cohort and negative controls (N = 5) and showed highly sensitive and specific past-infection diagnosis. Our results were benchmarked against an electrochemiluminescence assay and showed good concordance (R∼0.87). Our integrated nanoplasmonic biosensor has the potential to be used in epidemiological sero-profiling and vaccine studies.
Collapse
Affiliation(s)
- Wihan Adi
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Dhruv Biswas
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Miriam A. Shelef
- Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705, USA
- William S. Middleton Memorial Veterans Hospital, Madison, WI 53705, USA
| | - Filiz Yesilkoy
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI 53706, USA
| |
Collapse
|
16
|
Differentiation of Individuals Previously Infected with and Vaccinated for SARS-CoV-2 in an Inner-City Emergency Department. J Clin Microbiol 2022; 60:e0239021. [PMID: 35044204 PMCID: PMC8925900 DOI: 10.1128/jcm.02390-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Emergency departments (EDs) can serve as surveillance sites for infectious diseases. The objective of this study was to determine the burden of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and to monitor the prevalence of vaccination against coronavirus disease 2019 (COVID-19) among patients attending an urban ED in Baltimore City. Using 1,914 samples of known exposure status, we developed an algorithm to differentiate previously infected, vaccinated, and unexposed individuals using a combination of antibody assays. We applied this testing algorithm to 4,360 samples from ED patients obtained in the spring of 2020 and 2021. Using multinomial logistic regression, we determined factors associated with infection and vaccination. For the algorithm, sensitivity and specificity for identifying vaccinated individuals were 100% and 99%, respectively, and 84% and 100% for previously infected individuals. Among the ED subjects, seroprevalence to SARS-CoV-2 increased from 2% to 24% between April 2020 and March 2021. Vaccination prevalence rose to 11% by mid-March 2021. Marked differences in burden of disease and vaccination coverage were seen by sex, race, and ethnicity. Hispanic patients, though accounting for 7% of the study population, had the highest relative burden of disease (17% of total infections) but with similar vaccination rates. Women and white individuals were more likely to be vaccinated than men or Black individuals. Individuals previously infected with SARS-CoV-2 can often be differentiated from vaccinated individuals using a serologic testing algorithm. The utility of this algorithm can aid in monitoring SARS-CoV-2 exposure and vaccination uptake frequencies and can potentially reflect gender, race, and ethnic health disparities.
Collapse
|
17
|
Beck EJ, Hsieh YH, Fernandez RE, Dashler G, Egbert ER, Truelove SA, Garliss C, Wang R, Bloch EM, Shrestha R, Blankson J, Cox AL, Manabe YC, Kickler T, Rothman RE, Redd AD, Tobian AAR, Milstone AM, Quinn TC, Laeyendecker O. Differentiation of Individuals Previously Infected with and Vaccinated for SARS-CoV-2 in an Inner-City Emergency Department. J Clin Microbiol 2022. [PMID: 35044204 DOI: 10.1101/2021.10.13.21264968v1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023] Open
Abstract
Emergency departments (EDs) can serve as surveillance sites for infectious diseases. The objective of this study was to determine the burden of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and to monitor the prevalence of vaccination against coronavirus disease 2019 (COVID-19) among patients attending an urban ED in Baltimore City. Using 1,914 samples of known exposure status, we developed an algorithm to differentiate previously infected, vaccinated, and unexposed individuals using a combination of antibody assays. We applied this testing algorithm to 4,360 samples from ED patients obtained in the spring of 2020 and 2021. Using multinomial logistic regression, we determined factors associated with infection and vaccination. For the algorithm, sensitivity and specificity for identifying vaccinated individuals were 100% and 99%, respectively, and 84% and 100% for previously infected individuals. Among the ED subjects, seroprevalence to SARS-CoV-2 increased from 2% to 24% between April 2020 and March 2021. Vaccination prevalence rose to 11% by mid-March 2021. Marked differences in burden of disease and vaccination coverage were seen by sex, race, and ethnicity. Hispanic patients, though accounting for 7% of the study population, had the highest relative burden of disease (17% of total infections) but with similar vaccination rates. Women and white individuals were more likely to be vaccinated than men or Black individuals. Individuals previously infected with SARS-CoV-2 can often be differentiated from vaccinated individuals using a serologic testing algorithm. The utility of this algorithm can aid in monitoring SARS-CoV-2 exposure and vaccination uptake frequencies and can potentially reflect gender, race, and ethnic health disparities.
Collapse
Affiliation(s)
- Evan J Beck
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Yu-Hsiang Hsieh
- Department of Emergency Medicine, Johns Hopkins University School of Medicinegrid.471401.7, Baltimore, Maryland, USA
| | - Reinaldo E Fernandez
- Department of Medicine, Johns Hopkins University School of Medicinegrid.471401.7, Baltimore, Maryland, USA
| | - Gaby Dashler
- Department of Emergency Medicine, Johns Hopkins University School of Medicinegrid.471401.7, Baltimore, Maryland, USA
| | - Emily R Egbert
- Department of Pediatrics, Johns Hopkins University School of Medicinegrid.471401.7, Baltimore, Maryland, USA
| | - Shawn A Truelove
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Caroline Garliss
- Department of Medicine, Johns Hopkins University School of Medicinegrid.471401.7, Baltimore, Maryland, USA
| | - Richard Wang
- Department of Emergency Medicine, Johns Hopkins University School of Medicinegrid.471401.7, Baltimore, Maryland, USA
| | - Evan M Bloch
- Department of Pathology, Johns Hopkins University School of Medicinegrid.471401.7, Baltimore, Maryland, USA
| | - Ruchee Shrestha
- Department of Pathology, Johns Hopkins University School of Medicinegrid.471401.7, Baltimore, Maryland, USA
| | - Joel Blankson
- Department of Medicine, Johns Hopkins University School of Medicinegrid.471401.7, Baltimore, Maryland, USA
| | - Andrea L Cox
- Department of Medicine, Johns Hopkins University School of Medicinegrid.471401.7, Baltimore, Maryland, USA
| | - Yukari C Manabe
- Department of Medicine, Johns Hopkins University School of Medicinegrid.471401.7, Baltimore, Maryland, USA
| | - Thomas Kickler
- Department of Pathology, Johns Hopkins University School of Medicinegrid.471401.7, Baltimore, Maryland, USA
| | - Richard E Rothman
- Department of Emergency Medicine, Johns Hopkins University School of Medicinegrid.471401.7, Baltimore, Maryland, USA
| | - Andrew D Redd
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
- Department of Medicine, Johns Hopkins University School of Medicinegrid.471401.7, Baltimore, Maryland, USA
| | - Aaron A R Tobian
- Department of Pathology, Johns Hopkins University School of Medicinegrid.471401.7, Baltimore, Maryland, USA
| | - Aaron M Milstone
- Department of Pediatrics, Johns Hopkins University School of Medicinegrid.471401.7, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Thomas C Quinn
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
- Department of Medicine, Johns Hopkins University School of Medicinegrid.471401.7, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Oliver Laeyendecker
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
- Department of Medicine, Johns Hopkins University School of Medicinegrid.471401.7, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| |
Collapse
|
18
|
Mattila JP, Amaro A, Longo M, Antaki J, Koirala S, Gandini A. RapidQ: A reader-free microfluidic platform for the quantitation of antibodies against the SARS-CoV-2 spike protein. BIOMICROFLUIDICS 2022; 16:024105. [PMID: 35356130 PMCID: PMC8933056 DOI: 10.1063/5.0079054] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 03/04/2022] [Indexed: 06/14/2023]
Abstract
We describe RapidQ, a fast, disposable, easy-to-use microfluidic assay for the quantitation of the anti-SARS-CoV-2 spike (S) protein IgG in plasma samples. The assay utilizes antigen-coated paramagnetic microbeads, which are induced to aggregate inside the RapidQ microfluidic device in the presence of the target antibody. Aggregation occurs via interaction between the biotinylated detection antibody and polymeric streptavidin. The mobility of the beads inside the two microchannels of the device depends on their aggregation state, with larger clusters moving at higher velocities under a given liquid flow rate. One of the microchannels incorporates a permanent magnet that captures arriving beads and forms a localized constriction that retards liquid flow. Since the constriction grows faster when the beads are more aggregated, the length of the liquid column accumulated downstream from the constriction relative to that of the unconstricted control channel is proportional to the sample antibody concentration. The assay demonstrates a detection limit of 4 μg/ml of monoclonal anti-S protein antibody diluted in plasma with CV ≤ 13%, as well as negative and positive percent agreements of 100% (95% CI: 92.75%-100%) and 100% (95% CI: 80.5%-100%), respectively, when compared to a nucleic acid amplification test used to identify COVID-19 positive individuals, whose samples were collected ≥17 d from a positive PCR test. Finally, the RapidQ assay was used to monitor the kinetics of antibody responses to COVID-19 vaccination in a small study cohort.
Collapse
Affiliation(s)
| | - Arlene Amaro
- Accel Diagnostics, LLC, Houston, Texas 77057, USA
| | - Monica Longo
- Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Texas Health Science Center at Houston, Houston, Texas 77030, USA
| | - James Antaki
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, New York 14853, USA
| | | | | |
Collapse
|
19
|
Wilson S, Steele S, Adeli K. Innovative technological advancements in laboratory medicine: Predicting the lab of the future. BIOTECHNOL BIOTEC EQ 2022. [DOI: 10.1080/13102818.2021.2011413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
Affiliation(s)
- Siobhan Wilson
- Clinical Biochemistry, Pediatric Laboratory Medicine and Molecular Medicine, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Laboratory Medicine & Pathobiology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Shannon Steele
- Clinical Biochemistry, Pediatric Laboratory Medicine and Molecular Medicine, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
| | - Khosrow Adeli
- Clinical Biochemistry, Pediatric Laboratory Medicine and Molecular Medicine, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Laboratory Medicine & Pathobiology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
20
|
Heaney CD, Pisanic N, Randad PR, Kruczynski K, Howard T, Zhu X, Littlefield K, Patel EU, Shrestha R, Laeyendecker O, Shoham S, Sullivan D, Gebo K, Hanley D, Redd AD, Quinn TC, Casadevall A, Zenilman JM, Pekosz A, Bloch EM, Tobian AAR. Comparative performance of multiplex salivary and commercially available serologic assays to detect SARS-CoV-2 IgG and neutralization titers. J Clin Virol 2021; 145:104997. [PMID: 34695724 PMCID: PMC8502080 DOI: 10.1016/j.jcv.2021.104997] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 09/16/2021] [Accepted: 10/03/2021] [Indexed: 02/01/2023]
Abstract
Oral fluid (hereafter saliva) offers a non-invasive sampling method for detection of SARS-CoV-2 antibodies. However, data comparing performance of salivary tests against commercially-available serologic and neutralizing antibody (nAb) assays are lacking. This study compared the performance of a laboratory-developed multiplex salivary SARS-CoV-2 IgG assay targeting antibodies to nucleocapsid (N), receptor binding domain (RBD) and spike (S) antigens to three commercially-available SARS-CoV-2 serologic enzyme immunoassays (EIAs) (Ortho Vitros, Euroimmun, and BioRad) and nAb. Paired saliva and plasma samples were collected from 101 eligible COVID-19 convalescent plasma (CCP) donors >14 days since PCR+ confirmed diagnosis. Concordance was evaluated using positive (PPA) and negative (NPA) percent agreement, and Cohen's kappa coefficient. The range between salivary and plasma EIAs for SARS-CoV-2-specific N was PPA: 54.4-92.1% and NPA: 69.2-91.7%, for RBD was PPA: 89.9-100% and NPA: 50.0-84.6%, and for S was PPA: 50.6-96.6% and NPA: 50.0-100%. Compared to a plasma nAb assay, the multiplex salivary assay PPA ranged from 62.3% (N) and 98.6% (RBD) and NPA ranged from 18.8% (RBD) to 96.9% (S). Combinations of N, RBD, and S and a summary algorithmic index of all three (N/RBD/S) in saliva produced ranges of PPA: 87.6-98.9% and NPA: 50-91.7% with the three EIAs and ranges of PPA: 88.4-98.6% and NPA: 21.9-34.4% with the nAb assay. A multiplex salivary SARS-CoV-2 IgG assay demonstrated variable, but comparable performance to three commercially-available plasma EIAs and a nAb assay, and may be a viable alternative to assist in monitoring population-based seroprevalence and vaccine antibody response.
Collapse
Affiliation(s)
- Christopher D Heaney
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Room W7033B Baltimore, MD, 21205 USA; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
| | - Nora Pisanic
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Room W7033B Baltimore, MD, 21205 USA
| | - Pranay R Randad
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Room W7033B Baltimore, MD, 21205 USA
| | - Kate Kruczynski
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Room W7033B Baltimore, MD, 21205 USA
| | - Tyrone Howard
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Room W7033B Baltimore, MD, 21205 USA
| | - Xianming Zhu
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kirsten Littlefield
- Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Eshan U Patel
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ruchee Shrestha
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Oliver Laeyendecker
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Baltimore MD, USA
| | - Shmuel Shoham
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - David Sullivan
- Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kelly Gebo
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Daniel Hanley
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Andrew D Redd
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Baltimore MD, USA
| | - Thomas C Quinn
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Baltimore MD, USA
| | - Arturo Casadevall
- Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Jonathan M Zenilman
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Andrew Pekosz
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Room W7033B Baltimore, MD, 21205 USA; Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Evan M Bloch
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Aaron A R Tobian
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| |
Collapse
|
21
|
Churiwal M, Lin KD, Khan S, Chhetri S, Muller MS, Tompkins K, Smith J, Litel C, Whittelsey M, Basham C, Rapp T, Cerami C, Premkumar L, Lin JT. Assessment of the Field Utility of a Rapid Point-of-Care Test for SARS-CoV-2 Antibodies in a Household Cohort. Am J Trop Med Hyg 2021; 106:156-159. [PMID: 34818625 PMCID: PMC8733539 DOI: 10.4269/ajtmh.21-0592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 10/11/2021] [Indexed: 11/07/2022] Open
Abstract
Point-of-care (POC) tests to detect SARS-CoV-2 antibodies offer quick assessment of serostatus after natural infection or vaccination. We compared the field performance of the BioMedomics COVID-19 IgM/IgG Rapid Antibody Test against an ELISA in 303 participants enrolled in a SARS-CoV-2 household cohort study. The rapid antibody test was easily implemented with consistent interpretation across 14 users in a variety of field settings. Compared with ELISA, detection of seroconversion lagged by 5 to 10 days. However, it retained a sensitivity of 90% (160/177, 95% confidence interval [CI] 85-94%) and specificity of 100% (43/43, 95% CI 92-100%) for those tested 3 to 5 weeks after symptom onset. Sensitivity was diminished among those with asymptomatic infection (74% [14/19], 95% CI 49-91%) and early in infection (45% [29/64], 95% CI 33-58%). When used appropriately, rapid antibody tests offer a convenient way to detect symptomatic infections during convalescence.
Collapse
Affiliation(s)
- Mehal Churiwal
- Institute of Global Health and Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Kelly D. Lin
- Institute of Global Health and Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Salman Khan
- Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Srijana Chhetri
- Institute of Global Health and Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Meredith S. Muller
- Institute of Global Health and Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Kathleen Tompkins
- Institute of Global Health and Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Judy Smith
- Institute of Global Health and Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Christy Litel
- Institute of Global Health and Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Maureen Whittelsey
- Institute of Global Health and Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Christopher Basham
- Institute of Global Health and Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Tyler Rapp
- Institute of Global Health and Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Carla Cerami
- Institute of Global Health and Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina
- MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine, Fajara, The Gambia
| | - Lakshmanane Premkumar
- Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Jessica T. Lin
- Institute of Global Health and Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| |
Collapse
|
22
|
Ferreira AL, de Lima LF, Torres MDT, de Araujo WR, de la Fuente-Nunez C. Low-Cost Optodiagnostic for Minute-Time Scale Detection of SARS-CoV-2. ACS NANO 2021; 15:17453-17462. [PMID: 34669371 PMCID: PMC8547493 DOI: 10.1021/acsnano.1c03236] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 09/30/2021] [Indexed: 05/31/2023]
Abstract
The COVID-19 pandemic has exacerbated our society's tremendous health equity gap. Disadvantaged populations have been disproportionally affected by COVID-19, lacking access to affordable testing, a known effective tool for preventing viral spread, hospitalizations, and deaths. Here, we describe COVID-19 Low-cost Optodiagnostic for Rapid testing (COLOR), a colorimetric biosensor fabricated on cotton swabs using gold nanoparticles modified with human angiotensin-converting enzyme 2 (ACE2), which costs 15¢ to produce and detects SARS-CoV-2 within 5 min. COLOR detected very low viral particle loads (limit of detection: 0.154 pg mL-1 of SARS-CoV-2 spike protein), and its color intensity correlated with the cycle threshold (Ct) values obtained using reverse transcription polymerase chain reaction (RT-PCR). The performance of COLOR was assessed using 100 nasopharyngeal/oropharyngeal (NP/OP) clinical samples, yielding sensitivity, specificity, and accuracy values of 96%, 84%, and 90%, respectively. In summary, each COLOR test can be manufactured for 15¢ and presents rapid minute-time scale detection of SARS-CoV-2, thus providing a solution to enable high-frequency testing, particularly in low-resource communities.
Collapse
Affiliation(s)
- André Lopes Ferreira
- Machine Biology Group, Departments of Psychiatry and Microbiology, Institute for Biomedical Informatics, Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States of America
- Departments of Bioengineering and Chemical and Biomolecular Engineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States of America
- Penn Institute for Computational Science, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States of America
- Portable Chemical Sensors Lab, Department of Analytical Chemistry, Institute of Chemistry, State University of Campinas - UNICAMP, Campinas, SP 13083-970, Brazil
| | - Lucas Felipe de Lima
- Machine Biology Group, Departments of Psychiatry and Microbiology, Institute for Biomedical Informatics, Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States of America
- Departments of Bioengineering and Chemical and Biomolecular Engineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States of America
- Penn Institute for Computational Science, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States of America
- Portable Chemical Sensors Lab, Department of Analytical Chemistry, Institute of Chemistry, State University of Campinas - UNICAMP, Campinas, SP 13083-970, Brazil
| | - Marcelo Der Torossian Torres
- Machine Biology Group, Departments of Psychiatry and Microbiology, Institute for Biomedical Informatics, Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States of America
- Departments of Bioengineering and Chemical and Biomolecular Engineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States of America
- Penn Institute for Computational Science, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States of America
| | - William Reis de Araujo
- Portable Chemical Sensors Lab, Department of Analytical Chemistry, Institute of Chemistry, State University of Campinas - UNICAMP, Campinas, SP 13083-970, Brazil
| | - Cesar de la Fuente-Nunez
- Machine Biology Group, Departments of Psychiatry and Microbiology, Institute for Biomedical Informatics, Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States of America
- Departments of Bioengineering and Chemical and Biomolecular Engineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States of America
- Penn Institute for Computational Science, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States of America
| |
Collapse
|
23
|
A Hemagglutination-Based Semiquantitative Test for Point-of-Care Determination of SARS-CoV-2 Antibody Levels. J Clin Microbiol 2021; 59:e0118621. [PMID: 34469185 PMCID: PMC8601214 DOI: 10.1128/jcm.01186-21] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Serologic point-of-care tests to detect antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are an important tool in the COVID-19 pandemic. The majority of current point-of-care antibody tests developed for SARS-CoV-2 rely on lateral flow assays, but these do not offer quantitative information. To address this, we developed a novel antibody test leveraging hemagglutination, employing a dry card format currently used for typing ABO blood groups. Two hundred COVID-19 patient and 200 control plasma samples were reconstituted with O-negative red blood cells (RBCs) to form whole blood and added to dried viral-antibody fusion protein, followed by a stirring step and a tilting step, 3-min incubation, and a second tilting step. The sensitivities of the hemagglutination test, Euroimmun IgG enzyme-linked immunosorbent assay (ELISA), and receptor binding domain (RBD)-based CoronaChek lateral flow assay were 87.0%, 86.5%, and 84.5%, respectively, using samples obtained from recovered COVID-19 individuals. Testing prepandemic samples, the hemagglutination test had a specificity of 95.5%, compared to 97.3% and 98.9% for the ELISA and CoronaChek, respectively. A distribution of agglutination strengths was observed in COVID-19 convalescent-phase plasma samples, with the highest agglutination score (4) exhibiting significantly higher neutralizing antibody titers than weak positives (2) (P < 0.0001). Strong agglutinations were observed within 1 min of testing, and this shorter assay time also increased specificity to 98.5%. In conclusion, we developed a novel rapid, point-of-care RBC agglutination test for the detection of SARS-CoV-2 antibodies that can yield semiquantitative information on neutralizing antibody titer in patients. The 5-min test may find use in determination of serostatus prior to vaccination, postvaccination surveillance, and travel screening.
Collapse
|
24
|
Beck EJ, Hsieh YH, Fernandez RE, Dashler G, Egbert ER, Truelove SA, Garliss C, Wang R, Bloch EM, Shrestha R, Blankson J, Cox AL, Manabe YC, Kickler T, Rothman RE, Redd AD, Tobian AA, Milstone AM, Quinn TC, Laeyendecker O. Differentiation of SARS-CoV-2 naturally infected and vaccinated individuals in an inner-city emergency department. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021. [PMID: 34671778 PMCID: PMC8528087 DOI: 10.1101/2021.10.13.21264968] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background Emergency Departments (EDs) can serve as surveillance sites for infectious diseases. Our purpose was to determine the burden of SARS-CoV-2 infection and prevalence of vaccination against COVID-19 among patients attending an urban ED in Baltimore City. Methods Using 1914 samples of known exposure status, we developed an algorithm to differentiate previously infected, vaccinated, and unexposed individuals using a combination of antibody assays. We applied this testing algorithm to 4360 samples ED patients obtained in the springs of 2020 and 2021. Using multinomial logistic regression, we determined factors associated with infection and vaccination. Results For the algorithm, sensitivity and specificity for identifying vaccinated individuals was 100% and 99%, respectively, and 84% and 100% for naturally infected individuals. Among the ED subjects, seroprevalence to SARS-CoV-2 increased from 2% to 24% between April 2020 and March 2021. Vaccination prevalence rose to 11% by mid-March 2021. Marked differences in burden of disease and vaccination coverage were seen by sex, race, and ethnicity. Hispanic patients, though 7% of the study population, had the highest relative burden of disease (17% of total infections) but similar vaccination rates. Women and White individuals were more likely to be vaccinated than men or Black individuals (adjusted odds ratios [aOR] 1.35 [95% CI: 1.02, 1.80] and aOR 2.26 [95% CI: 1.67, 3.07], respectively). Conclusions Individuals previously infected with SARS-CoV-2 can be differentiated from vaccinated individuals using a serologic testing algorithm. SARS-CoV-2 exposure and vaccination uptake frequencies reflect gender, race and ethnic health disparities in this urban context. Summary Using an antibody testing algorithm, we distinguished between immune responses from SARS-CoV-2-infected and vaccinated individuals. When applied to blood samples from an emergency department in Baltimore, disparities in disease burden and vaccine uptake by sex, race, and ethnicity were identified.
Collapse
|
25
|
Liu G. Grand Challenges in Biosensors and Biomolecular Electronics. Front Bioeng Biotechnol 2021; 9:707615. [PMID: 34422782 PMCID: PMC8377753 DOI: 10.3389/fbioe.2021.707615] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 07/28/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- Guozhen Liu
- School of Life and Health Sciences, The Chinese University of Hong Kong, Shenzhen, China
| |
Collapse
|
26
|
Yuan H, Chiu PY, Chen CF. Paper-based analytical devices for point-of-care blood tests. BIOMICROFLUIDICS 2021; 15:041303. [PMID: 34326913 PMCID: PMC8310430 DOI: 10.1063/5.0055601] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 07/11/2021] [Indexed: 05/28/2023]
Abstract
Blood can be a window to health, and as a result, is the most intensively studied human biofluid. Blood tests can diagnose diseases, monitor therapeutic drugs, and provide information about the health of an individual. Rapid response blood tests are becoming increasingly essential, especially when subsequent treatment is required. Toward this need, paper-based devices have been excellent tools for performing blood tests due to their ability to conduct rapid and low-cost diagnostics and analyses in a non-laboratory environment. In this Perspective, we review recent advances in paper-based blood tests, particularly focusing on the specific techniques and assays applied. Additionally, we discuss the future of these paper-based devices, such as how the signal intensity can be enhanced and how the in situ synthesis of nanomaterials can be used to improve the sensitivity, functionality, and operational simplicity. With these advances, paper-based devices are becoming increasingly valuable tools for point-of-care blood tests in various practical scenarios.
Collapse
Affiliation(s)
- Hao Yuan
- Institute of Applied Mechanics, National Taiwan University, Taipei 106, Taiwan
| | | | - Chien-Fu Chen
- Institute of Applied Mechanics, National Taiwan University, Taipei 106, Taiwan
| |
Collapse
|
27
|
Meireles P, Amaro J, Pinto da Costa J, Lopes MM, Varandas T, Norton P, Guimarães JT, Severo M, Barros H. Prevalence of SARS-CoV-2 antibodies among workers of the public higher education institutions of Porto, Portugal: a cross-sectional study. Occup Environ Med 2021; 78:648-653. [PMID: 34193594 PMCID: PMC8380891 DOI: 10.1136/oemed-2021-107519] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 06/14/2021] [Indexed: 11/29/2022]
Abstract
Objectives To assess the prevalence of SARS-CoV-2-specific IgM and IgG antibodies among workers of the three public higher education institutions of Porto, Portugal, up to July 2020. Methods A rapid point-of-care test for specific IgM and IgG antibodies of SARS-CoV-2 was offered to all workers (SD Biosensor STANDARD Q COVID-19 IgM/IgG Duo and STANDARD Q COVID-19 IgM/IgG Combo). Testing was performed and a questionnaire was completed by 4592 workers on a voluntary basis from 21 May to 31 July 2020. We computed the apparent IgM, IgG, and combined IgM or IgG prevalence, along with the true prevalence and 95% credible intervals (95% CrI) using Bayesian inference. Results We found an apparent prevalence of 3.1% for IgM, 1.0% for IgG and 3.9% for either. The estimated true prevalence was 2.0% (95% CrI 0.1% to 4.3%) for IgM, 0.6% (95% CrI 0.0% to 1.3%) for IgG, and 2.5% (95% CrI 0.1% to 5.3%) for IgM or IgG. A SARS-CoV-2 molecular diagnosis was reported by 21 (0.5%) workers; and of these, 90.5% had a reactive IgG result. Seroprevalence was higher among those reporting contacts with confirmed cases, having been quarantined, having a previous molecular negative test or having had symptoms. Conclusions The seroprevalence among workers from the three public higher education institutions of Porto after the first wave of the SARS-CoV-2 infection was similar to national estimates for the same age working population. However, the estimated true seroprevalence was approximately five times higher than the reported SARS-CoV-2 infection based on a molecular test.
Collapse
Affiliation(s)
- Paula Meireles
- EPI Unit, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - Joana Amaro
- EPI Unit, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.,Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | | | | | - Tatiana Varandas
- EPI Unit, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - Pedro Norton
- EPI Unit, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.,Faculdade de Medicina, Universidade do Porto, Porto, Portugal.,Serviço de Saúde Ocupacional, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - João Tiago Guimarães
- EPI Unit, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.,Faculdade de Medicina, Universidade do Porto, Porto, Portugal.,Serviço de Patologia Clínica, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Milton Severo
- EPI Unit, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - Henrique Barros
- EPI Unit, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.,Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| |
Collapse
|
28
|
Differential Performance of CoronaCHEK SARS-CoV-2 Lateral Flow Antibody Assay by Geographic Origin of Samples. J Clin Microbiol 2021; 59:e0083721. [PMID: 33903166 DOI: 10.1128/jcm.00837-21] [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] [Indexed: 01/02/2023] Open
Abstract
We assessed the performance of the CoronaCHEK lateral flow assay on samples from Uganda and Baltimore to determine the impact of geographic origin on assay performance. Plasma samples from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) PCR-positive individuals (Uganda, 78 samples from 78 individuals, and Baltimore, 266 samples from 38 individuals) and from prepandemic individuals (Uganda, 1,077, and Baltimore, 532) were evaluated. Prevalence ratios (PR) were calculated to identify factors associated with a false-positive test. After the first positive PCR in Ugandan samples, the sensitivity was 45% (95% confidence interval [CI], 24,68) at 0 to 7 days, 79% (95% CI, 64 to 91) at 8 to 14 days, and 76% (95% CI, 50 to 93) at >15 days. In samples from Baltimore, sensitivity was 39% (95% CI, 30 to 49) at 0 to 7 days, 86% (95% CI, 79 to 92) at 8 to 14 days, and 100% (95% CI, 89 to 100) at 15 days after positive PCR. The specificity of 96.5% (95% CI, 97.5 to 95.2) in Ugandan samples was significantly lower than that in samples from Baltimore, 99.3% (95% CI, 98.1 to 99.8; P < 0.01). In Ugandan samples, individuals with a false-positive result were more likely to be male (PR, 2.04; 95% CI, 1.03,3.69) or individuals who had had a fever more than a month prior to sample acquisition (PR, 2.87; 95% CI, 1.12 to 7.35). Sensitivity of the CoronaCHEK was similar in samples from Uganda and Baltimore. The specificity was significantly lower in Ugandan samples than in Baltimore samples. False-positive results in Ugandan samples appear to correlate with a recent history of a febrile illness, potentially indicative of a cross-reactive immune response in individuals from East Africa.
Collapse
|
29
|
Naseri M, Ziora ZM, Simon GP, Batchelor W. ASSURED‐compliant point‐of‐care diagnostics for the detection of human viral infections. Rev Med Virol 2021. [DOI: 10.1002/rmv.2263] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Mahdi Naseri
- Department of Chemical Engineering Bioresource Processing Research Institute of Australia (BioPRIA) Monash University Clayton VIC Australia
| | - Zyta M Ziora
- Institute for Molecular Bioscience The University of Queensland St Lucia QLD Australia
| | - George P Simon
- Department of Materials Science and Engineering Monash University Clayton VIC Australia
| | - Warren Batchelor
- Department of Chemical Engineering Bioresource Processing Research Institute of Australia (BioPRIA) Monash University Clayton VIC Australia
| |
Collapse
|
30
|
Zavyalova E, Ambartsumyan O, Zhdanov G, Gribanyov D, Gushchin V, Tkachuk A, Rudakova E, Nikiforova M, Kuznetsova N, Popova L, Verdiev B, Alatyrev A, Burtseva E, Ignatieva A, Iliukhina A, Dolzhikova I, Arutyunyan A, Gambaryan A, Kukushkin V. SERS-Based Aptasensor for Rapid Quantitative Detection of SARS-CoV-2. NANOMATERIALS (BASEL, SWITZERLAND) 2021; 11:1394. [PMID: 34070421 PMCID: PMC8228355 DOI: 10.3390/nano11061394] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/21/2021] [Accepted: 05/22/2021] [Indexed: 12/21/2022]
Abstract
During the COVID-19 pandemic, the development of sensitive and rapid techniques for detection of viruses have become vital. Surface-enhanced Raman scattering (SERS) is an appropriate tool for new techniques due to its high sensitivity. SERS materials modified with short-structured oligonucleotides (DNA aptamers) provide specificity for SERS biosensors. Existing SERS-based aptasensors for rapid virus detection are either inapplicable for quantitative determination or have sophisticated and expensive construction and implementation. In this paper, we provide a SERS-aptasensor based on colloidal solutions which combines rapidity and specificity in quantitative determination of SARS-CoV-2 virus, discriminating it from the other respiratory viruses.
Collapse
Affiliation(s)
- Elena Zavyalova
- Chemistry Department, Lomonosov Moscow State University, 119991 Moscow, Russia;
| | - Oganes Ambartsumyan
- Department of Microbiology, Virology and Immunology, I.M. Sechenov First Moscow State Medical University, 125009 Moscow, Russia;
| | - Gleb Zhdanov
- Chemistry Department, Lomonosov Moscow State University, 119991 Moscow, Russia;
| | - Dmitry Gribanyov
- Institute of Solid State Physics of Russian Academy of Science, 142432 Chernogolovka, Russia;
| | - Vladimir Gushchin
- National Research Center for Epidemiology and Microbiology Named after the Honorary Academician N. F. Gamaleya, 123098 Moscow, Russia; (V.G.); (A.T.); (M.N.); (N.K.); (L.P.); (B.V.); (A.A.); (E.B.); (A.I.); (A.I.); (I.D.)
| | - Artem Tkachuk
- National Research Center for Epidemiology and Microbiology Named after the Honorary Academician N. F. Gamaleya, 123098 Moscow, Russia; (V.G.); (A.T.); (M.N.); (N.K.); (L.P.); (B.V.); (A.A.); (E.B.); (A.I.); (A.I.); (I.D.)
| | - Elena Rudakova
- Institute of Physiologically Active Compounds of Russian Academy of Science, 142432 Chernogolovka, Russia;
| | - Maria Nikiforova
- National Research Center for Epidemiology and Microbiology Named after the Honorary Academician N. F. Gamaleya, 123098 Moscow, Russia; (V.G.); (A.T.); (M.N.); (N.K.); (L.P.); (B.V.); (A.A.); (E.B.); (A.I.); (A.I.); (I.D.)
| | - Nadezhda Kuznetsova
- National Research Center for Epidemiology and Microbiology Named after the Honorary Academician N. F. Gamaleya, 123098 Moscow, Russia; (V.G.); (A.T.); (M.N.); (N.K.); (L.P.); (B.V.); (A.A.); (E.B.); (A.I.); (A.I.); (I.D.)
| | - Liubov Popova
- National Research Center for Epidemiology and Microbiology Named after the Honorary Academician N. F. Gamaleya, 123098 Moscow, Russia; (V.G.); (A.T.); (M.N.); (N.K.); (L.P.); (B.V.); (A.A.); (E.B.); (A.I.); (A.I.); (I.D.)
| | - Bakhtiyar Verdiev
- National Research Center for Epidemiology and Microbiology Named after the Honorary Academician N. F. Gamaleya, 123098 Moscow, Russia; (V.G.); (A.T.); (M.N.); (N.K.); (L.P.); (B.V.); (A.A.); (E.B.); (A.I.); (A.I.); (I.D.)
| | - Artem Alatyrev
- National Research Center for Epidemiology and Microbiology Named after the Honorary Academician N. F. Gamaleya, 123098 Moscow, Russia; (V.G.); (A.T.); (M.N.); (N.K.); (L.P.); (B.V.); (A.A.); (E.B.); (A.I.); (A.I.); (I.D.)
| | - Elena Burtseva
- National Research Center for Epidemiology and Microbiology Named after the Honorary Academician N. F. Gamaleya, 123098 Moscow, Russia; (V.G.); (A.T.); (M.N.); (N.K.); (L.P.); (B.V.); (A.A.); (E.B.); (A.I.); (A.I.); (I.D.)
| | - Anna Ignatieva
- National Research Center for Epidemiology and Microbiology Named after the Honorary Academician N. F. Gamaleya, 123098 Moscow, Russia; (V.G.); (A.T.); (M.N.); (N.K.); (L.P.); (B.V.); (A.A.); (E.B.); (A.I.); (A.I.); (I.D.)
| | - Anna Iliukhina
- National Research Center for Epidemiology and Microbiology Named after the Honorary Academician N. F. Gamaleya, 123098 Moscow, Russia; (V.G.); (A.T.); (M.N.); (N.K.); (L.P.); (B.V.); (A.A.); (E.B.); (A.I.); (A.I.); (I.D.)
| | - Inna Dolzhikova
- National Research Center for Epidemiology and Microbiology Named after the Honorary Academician N. F. Gamaleya, 123098 Moscow, Russia; (V.G.); (A.T.); (M.N.); (N.K.); (L.P.); (B.V.); (A.A.); (E.B.); (A.I.); (A.I.); (I.D.)
| | - Alexander Arutyunyan
- Belozersky Research Institute of Physico-Chemical Biology, Lomonosov Moscow State University, 119991 Moscow, Russia;
| | - Alexandra Gambaryan
- Chumakov Federal Scientific Center for Research and Development of Immune and Biological Products RAS, 108819 Moscow, Russia;
| | - Vladimir Kukushkin
- Institute of Solid State Physics of Russian Academy of Science, 142432 Chernogolovka, Russia;
| |
Collapse
|
31
|
Wang L, Wang X, Cheng L, Ding S, Wang G, Choo J, Chen L. SERS-based test strips: Principles, designs and applications. Biosens Bioelectron 2021; 189:113360. [PMID: 34051383 DOI: 10.1016/j.bios.2021.113360] [Citation(s) in RCA: 80] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 05/10/2021] [Accepted: 05/16/2021] [Indexed: 10/21/2022]
Abstract
Test strips represent a class of point-of-care testing (POCT) tools for analysis of a variety of biomarkers towards diagnostics. Conventional test strips offer benefits of simple operation, visualization, and short detection time, along with the drawbacks of relatively low sensitivity and unavailability of quantitative analysis. Recently, the combination of surface-enhanced Raman scattering (SERS) and test strips have evolved to provide a powerful platform capable of ultrasensitive and multiplex detection of extensive analytes of interest. In this review, we focus on the working principles, design strategies and POCT applications of SERS-based test strips. Initially, both lateral and vertical flow test strips are briefly introduced, followed by presentation of various strategies for reforming SERS-based test strips with better detection performance. Applications of SERS-based test strips in diagnosis of disease biomarkers, nucleic acids and toxins are reviewed, with an emphasis on SERS tag design, sensitivity and analytical applicability. Finally, conclusions are made and perspectives on futuristic research directions are given.
Collapse
Affiliation(s)
- Luyang Wang
- College of Food Science and Engineering, Ocean University of China, 5 Yushan Road, Qingdao, 266003, China
| | - Xiaokun Wang
- Shandong Provincial Key Laboratory of Biochemical Engineering, College of Marine Science and Biological Engineering, Qingdao University of Science and Technology, Qingdao, 266042, China
| | - Lu Cheng
- College of Food Science and Engineering, Ocean University of China, 5 Yushan Road, Qingdao, 266003, China
| | - Shansen Ding
- College of Food Science and Engineering, Ocean University of China, 5 Yushan Road, Qingdao, 266003, China
| | - Guoqing Wang
- College of Food Science and Engineering, Ocean University of China, 5 Yushan Road, Qingdao, 266003, China; Laboratory for Marine Drugs and Bioproducts of Qingdao National Laboratory for Marine Science and Technology, Qingdao, 266237, China.
| | - Jaebum Choo
- Department of Chemistry, Chung-Ang University, Seoul, 06974, South Korea.
| | - Lingxin Chen
- CAS Key Laboratory of Coastal Environmental Processes and Ecological Remediation, Shandong Key Laboratory of Coastal Environmental Processes, Yantai Institute of Coastal Zone Research, Chinese Academy of Sciences, Yantai, 264003, China; College of Chemistry and Chemical Engineering, Qufu Normal University, Qufu, 273165, China.
| |
Collapse
|
32
|
Laeyendecker O, Hsieh YH, Rothman RE, Dashler G, Kickler T, Fernandez RE, Clarke W, Patel EU, Tobian AAR, Kelen GD, Quinn TC. Demographic and clinical correlates of acute and convalescent SARS-CoV-2 infection among patients of a U.S. emergency department. Am J Emerg Med 2021; 48:261-268. [PMID: 34015609 PMCID: PMC8086378 DOI: 10.1016/j.ajem.2021.04.081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/21/2021] [Accepted: 04/26/2021] [Indexed: 11/14/2022] Open
Abstract
Background Emergency Departments (EDs) have served as critical surveillance sites for infectious diseases. We sought to determine the prevalence and temporal trends of acute (by PCR) and convalescent (by antibody [Ab]) SARS-CoV-2 infection during the earliest phase of the pandemic among patients in an urban ED in Baltimore City. Methods We tested remnant blood samples from 3255 unique ED patients, collected between March 16th and May 31st 2020 for SARS-CoV-2 Ab. PCR for acute SARS-CoV-2 infection from nasopharyngeal swabs was obtained on any patients based on clinical suspicion. Hospital records were abstracted and factors associated with SARS-CoV-2 infection were assessed. Results Of 3255 ED patients, 8.2% (95%CI: 7.3%, 9.2%) individuals had evidence of SARS-CoV-2 infection; 155 PCR+, 78 Ab+, and 35 who were both PCR+ and Ab+. Prevalence of disease increased throughout the study period, ranging from 3.2% (95%CI: 1.8%, 5.2%) PCR+ and 0.6% (95%CI: 0.1%, 1.8%) Ab+ in March, to 6.2% (95%CI: 5.1%, 7.4%) PCR+ and 4.2% (95%CI: 3.3%, 5.3%) Ab+ in May. The highest SARS-CoV-2 prevalence was found in Hispanic individuals who made up 8.4% (95%CI: 7.4%, 9.4%) of individuals screened, but 35% (95%CI: 29%, 41%) of infections (PCR and/or Ab+). Demographic and clinical factors independently associated with acute infection included Hispanic ethnicity, loss of smell or taste, subjective fever, cough, muscle ache and fever. Factors independently associated with convalescent infection were Hispanic ethnicity and low oxygen saturation. Conclusions The burden of COVID-19 in Baltimore City increased dramatically over the 11-week study period and was disproportionately higher among Hispanic individuals. ED-based surveillance methods are important for identifying both acute and convalescent SARS-CoV-2 infections and provides important information regarding demographic and clinical correlates of disease in the local community.
Collapse
Affiliation(s)
- Oliver Laeyendecker
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Baltimore, MD, United States of America; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America.
| | - Yu-Hsiang Hsieh
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Richard E Rothman
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Gaby Dashler
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Thomas Kickler
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Reinaldo E Fernandez
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - William Clarke
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Eshan U Patel
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Aaron A R Tobian
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Gabor D Kelen
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Thomas C Quinn
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Baltimore, MD, United States of America; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | | |
Collapse
|
33
|
Baker OR, Grabowski MK, Galiwango RM, Nalumansi A, Serwanga J, Clarke W, Hsieh YH, Rothman RE, Fernandez RE, Serwadda D, Kagaayi J, Lutalo T, Reynolds SJ, Kaleebu P, Quinn TC, Laeyendecker O. Differential Performance of CoronaCHEK SARS-CoV-2 Lateral Flow Antibody Assay by Geographic Origin of Samples. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.04.12.21255284. [PMID: 33880484 PMCID: PMC8057252 DOI: 10.1101/2021.04.12.21255284] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Background We assessed the performance of CoronaCHEK lateral flow assay on samples from Uganda and Baltimore to determine the impact of geographic origin on assay performance. Methods Serum samples from SARS-CoV-2 PCR+ individuals (Uganda: 78 samples from 78 individuals and Baltimore: 266 samples from 38 individuals) and from pre-pandemic individuals (Uganda 1077 and Baltimore 532) were evaluated. Prevalence ratios (PR) were calculated to identify factors associated with a false-positive test. Results After first positive PCR in Ugandan samples the sensitivity was: 45% (95% CI 24,68) at 0-7 days; 79% (95%CI 64,91) 8-14 days; and 76% (95%CI 50,93) >15 days. In samples from Baltimore, sensitivity was: 39% (95% CI 30, 49) 0-7 days; 86% (95% CI 79,92) 8-14 days; and 100% (95% CI 89,100) 15 days post positive PCR. The specificity of 96.5% (95% CI 97.5,95.2) in Ugandan samples was significantly lower than samples from Baltimore 99.3% (95% CI 98.1,99.8), p<0.01. In Ugandan samples, individuals with a false positive result were more likely to be male (PR 2.04, 95% CI 1.03,3.69) or individuals who had a fever more than a month prior to sample acquisition (PR 2.87, 95% CI 1.12,7.35). Conclusions Sensitivity of the CoronaCHEK was similar in samples from Uganda and Baltimore. The specificity was significantly lower in Ugandan samples than in Baltimore samples. False positive results in Ugandan samples appear to correlate with a recent history of a febrile illness, potentially indicative of a cross-reactive immune response in individuals from East Africa.
Collapse
Affiliation(s)
- Owen R. Baker
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Baltimore, MD, USA
| | - M. Kate Grabowski
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Rakai Health Sciences Program, Kalisizo, Uganda
| | | | | | - Jennifer Serwanga
- Uganda Virus Research Institute, Entebbe, Uganda
- Medical Research Council, Uganda Virus Research Institute and London School of hygiene and Tropical Medicine Uganda Research Unit
| | - William Clarke
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Yu-Hsiang Hsieh
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | | | - David Serwadda
- Rakai Health Sciences Program, Kalisizo, Uganda
- Makerere University School of Public Health, Kampala, Uganda
| | | | - Tom Lutalo
- Rakai Health Sciences Program, Kalisizo, Uganda
- Uganda Virus Research Institute, Entebbe, Uganda
| | - Steven J. Reynolds
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Baltimore, MD, USA
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Rakai Health Sciences Program, Kalisizo, Uganda
| | - Pontiano Kaleebu
- Uganda Virus Research Institute, Entebbe, Uganda
- Medical Research Council, Uganda Virus Research Institute and London School of hygiene and Tropical Medicine Uganda Research Unit
| | - Thomas C. Quinn
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Baltimore, MD, USA
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Oliver Laeyendecker
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Baltimore, MD, USA
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| |
Collapse
|
34
|
Moshe M, Daunt A, Flower B, Simmons B, Brown JC, Frise R, Penn R, Kugathasan R, Petersen C, Stockmann H, Ashby D, Riley S, Atchison C, Taylor GP, Satkunarajah S, Naar L, Klaber R, Badhan A, Rosadas C, Marchesin F, Fernandez N, Sureda-Vives M, Cheeseman H, O'Hara J, Shattock R, Fontana G, Pallett SJC, Rayment M, Jones R, Moore LSP, Ashrafian H, Cherapanov P, Tedder R, McClure M, Ward H, Darzi A, Elliott P, Cooke GS, Barclay WS. SARS-CoV-2 lateral flow assays for possible use in national covid-19 seroprevalence surveys (React 2): diagnostic accuracy study. BMJ 2021; 372:n423. [PMID: 33653694 PMCID: PMC7921617 DOI: 10.1136/bmj.n423] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/11/2021] [Indexed: 12/02/2022]
Abstract
OBJECTIVE To evaluate the performance of new lateral flow immunoassays (LFIAs) suitable for use in a national coronavirus disease 2019 (covid-19) seroprevalence programme (real time assessment of community transmission 2-React 2). DESIGN Diagnostic accuracy study. SETTING Laboratory analyses were performed in the United Kingdom at Imperial College, London and university facilities in London. Research clinics for finger prick sampling were run in two affiliated NHS trusts. PARTICIPANTS Sensitivity analyses were performed on sera stored from 320 previous participants in the React 2 programme with confirmed previous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Specificity analyses were performed on 1000 prepandemic serum samples. 100 new participants with confirmed previous SARS-CoV-2 infection attended study clinics for finger prick testing. INTERVENTIONS Laboratory sensitivity and specificity analyses were performed for seven LFIAs on a minimum of 200 serum samples from participants with confirmed SARS-CoV-2 infection and 500 prepandemic serum samples, respectively. Three LFIAs were found to have a laboratory sensitivity superior to the finger prick sensitivity of the LFIA currently used in React 2 seroprevalence studies (84%). These LFIAs were then further evaluated through finger prick testing on participants with confirmed previous SARS-CoV-2 infection: two LFIAs (Surescreen, Panbio) were evaluated in clinics in June-July 2020 and the third LFIA (AbC-19) in September 2020. A spike protein enzyme linked immunoassay and hybrid double antigen binding assay were used as laboratory reference standards. MAIN OUTCOME MEASURES The accuracy of LFIAs in detecting immunoglobulin G (IgG) antibodies to SARS-CoV-2 compared with two reference standards. RESULTS The sensitivity and specificity of seven new LFIAs that were analysed using sera varied from 69% to 100%, and from 98.6% to 100%, respectively (compared with the two reference standards). Sensitivity on finger prick testing was 77% (95% confidence interval 61.4% to 88.2%) for Panbio, 86% (72.7% to 94.8%) for Surescreen, and 69% (53.8% to 81.3%) for AbC-19 compared with the reference standards. Sensitivity for sera from matched clinical samples performed on AbC-19 was significantly higher with serum than finger prick at 92% (80.0% to 97.7%, P=0.01). Antibody titres varied considerably among cohorts. The numbers of positive samples identified by finger prick in the lowest antibody titre quarter varied among LFIAs. CONCLUSIONS One new LFIA was identified with clinical performance suitable for potential inclusion in seroprevalence studies. However, none of the LFIAs tested had clearly superior performance to the LFIA currently used in React 2 seroprevalence surveys, and none showed sufficient sensitivity and specificity to be considered for routine clinical use.
Collapse
Affiliation(s)
- Maya Moshe
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Anna Daunt
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
- Imperial College Healthcare NHS Trust, St Mary's Hospital, London, UK
| | - Barnaby Flower
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
- Imperial College Healthcare NHS Trust, St Mary's Hospital, London, UK
| | - Bryony Simmons
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Jonathan C Brown
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Rebecca Frise
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Rebecca Penn
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Ruthiran Kugathasan
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Claire Petersen
- Imperial College Healthcare NHS Trust, St Mary's Hospital, London, UK
| | - Helen Stockmann
- Imperial College Healthcare NHS Trust, St Mary's Hospital, London, UK
| | - Deborah Ashby
- School of Public Health, Imperial College London, St Mary's Hospital, London, UK
| | - Steven Riley
- School of Public Health, Imperial College London, St Mary's Hospital, London, UK
| | - Christina Atchison
- School of Public Health, Imperial College London, St Mary's Hospital, London, UK
| | - Graham P Taylor
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Sutha Satkunarajah
- Institute for Global Health Innovation, Imperial College London, London, UK
| | - Lenny Naar
- Institute for Global Health Innovation, Imperial College London, London, UK
| | - Robert Klaber
- Imperial College Healthcare NHS Trust, St Mary's Hospital, London, UK
| | - Anjna Badhan
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Carolina Rosadas
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Federica Marchesin
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Natalia Fernandez
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Macià Sureda-Vives
- Synthetic Biology Group, London Institute of Medical Sciences, Imperial College London, London, UK
| | - Hannah Cheeseman
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Jessica O'Hara
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Robin Shattock
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Gianluca Fontana
- Institute for Global Health Innovation, Imperial College London, London, UK
| | - Scott J C Pallett
- Chelsea and Westminster NHS Foundation Trust, London, UK
- Centre of Defence Pathology, Royal Centre for Defence Medicine, Queen Elizabeth Hospital, Birmingham, UK
| | | | - Rachael Jones
- Chelsea and Westminster NHS Foundation Trust, London, UK
| | - Luke S P Moore
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
- Chelsea and Westminster NHS Foundation Trust, London, UK
| | - Hutan Ashrafian
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Peter Cherapanov
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
- Chromatin Structure and Mobile DNA Laboratory, Francis Crick Institute, London, UK
| | - Richard Tedder
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Myra McClure
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Helen Ward
- School of Public Health, Imperial College London, St Mary's Hospital, London, UK
| | - Ara Darzi
- Institute for Global Health Innovation, Imperial College London, London, UK
| | - Paul Elliott
- Imperial College Healthcare NHS Trust, St Mary's Hospital, London, UK
- School of Public Health, Imperial College London, St Mary's Hospital, London, UK
- National Institute for Health Research (NIHR) Health Protection Research Unit (HPRU) in Chemical and Radiation Threats and Hazards, Imperial College London, London, UK
| | - Graham S Cooke
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Wendy S Barclay
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
- Imperial College Healthcare NHS Trust, St Mary's Hospital, London, UK
| |
Collapse
|
35
|
Heaney CD, Pisanic N, Randad PR, Kruczynski K, Howard T, Zhu X, Littlefield K, Patel EU, Shrestha R, Laeyendecker O, Shoham S, Sullivan D, Gebo K, Hanley D, Redd AD, Quinn TC, Casadevall A, Zenilman JM, Pekosz A, Bloch EM, Tobian AAR. Comparative performance of multiplex salivary and commercially available serologic assays to detect SARS-CoV-2 IgG and neutralization titers. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.01.28.21250717. [PMID: 33532806 PMCID: PMC7852272 DOI: 10.1101/2021.01.28.21250717] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Oral fluid (hereafter saliva) offers a non-invasive sampling method for the detection of SARS-CoV-2 antibodies. However, data comparing performance of salivary tests against commercially-available serologic and neutralizing antibody (nAb) assays are lacking. This study compared the performance of a multiplex salivary SARS-CoV-2 IgG assay targeting antibodies to nucleocapsid (N), receptor binding domain (RBD) and spike (S) antigens to three commercially-available SARS-CoV-2 serology enzyme immunoassays (EIAs) (Ortho Vitros, Euroimmun, and BioRad) and nAb. Paired saliva and plasma samples were collected from 101 eligible COVID-19 convalescent plasma (CCP) donors >14 days since PCR+ confirmed diagnosis. Concordance was evaluated using positive (PPA) and negative (NPA) percent agreement, overall percent agreement (PA), and Cohen kappa coefficient. The range between salivary and plasma EIAs for SARS-CoV-2-specific N was PPA: 54.4-92.1% and NPA: 69.2-91.7%, for RBD was PPA: 89.9-100% and NPA: 50.0-84.6%, and for S was PPA: 50.6-96.6% and NPA: 50.0-100%. Compared to a plasma nAb assay, the multiplex salivary assay PPA ranged from 62.3% (N) and 98.6% (RBD) and NPA ranged from 18.8% (RBD) to 96.9% (S). Combinations of N, RBD, and S and a summary algorithmic index of all three (N/RBD/S) in saliva produced ranges of PPA: 87.6-98.9% and NPA: 50-91.7% with the three EIAs and ranges of PPA: 88.4-98.6% and NPA: 21.9-34.4% with the nAb assay. A multiplex salivary SARS-CoV-2 IgG assay demonstrated comparable performance to three commercially-available plasma EIAs and a nAb assay, and may be a viable alternative to assist in screening CCP donors and monitoring population-based seroprevalence and vaccine antibody response.
Collapse
Affiliation(s)
- Christopher D. Heaney
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Nora Pisanic
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Pranay R. Randad
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Kate Kruczynski
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Tyrone Howard
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Xianming Zhu
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kirsten Littlefield
- Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Eshan U. Patel
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ruchee Shrestha
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Oliver Laeyendecker
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Baltimore MD
| | - Shmuel Shoham
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - David Sullivan
- Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kelly Gebo
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Daniel Hanley
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Andrew D. Redd
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Baltimore MD
| | - Thomas C. Quinn
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Baltimore MD
| | - Arturo Casadevall
- Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Jonathan M. Zenilman
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Andrew Pekosz
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Evan M. Bloch
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Aaron A. R. Tobian
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| |
Collapse
|
36
|
Galipeau Y, Greig M, Liu G, Driedger M, Langlois MA. Humoral Responses and Serological Assays in SARS-CoV-2 Infections. Front Immunol 2020; 11:610688. [PMID: 33391281 PMCID: PMC7775512 DOI: 10.3389/fimmu.2020.610688] [Citation(s) in RCA: 162] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 11/23/2020] [Indexed: 12/14/2022] Open
Abstract
In December 2019, the novel betacoronavirus Severe Acute Respiratory Disease Coronavirus 2 (SARS-CoV-2) was first detected in Wuhan, China. SARS-CoV-2 has since become a pandemic virus resulting in hundreds of thousands of deaths and deep socioeconomic implications worldwide. In recent months, efforts have been directed towards detecting, tracking, and better understanding human humoral responses to SARS-CoV-2 infection. It has become critical to develop robust and reliable serological assays to characterize the abundance, neutralization efficiency, and duration of antibodies in virus-exposed individuals. Here we review the latest knowledge on humoral immune responses to SARS-CoV-2 infection, along with the benefits and limitations of currently available commercial and laboratory-based serological assays. We also highlight important serological considerations, such as antibody expression levels, stability and neutralization dynamics, as well as cross-reactivity and possible immunological back-boosting by seasonal coronaviruses. The ability to accurately detect, measure and characterize the various antibodies specific to SARS-CoV-2 is necessary for vaccine development, manage risk and exposure for healthcare and at-risk workers, and for monitoring reinfections with genetic variants and new strains of the virus. Having a thorough understanding of the benefits and cautions of standardized serological testing at a community level remains critically important in the design and implementation of future vaccination campaigns, epidemiological models of immunity, and public health measures that rely heavily on up-to-date knowledge of transmission dynamics.
Collapse
Affiliation(s)
- Yannick Galipeau
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON, Canada
| | - Matthew Greig
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON, Canada
| | - George Liu
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON, Canada
| | | | - Marc-André Langlois
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON, Canada
- uOttawa Center for Infection, Immunity and Inflammation (CI3), Ottawa, ON, Canada
| |
Collapse
|
37
|
Althoff KN, Laeyendecker O, Li R, Coburn SB, Klock E, Baker OR, Quinn TC, Michael J, Shields WC, Ehsani J, Thomas FD, Graham LA, Ali Z, Manabe YC, Li L. Severe Acute Respiratory Syndrome Coronavirus 2 Antibody Status in Decedents Undergoing Forensic Postmortem Examination in Maryland, May 24 to June 30, 2020. Open Forum Infect Dis 2020; 8:ofaa611. [PMID: 33506069 PMCID: PMC7798730 DOI: 10.1093/ofid/ofaa611] [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: 10/05/2020] [Accepted: 12/12/2020] [Indexed: 12/05/2022] Open
Abstract
Seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies was 10% among the subset of decedents undergoing forensic postmortem examination in June in Maryland. Decedents of motor vehicle crashes had similar seroprevalence compared with those with a natural death (including decedents with SARS-CoV-2 infection). Decedents of motor vehicle crashes may be a sentinel surveillance population.
Collapse
Affiliation(s)
- Keri N Althoff
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Oliver Laeyendecker
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.,Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Rong Li
- Office of the Chief Medical Examiner, Maryland Department of Health, Baltimore, Maryland, USA
| | - Sally B Coburn
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ethan Klock
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Owen R Baker
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Thomas C Quinn
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.,Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Jeffrey Michael
- Center for Injury Research and Policy, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Wendy C Shields
- Center for Injury Research and Policy, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Johnathon Ehsani
- Center for Injury Research and Policy, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | | | - Zabiullah Ali
- Office of the Chief Medical Examiner, Maryland Department of Health, Baltimore, Maryland, USA
| | - Yukari C Manabe
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Ling Li
- Office of the Chief Medical Examiner, Maryland Department of Health, Baltimore, Maryland, USA.,Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| |
Collapse
|
38
|
Lee W, Straube S, Sincic R, Noble JA, Montoy JC, Kornblith AE, Prakash A, Wang R, Bainton RJ, Kurien PA. Clinical Evaluation of a COVID-19 Antibody Lateral Flow Assay using Point of Care Samples. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020:2020.12.02.20242750. [PMID: 33300003 PMCID: PMC7724668 DOI: 10.1101/2020.12.02.20242750] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Introduction The ongoing SARS-CoV-2 pandemic has spurred the development of numerous point of care (PoC) immunoassays. Assessments of performance of available kits are necessary to determine their clinical utility. Previous studies have mostly performed these assessments in a laboratory setting, which raises concerns of translating findings for PoC use. The aim of this study was to assess the performance of a lateral flow immunoassay for the detection of SARS-CoV-2 antibodies using samples collected at PoC. Method One lateral flow immunoassay (Humasis® COVID-19 IgG/IgM) was tested. In total, 50 PCR RT-PCR positive and 52 RT-PCR negative samples were collected at PoC. Fifty serum specimens from Dec 2018 to Feb 2019 were used as controls for specificity. Serum samples collected between Dec 2019 to Feb 2020 were used as additional comparators. Clinical data including symptom onset date was collected from patient history and the medical record. Results The overall sensitivity for the kit was 74% (95% CI: 59.7% - 85.4%). The sensitivity for IgM and IgG detection >14 days after date of onset was 88% (95% CI: 68.8% - 97.5%) and 84% (95% CI: 63.9% - 95.5%), with a negative predictive value (NPV) of 94% for IgM (95% CI: 83.5% - 98.8%) and 93% for IgG (95% CI: 81.8% - 97.9%). The overall specificity was 94% (95% CI: 83.5% - 98.8%). The Immunoglobulin specific specificity was 94% for IgM (95% CI: 83.5% - 98.8%) and 98% for IgG (95% CI: 89.4% - 100.0%), with a positive predictive value (PPV) of 88% for IgM (95% CI: 68.8% - 97.5%) and 95% for IgG (95% CI: 77.2% - 99.9%) respectively for samples collected from patients >14 days after date of onset. Specimen collected during early phase of COVID-19 pandemic (Dec 2019 to Feb 2020) showed 11.8% antibody positivity, and 11.3% of PCR-negative patients demonstrated antibody positivity. Discussion Humasis® COVID-19 IgG/IgM LFA demonstrates greater than 90% PPV and NPV for samples collected 14 days after the onset of symptoms using samples collected at PoC. While not practical for the diagnosis of acute infection, the use of the lateral flow assays with high specificity may have utility for determining seroprevalence or seroconversion in longitudinal studies.
Collapse
Affiliation(s)
- Won Lee
- Department of Anesthesiology and Perioperative Care, University of California San Francisco, San Francisco CA 94143, USA
| | - Steven Straube
- Department of Emergency Medicine, University of California San Francisco, San Francisco CA 94143, USA
| | - Ryan Sincic
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco CA 94143, USA
| | - Jeanne A. Noble
- Department of Emergency Medicine, University of California San Francisco, San Francisco CA 94143, USA
| | - Juan Carlos Montoy
- Department of Emergency Medicine, University of California San Francisco, San Francisco CA 94143, USA
| | - Aaron E. Kornblith
- Department of Emergency Medicine, University of California San Francisco, San Francisco CA 94143, USA
- Department of Pediatrics, University of California San Francisco, San Francisco CA 94143, USA
| | - Arun Prakash
- Department of Anesthesiology and Perioperative Care, University of California San Francisco, San Francisco CA 94143, USA
| | - Ralph Wang
- Department of Emergency Medicine, University of California San Francisco, San Francisco CA 94143, USA
| | - Roland J. Bainton
- Department of Anesthesiology and Perioperative Care, University of California San Francisco, San Francisco CA 94143, USA
| | - Philip A. Kurien
- Department of Anesthesiology and Perioperative Care, University of California San Francisco, San Francisco CA 94143, USA
| |
Collapse
|
39
|
Woldemeskel BA, Kwaa AK, Garliss CC, Laeyendecker O, Ray SC, Blankson JN. Healthy donor T cell responses to common cold coronaviruses and SARS-CoV-2. J Clin Invest 2020; 130:6631-6638. [PMID: 32966269 PMCID: PMC7685719 DOI: 10.1172/jci143120] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 09/09/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUNDT cell responses to the common cold coronaviruses have not been well characterized. Preexisting T cell immunity to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been reported, and a recent study suggested that this immunity was due to cross-recognition of the novel coronavirus by T cells specific for the common cold coronaviruses.METHODSWe used the enzyme-linked immunospot (ELISPOT) assay to characterize the T cell responses against peptide pools derived from the spike protein of 3 common cold coronaviruses (HCoV-229E, HCoV-NL63, and HCoV-OC43) and SARS-CoV-2 in 21 healthy donors (HDs) who were seronegative for SARS-CoV-2 and had no known exposure to the virus. An in vitro expansion culture assay was also used to analyze memory T cell responses.RESULTSWe found responses to the spike protein of the 3 common cold coronaviruses in many of the donors. We then focused on HCoV-NL63 and detected broad T cell responses to the spike protein and identified 22 targeted peptides. Interestingly, only 1 study participant had a significant response to SARS-CoV-2 spike or nucleocapsid protein in the ELISPOT assay. In vitro expansion studies suggested that T cells specific for the HCoV-NL63 spike protein in this individual could also recognize SARS-CoV-2 spike protein peptide pools.CONCLUSIONHDs have circulating T cells specific for the spike proteins of HCoV-NL63, HCoV-229E, and HCoV-OC43. T cell responses to SARS-CoV-2 spike and nucleocapsid proteins were present in only 1 participant and were potentially the result of cross-recognition by T cells specific for the common cold coronaviruses. Further studies are needed to determine whether this cross-recognition influences coronavirus disease 2019 (COVID-19) outcomes.
Collapse
Affiliation(s)
- Bezawit A. Woldemeskel
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Abena K. Kwaa
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Caroline C. Garliss
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Oliver Laeyendecker
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases (NIAID), NIH, Baltimore, Maryland, USA
| | - Stuart C. Ray
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Joel N. Blankson
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| |
Collapse
|