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Alquero JNM, Estanislao PMS, Hermino SMM, Manding RDM, Robles JED, Canillo CMA, Tantengco OAG. Use of dried blood spots in the detection of coronavirus disease 2019 (COVID-19): A systematic review. Indian J Med Microbiol 2024; 51:100700. [PMID: 39127256 DOI: 10.1016/j.ijmmb.2024.100700] [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: 06/01/2024] [Revised: 07/09/2024] [Accepted: 08/07/2024] [Indexed: 08/12/2024]
Abstract
INTRODUCTION COVID-19 disease continues to be a global health concern. The current protocol for detecting SARS-CoV-2 requires healthcare professionals to draw blood from patients. Recent studies showed that dried blood spot (DBS) is a valuable sampling procedure that can collect a low blood volume without the need for the presence of medical practitioners. This study synthesized the available literature on using DBS as a blood collection tool to diagnose COVID-19 disease. MATERIALS AND METHODS A comprehensive search utilizing OVID, CINAHL, and Scopus databases was done from inception to March 2023. Five reviewers collected, extracted and organized the study data. RESULTS This systematic review included 57 articles. DBS was commonly prepared by finger pricking. Most studies showed more favorable results and longer sample stability (more than 1080 days) with lower storage temperature conditions for the DBS. DBS samples were mostly used for serological assays for COVID-19 disease detection. ELISA was the most used detection method (43.66 %). Diagnostic performance of laboratory tests for COVID-19 using DBS sample showed high sensitivity of up to 100 % for immunoassay tests and 100 % specificity in agglutination, PCR, and DELFIA assays. CONCLUSION DBS sampling coupled with serological testing can be an alternative method for collecting blood and detecting COVID-19 disease. These tests using DBS samples showed excellent diagnostic performance across various geographic locations and demographics.
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Affiliation(s)
- Jannie Nikolai M Alquero
- Department of Biology, College of Arts and Sciences, University of the Philippines Manila, Manila, 1000, Philippines.
| | - Patrizia Marie S Estanislao
- Department of Biology, College of Arts and Sciences, University of the Philippines Manila, Manila, 1000, Philippines.
| | - Svethlana Marie M Hermino
- Department of Biology, College of Arts and Sciences, University of the Philippines Manila, Manila, 1000, Philippines.
| | - Ranna Duben M Manding
- Department of Biology, College of Arts and Sciences, University of the Philippines Manila, Manila, 1000, Philippines.
| | - Joshua Euchie D Robles
- Department of Biology, College of Arts and Sciences, University of the Philippines Manila, Manila, 1000, Philippines.
| | - Christene Mae A Canillo
- Department of Biology, College of Arts and Sciences, University of the Philippines Manila, Manila, 1000, Philippines.
| | - Ourlad Alzeus G Tantengco
- Department of Physiology, College of Medicine, University of the Philippines Manila, Manila, 1000, Philippines; Department of Biology, College of Science, De La Salle University, Manila, 1000, Philippines.
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2
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Ylade M, Aziz AB, Daag JV, Crisostomo MV, Agrupis KA, Maronilla MA, Sye Lim Hong C, Kim HY, Njau I, Lopez MHJ, Deen J, Kim DR, You YA, Kang SSY, Marks F, Tadesse BT. Using Dried Blood Spots to Quantitatively Detect Anti-SARS-CoV-2 IgG Antibodies by ELISA: A Validation Study. Am J Trop Med Hyg 2024; 111:391-395. [PMID: 38917817 PMCID: PMC11310613 DOI: 10.4269/ajtmh.23-0306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 03/15/2024] [Indexed: 06/27/2024] Open
Abstract
SARS-CoV-2 serological testing is useful to determine seroprevalence, epidemiological trends, and the extent of transmission. The collection and transport of serum samples can be logistically challenging, especially in remote underserved areas. Dried blood spots (DBSs) would allow easier sample collection and logistical handling compared with standard serum collection, particularly for extensive and repeated SARS-CoV-2 serosurveys. We evaluated the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the IgG ELISA (Wantai, Beijing, China) using DBSs against sera for the quantitative detection of SARS-CoV-2 IgG antibody. The IgG ELISA was used to test paired sera and DBSs obtained from individuals with recent virologically confirmed COVID-19 illness and banked paired sera and DBSs collected before the COVID-19 pandemic. We found that 100/100 (100%) seropositive samples were positive using DBSs, and 193/194 (99%) seronegative samples were negative using DBSs. Compared with sera, the DBS method had a 100% sensitivity, 99% specificity, 99% PPV, and 100% NPV. Use of DBSs for SARS-CoV-2 household or population serosurveys may be considered in situations with limitations in sample collection, shipment, and storage.
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Affiliation(s)
- Michelle Ylade
- Institute of Child Health and Human Development, National Institutes of Health, University of the Philippines–Manila, Manila, Philippines
| | | | - Jedas Veronica Daag
- Institute of Child Health and Human Development, National Institutes of Health, University of the Philippines–Manila, Manila, Philippines
| | - Maria Vinna Crisostomo
- Institute of Child Health and Human Development, National Institutes of Health, University of the Philippines–Manila, Manila, Philippines
| | - Kristal-An Agrupis
- Institute of Child Health and Human Development, National Institutes of Health, University of the Philippines–Manila, Manila, Philippines
| | - Maria Angela Maronilla
- Institute of Child Health and Human Development, National Institutes of Health, University of the Philippines–Manila, Manila, Philippines
| | | | | | - Irene Njau
- International Vaccine Institute, Seoul, Korea
| | - March Helena Jane Lopez
- Institute of Child Health and Human Development, National Institutes of Health, University of the Philippines–Manila, Manila, Philippines
| | - Jacqueline Deen
- Institute of Child Health and Human Development, National Institutes of Health, University of the Philippines–Manila, Manila, Philippines
| | | | | | | | - Florian Marks
- International Vaccine Institute, Seoul, Korea
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
- Madagascar Institute for Vaccine Research, University of Antananarivo, Antananarivo, Madagascar
| | - Birkneh Tilahun Tadesse
- International Vaccine Institute, Seoul, Korea
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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Walter JR, Lee JY, Yu L, Kim B, Martell K, Opdycke A, Scheffel J, Felsl I, Patel S, Rangel S, Serao A, Edel C, Bharat A, Xu S. Use of artificial intelligence to develop predictive algorithms of cough and PCR-confirmed COVID-19 infections based on inputs from clinical-grade wearable sensors. Sci Rep 2024; 14:8072. [PMID: 38580712 PMCID: PMC10997665 DOI: 10.1038/s41598-024-57830-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 03/21/2024] [Indexed: 04/07/2024] Open
Abstract
There have been over 769 million cases of COVID-19, and up to 50% of infected individuals are asymptomatic. The purpose of this study aimed to assess the use of a clinical-grade physiological wearable monitoring system, ANNE One, to develop an artificial intelligence algorithm for (1) cough detection and (2) early detection of COVID-19, through the retrospective analysis of prospectively collected physiological data from longitudinal wear of ANNE sensors in a multicenter single arm study of subjects at high risk for COVID-19 due to occupational or home exposures. The study employed a two-fold approach: cough detection algorithm development and COVID-19 detection algorithm development. For cough detection, healthy individuals wore an ANNE One chest sensor during scripted activity. The final performance of the algorithm achieved an F-1 score of 83.3% in twenty-seven healthy subjects during biomarker validation. In the COVID-19 detection algorithm, individuals at high-risk for developing COVID-19 because of recent exposures received ANNE One sensors and completed daily symptom surveys. An algorithm analyzing vital parameters (heart rate, respiratory rate, cough count, etc.) for early COVID-19 detection was developed. The COVID-19 detection algorithm exhibited a sensitivity of 0.47 and specificity of 0.72 for detecting COVID-19 in 325 individuals with recent exposures. Participants demonstrated high adherence (≥ 4 days of wear per week). ANNE One shows promise for detection of COVID-19. Inclusion of respiratory biomarkers (e.g., cough count) enhanced the algorithm's predictive ability. These findings highlight the potential value of wearable devices in early disease detection and monitoring.
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Affiliation(s)
- Jessica R Walter
- Department of Obstetrics and Gynecology, Northwestern University, Chicago, IL, USA
| | - Jong Yoon Lee
- Sibel Health, Chicago, USA
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, USA
| | - Lian Yu
- Sibel Health, Chicago, USA
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, USA
| | - Brandon Kim
- Sibel Health, Chicago, USA
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, USA
| | - Knute Martell
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, USA
| | | | | | | | - Soham Patel
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Stephanie Rangel
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Alexa Serao
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Claire Edel
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Ankit Bharat
- Department of Surgery, Northwestern University, Chicago, IL, USA
| | - Shuai Xu
- Sibel Health, Chicago, USA.
- Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, USA.
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, USA.
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Castelletti N, Paunovic I, Rubio-Acero R, Beyerl J, Plank M, Reinkemeyer C, Kroidl I, Noreña I, Winter S, Olbrich L, Janke C, Hoelscher M, Wieser A. A Dried Blood Spot protocol for high-throughput quantitative analysis of SARS-CoV-2 RBD serology based on the Roche Elecsys system. Microbiol Spectr 2024; 12:e0288523. [PMID: 38426747 PMCID: PMC10986497 DOI: 10.1128/spectrum.02885-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 11/15/2023] [Indexed: 03/02/2024] Open
Abstract
SARS-CoV-2 spreads pandemically since 2020; in 2021, effective vaccinations became available and vaccination campaigns commenced. Still, it is hard to track the spread of the infection or to assess vaccination success in the broader population. Measuring specific anti-SARS-CoV-2 antibodies is the most effective tool to track the spread of the infection or successful vaccinations. The need for venous-blood sampling however poses a significant barrier for large studies. Dried-blood-spots on filter-cards (DBS) have been used for SARS-CoV-2 serology in our laboratory, but so far not to follow quantitative SARS-CoV-2 anti-spike reactivity in a longitudinal cohort. We developed a semi-automated protocol or quantitative SARS-CoV-2 anti-spike serology from self-sampled DBS, validating it in a cohort of matched DBS and venous-blood samples (n = 825). We investigated chromatographic effects, reproducibility, and carry-over effects and calculated a positivity threshold as well as a conversion formula to determine the quantitative binding units in the DBS with confidence intervals. Sensitivity and specificity reached 96.63% and 97.81%, respectively, compared to the same test performed in paired venous samples. Between a signal of 0.018 and 250 U/mL, we calculated a correction formula. Measuring longitudinal samples during vaccinations, we demonstrated relative changes in titers over time in several individuals and in a longitudinal cohort over four follow-ups. DBS sampling has proven itself for anti-nucleocapsid serosurveys in our laboratory. Similarly, anti-spike high-throughput DBS serology is feasible as a complementary assay. Quantitative measurements are accurate enough to follow titer dynamics in populations also after vaccination campaigns. This work was supported by the Bavarian State Ministry of Science and the Arts; LMU University Hospital, LMU Munich; Helmholtz Center Munich; University of Bonn; University of Bielefeld; German Ministry for Education and Research (proj. nr.: 01KI20271 and others) and the Medical Biodefense Research Program of the Bundeswehr Medical Service. Roche Diagnostics provided kits and machines for analyses at discounted rates. The project is funded also by the European-wide Consortium ORCHESTRA. The ORCHESTRA project has received funding from the European Union's Horizon 2020 research and innovation program under grant agreement No 101016167. The views expressed in this publication are the sole responsibility of the author, and the Commission is not responsible for any use that may be made of the information it contains.IMPORTANCESARS-CoV-2 has been spreading globally as a pandemic since 2020. To determine the prevalence of SARS-CoV-2 antibodies among populations, the most effective public health tool is measuring specific anti-SARS-CoV-2 antibodies induced by infection or vaccination. However, conducting large-scale studies that involve venous-blood sampling is challenging due to the associated feasibility and cost issues. A more cost-efficient and less invasive method for SARS-CoV-2 serological testing is using Dried-Blood-Spots on filter cards (DBS). In this paper, we have developed a semi-automated protocol for quantifying SARS-CoV-2 anti-spike antibodies from self-collected DBS. Our laboratory has previously successfully used DBS sampling for anti-nucleocapsid antibody surveys. Likewise, conducting high-throughput DBS serology for anti-spike antibodies is feasible as an additional test that can be performed using the same sample preparation as the anti-nucleocapsid analysis. The quantitative measurements obtained are accurate enough to track the dynamics of antibody levels in populations, even after vaccination campaigns.
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Affiliation(s)
- Noemi Castelletti
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Institute of Radiation Medicine, Helmholtz Zentrum München, Neuherberg, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, Munich, Germany
| | - Ivana Paunovic
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, Munich, Germany
- Max-von-Pettenkofer Institute, LMU Munich, Munich, Germany
| | - Raquel Rubio-Acero
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Jessica Beyerl
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, Munich, Germany
- Max-von-Pettenkofer Institute, LMU Munich, Munich, Germany
| | - Michael Plank
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Christina Reinkemeyer
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Inge Kroidl
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- German Center for Infection Research (DZIF), partner site Munich, Munich, Germany
| | - Ivan Noreña
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Simon Winter
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, Munich, Germany
| | - Laura Olbrich
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, Munich, Germany
- German Center for Infection Research (DZIF), partner site Munich, Munich, Germany
| | - Christian Janke
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Michael Hoelscher
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, Munich, Germany
- German Center for Infection Research (DZIF), partner site Munich, Munich, Germany
- Center for International Health (CIH), University Hospital, LMU Munich, Munich, Germany
| | - Andreas Wieser
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, Munich, Germany
- Max-von-Pettenkofer Institute, LMU Munich, Munich, Germany
- German Center for Infection Research (DZIF), partner site Munich, Munich, Germany
| | - on behalf of the KoCo19/ORCHESTRA Working group
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Institute of Radiation Medicine, Helmholtz Zentrum München, Neuherberg, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, Munich, Germany
- Max-von-Pettenkofer Institute, LMU Munich, Munich, Germany
- German Center for Infection Research (DZIF), partner site Munich, Munich, Germany
- Center for International Health (CIH), University Hospital, LMU Munich, Munich, Germany
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5
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McBride DJ, Fielding C, Newington T, Vatsiou A, Fischl H, Bajracharya M, Thomson VS, Fraser LJ, Fujita PA, Becq J, Kingsbury Z, Ross MT, Moat SJ, Morgan S. Whole-Genome Sequencing Can Identify Clinically Relevant Variants from a Single Sub-Punch of a Dried Blood Spot Specimen. Int J Neonatal Screen 2023; 9:52. [PMID: 37754778 PMCID: PMC10532340 DOI: 10.3390/ijns9030052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/01/2023] [Accepted: 09/06/2023] [Indexed: 09/28/2023] Open
Abstract
The collection of dried blood spots (DBS) facilitates newborn screening for a variety of rare, but very serious conditions in healthcare systems around the world. Sub-punches of varying sizes (1.5-6 mm) can be taken from DBS specimens to use as inputs for a range of biochemical assays. Advances in DNA sequencing workflows allow whole-genome sequencing (WGS) libraries to be generated directly from inputs such as peripheral blood, saliva, and DBS. We compared WGS metrics obtained from libraries generated directly from DBS to those generated from DNA extracted from peripheral blood, the standard input for this type of assay. We explored the flexibility of DBS as an input for WGS by altering the punch number and size as inputs to the assay. We showed that WGS libraries can be successfully generated from a variety of DBS inputs, including a single 3 mm or 6 mm diameter punch, with equivalent data quality observed across a number of key metrics of importance in the detection of gene variants. We observed no difference in the performance of DBS and peripheral-blood-extracted DNA in the detection of likely pathogenic gene variants in samples taken from individuals with cystic fibrosis or phenylketonuria. WGS can be performed directly from DBS and is a powerful method for the rapid discovery of clinically relevant, disease-causing gene variants.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Stuart J. Moat
- Wales Newborn Screening Laboratory, University Hospital of Wales, Cardiff CF14 4XW, UK
- School of Medicine, Cardiff University, Cardiff CF14 4XW, UK
| | - Sian Morgan
- All Wales Genetics Laboratory, University Hospital of Wales, Cardiff CF14 4XW, UK
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6
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Roper KJ, Thomas J, Albalawi W, Maddocks E, Dobson S, Alshehri A, Barone FG, Baltazar M, Semple MG, Ho A, Turtle L, Paxton WA, Pollakis G. Quantifying neutralising antibody responses against SARS-CoV-2 in dried blood spots (DBS) and paired sera. Sci Rep 2023; 13:15014. [PMID: 37697014 PMCID: PMC10495436 DOI: 10.1038/s41598-023-41928-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 09/04/2023] [Indexed: 09/13/2023] Open
Abstract
The ongoing SARS-CoV-2 pandemic was initially managed by non-pharmaceutical interventions such as diagnostic testing, isolation of positive cases, physical distancing and lockdowns. The advent of vaccines has provided crucial protection against SARS-CoV-2. Neutralising antibody (nAb) responses are a key correlate of protection, and therefore measuring nAb responses is essential for monitoring vaccine efficacy. Fingerstick dried blood spots (DBS) are ideal for use in large-scale sero-surveillance because they are inexpensive, offer the option of self-collection and can be transported and stored at ambient temperatures. Such advantages also make DBS appealing to use in resource-limited settings and in potential future pandemics. In this study, nAb responses in sera, venous blood and fingerstick blood stored on filter paper were measured. Samples were collected from SARS-CoV-2 acutely infected individuals, SARS-CoV-2 convalescent individuals and SARS-CoV-2 vaccinated individuals. Good agreement was observed between the nAb responses measured in eluted DBS and paired sera. Stability of nAb responses was also observed in sera stored on filter paper at room temperature for 28 days. Overall, this study provides support for the use of filter paper as a viable sample collection method to study nAb responses.
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Affiliation(s)
- Kelly J Roper
- Department of Clinical Infection, Microbiology and Immunology (CIMI), Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, Liverpool, L69 7BE, UK
- Faculty of Health and Life Sciences, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Jordan Thomas
- Department of Clinical Infection, Microbiology and Immunology (CIMI), Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, Liverpool, L69 7BE, UK
- Faculty of Health and Life Sciences, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Wejdan Albalawi
- Department of Clinical Infection, Microbiology and Immunology (CIMI), Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, Liverpool, L69 7BE, UK
- Faculty of Health and Life Sciences, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Emily Maddocks
- Department of Clinical Infection, Microbiology and Immunology (CIMI), Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, Liverpool, L69 7BE, UK
- Faculty of Health and Life Sciences, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Susan Dobson
- Department of Clinical Infection, Microbiology and Immunology (CIMI), Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, Liverpool, L69 7BE, UK
- Faculty of Health and Life Sciences, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Abdullateef Alshehri
- Department of Clinical Infection, Microbiology and Immunology (CIMI), Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, Liverpool, L69 7BE, UK
- Faculty of Health and Life Sciences, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Francesco G Barone
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology (ISMIB), University of Liverpool, Liverpool, L69 3BX, UK
| | - Murielle Baltazar
- Department of Clinical Infection, Microbiology and Immunology (CIMI), Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, Liverpool, L69 7BE, UK
- Faculty of Health and Life Sciences, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Malcolm G Semple
- Department of Clinical Infection, Microbiology and Immunology (CIMI), Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, Liverpool, L69 7BE, UK
- Faculty of Health and Life Sciences, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
- Respiratory Medicine, Alder Hey Children's Hospital, Institute in The Park, University of Liverpool, Liverpool, UK
| | - Antonia Ho
- MRC-University of Glasgow Centre for Virus Research, 464 Bearsden Road, Glasgow, G61 1QH, UK
| | - Lance Turtle
- Department of Clinical Infection, Microbiology and Immunology (CIMI), Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, Liverpool, L69 7BE, UK
- Faculty of Health and Life Sciences, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - William A Paxton
- Department of Clinical Infection, Microbiology and Immunology (CIMI), Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, Liverpool, L69 7BE, UK
- Faculty of Health and Life Sciences, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Liverpool, UK
| | - Georgios Pollakis
- Department of Clinical Infection, Microbiology and Immunology (CIMI), Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, Liverpool, L69 7BE, UK.
- Faculty of Health and Life Sciences, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK.
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Liverpool, UK.
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7
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Guttmann S, Bunte S, Eschrig S, Janzen N, Klemens J, Koenemann Y, Münstermann D, Neisse T, Niedergassel T, Steinhagen K, Meyer-Schlinkmann KM. Dried blood spot eluates are suitable for testing of SARS-CoV-2 IgG antibodies targeting Spike protein 1 and Nucleocapsid protein. Biochem Biophys Rep 2023; 34:101479. [PMID: 37125078 PMCID: PMC10126220 DOI: 10.1016/j.bbrep.2023.101479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 04/24/2023] [Indexed: 05/02/2023] Open
Abstract
Dried blood spots (DBS) provide easy handling and are thus a beneficial tool for data collection, e.g. for epidemiological studies. The suitability of DBS for the assessment of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was analyzed with regards to the use in future studies addressing seroprevalence in the population. 121 volunteers gave a venous blood sample and capillary blood samples on two DBS cards (PerkinElmer and Ahlstrom-Munksjö) via self-sampling under supervision. All samples were analyzed using the Anti-SARS-CoV-2 ELISA (IgG) and the Anti-SARS-CoV-2 NCP ELISA (IgG) from EUROIMMUN performed on the EUROIMMUN EUROLabWorkstation ELISA. Correlation coefficients between ELISA results based on the different sampling methods were calculated. Results of DBS analysis for SARS-CoV-2 IgG S1 and NCP highly correlated with the serum values (r = 0.96). In addition, the calculation of the phi coefficient showed no significant difference between the qualitative results of both sampling methods (rφ = 0.98-1.0). Further analysis of DBS eluates after prolonged storage of 6-8 h also showed a high correlation with serum results (r = 0.97 and r = 0.93, respectively). The study results indicate suitability of DBS for the analysis of antibodies against SARS-CoV-2 S1 and NCP. For DBS eluate, a stability of 6-8 h for measurement of SARS-CoV-2 antibodies can be assumed.
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Affiliation(s)
- Sarah Guttmann
- MVZ Labor Krone GbR, Studienzentrum Immunologie, Bad Salzuflen, Germany
| | | | | | - Nils Janzen
- Screening-Labor Hannover, Hannover, Germany
- Department of Clinical Chemistry, Hannover Medical School, Hannover, Germany
- Division of Laboratory Medicine, Centre for Children and Adolescents, Kinder- und Jugendkrankenhaus Auf der Bult, Hannover, Germany
| | - Julia Klemens
- Insitute for Experimental Immunology, Affiliated to EUROIMMUN Medizinische Labordiagnostika AG, Lübeck, Germany
| | - Yara Koenemann
- Insitute for Experimental Immunology, Affiliated to EUROIMMUN Medizinische Labordiagnostika AG, Lübeck, Germany
| | | | - Thomas Neisse
- MVZ Labor Krone GbR, Studienzentrum Immunologie, Bad Salzuflen, Germany
- Screening-Labor Hannover, Hannover, Germany
| | | | - Katja Steinhagen
- Insitute for Experimental Immunology, Affiliated to EUROIMMUN Medizinische Labordiagnostika AG, Lübeck, Germany
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8
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Sims MD, Podolsky RH, Childers KL, Higgins B, Trueman J, Homayouni R, Voss DR, Berkiw-Scenna N, Keil H, Kennedy RH, Maine GN. Dried blood spots are a valid alternative to venipuncture for COVID-19 antibody testing. J Immunol Methods 2023; 513:113420. [PMID: 36596443 PMCID: PMC9804961 DOI: 10.1016/j.jim.2022.113420] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 12/25/2022] [Accepted: 12/29/2022] [Indexed: 01/02/2023]
Abstract
BACKGROUND Serologic analysis is an important tool towards assessing the humoral response to COVID-19 infection and vaccination. Numerous serologic tests and platforms are currently available to support this line of testing. Two broad antibody testing categories are point-of-care lateral flow immunoassays and semi-quantitative immunoassays performed in clinical laboratories, which typically require blood collected from a finger-stick and a standard venipuncture blood draw, respectively. This study evaluated the use of dried blood spot (DBS) collections as a sample source for COVID-19 antibody testing using an automated clinical laboratory test system. METHODS Two hundred and ninety-four participants in the BLAST COVID-19 seroprevalence study (NCT04349202) were recruited at the time of a scheduled blood draw to have an additional sample taken via finger stick as a DBS collection. Using the EUROIMMUN assay to assess SARS-CoV-2 anti-spike IgG status, DBS specimens were tested on 7, 14, 21, and 28 days post- collection and compared to the reference serum sample obtained from a blood draw for the BLAST COVID-19 study. RESULTS SARS-CoV-2 anti-spike IgG status from DBS collections demonstrated high concordance with serum across all time points (7-28 days). However, the semi-quantitative value from DBS collections was lower on average than that from serum, resulting in increased uncertainty around the equivocal-to-positive analytical decision point. CONCLUSIONS DBS collections can be substituted for venipuncture when assaying for COVID-19 IgG antibody, with samples being stable for at least 28 days at room temperature. Finger-stick sampling can therefore be advantageous for testing large populations for SARS-CoV-2 antibodies without the need for phlebotomists or immediate processing of samples. We have high confidence in serostaus determination from DBS collections, although the reduced semi-quantitative value may cause some low-level positives to fall into the equivocal or even negative range.
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Affiliation(s)
- Matthew D. Sims
- Section of Infectious Diseases and International Medicine, Department of Internal Medicine, Beaumont Royal Oak, Royal Oak, MI, USA,Department of Internal Medicine, Oakland University William Beaumont School of Medicine, Rochester, MI, USA,Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | | | | | - Barbara Higgins
- Research Education and Process Improvement, Beaumont Research Institute, Royal Oak, MI, USA
| | - Jillian Trueman
- Department of Pathology and Laboratory Medicine, Beaumont Royal Oak, Royal Oak, MI, USA
| | - Ramin Homayouni
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Daniel R. Voss
- Research Computing, Beaumont Research Institute, Royal Oak, MI, USA
| | | | - Hans Keil
- Beaumont Health, Information Technology, Southfield, MI, USA
| | - Richard H. Kennedy
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI, USA,Beaumont Research Institute, Royal Oak, MI, USA
| | - Gabriel N. Maine
- Department of Pathology and Laboratory Medicine, Beaumont Royal Oak, Royal Oak, MI, USA,Department of Pathology, Oakland University William Beaumont School of Medicine, Rochester, MI, USA,Corresponding author at: Department of Pathology & Laboratory Medicine, Beaumont Health, 3601West Thirteen Mile Road, Royal Oak, MI 48073, USA
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9
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Rodríguez-Mateos M, Jaso J, Martínez de Aguirre P, Carlos S, Fernández-Ciriza L, Holguín Á, Reina G. Effect of the Hematocrit and Storage Temperature of Dried Blood Samples in the Serological Study of Mumps, Measles and Rubella. Diagnostics (Basel) 2023; 13:diagnostics13030349. [PMID: 36766454 PMCID: PMC9913955 DOI: 10.3390/diagnostics13030349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/10/2023] [Accepted: 01/14/2023] [Indexed: 01/20/2023] Open
Abstract
Dried blood spots (DBSs) are an economical and convenient alternative to serum/plasma, which allow for the serological and molecular study of different pathogens. Sixty-four blood samples were collected by venipuncture and spotted onto Whatman™ 903 cards to evaluate the utility of DBSs and the effect of the storage temperature for 120 days after sample collection to carry out serological diagnosis. Mumps, measles and rubella IgG were investigated from DBSs and plasma using an automated chemiluminescent immunoassay. Using a calculated optimal cut-off value, the serological evaluation of mumps, measles and rubella using DBSs achieved high sensitivity (100%, 100% and 82.5%, respectively) and specificity (100%, 87.5% and 100%, respectively). The correlation observed between the plasma and the DBSs processed after sample collection was high (0.914-0.953) for all antibodies studied, both considering hematocrit before sample elution or not. For the different storage conditions, the correlation with plasma was high at 4 °C (0.889-0.925) and at -20 °C (0.878-0.951) but lower at room temperature (0.762-0.872). Measles IgG results were more affected than other markers when DBSs were stored at any temperature for 120 days. To summarize, hematocrit does not affect the processing of DBSs in the study of serological markers of mumps, measles and rubella. DBS stability for serological diagnosis of mumps and rubella is adequate when samples are stored at -20 °C or 4 °C, but not at room temperature, for a period of 4 months.
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Affiliation(s)
| | - Javier Jaso
- Microbiology Department, Clínica Universidad de Navarra, 31008 Pamplona, Spain
| | - Paula Martínez de Aguirre
- Microbiology Department, Clínica Universidad de Navarra, 31008 Pamplona, Spain
- ISTUN, Institute of Tropical Health, Universidad de Navarra, 31008 Pamplona, Spain
| | - Silvia Carlos
- ISTUN, Institute of Tropical Health, Universidad de Navarra, 31008 Pamplona, Spain
- Department of Preventive Medicine and Public Health, Universidad de Navarra, 31008 Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
- Correspondence: ; Tel.: +34-948-425-600 (ext. 826636)
| | | | - África Holguín
- HIV-1 Molecular Epidemiology Laboratory, Microbiology and Parasitology Department, University Hospital Ramón y Cajal-IRYCIS and CIBEREsp-RITIP, 28034 Madrid, Spain
| | - Gabriel Reina
- Microbiology Department, Clínica Universidad de Navarra, 31008 Pamplona, Spain
- ISTUN, Institute of Tropical Health, Universidad de Navarra, 31008 Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
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10
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Øverbø J, Aziz A, Zaman K, Julin CH, Qadri F, Stene-Johansen K, Biswas R, Islam S, Bhuiyan TR, Haque W, Sandbu S, Dembinski JL, Dudman S. Stability and Feasibility of Dried Blood Spots for Hepatitis E Virus Serology in a Rural Setting. Viruses 2022; 14:v14112525. [PMID: 36423134 PMCID: PMC9692628 DOI: 10.3390/v14112525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/11/2022] [Accepted: 11/13/2022] [Indexed: 11/16/2022] Open
Abstract
Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis worldwide. In many low-income countries it causes large outbreaks and disproportionally affects pregnant women and their offspring. Surveillance studies to find effective preventive interventions are needed but are hampered by the lack of funding and infrastructure. Dried blood spots (DBS) offer an easier and more robust way to collect, transport, and store blood samples compared to plasma/serum samples, and could ease some of the barriers for such studies. In this study we optimize an HEV IgG ELISA for DBS samples and validate it on 300 paired DBS and plasma samples collected in rural areas of Bangladesh from participants in a HEV vaccine study. We demonstrate that HEV IgG in blood stored as DBS is stable for two months at up to 40 °C, and for five freeze-thaw cycles. The specificity was 97% and the overall sensitivity of the DBS assay was 81%. The sensitivity was higher in samples from vaccinated participants (100%) compared to previously infected participants (59%), reflecting a positive correlation between IgG titer and sensitivity. We found a strong correlation between DBS and plasma samples with an r2 of 0.90, but with a higher degree of difference between individual paired samples. Our study shows that DBS offers a stable alternative to plasma/serum for HEV IgG measurements and can facilitate serological studies, particularly in resource limited areas.
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Affiliation(s)
- Joakim Øverbø
- Norwegian Institute of Public Health, NO-0213 Oslo, Norway
- Department of Microbiology, Institute of Clinical Medicine, University of Oslo, NO-0424 Oslo, Norway
- Correspondence: (J.Ø.); (S.D.)
| | - Asma Aziz
- Department of Microbiology, Institute of Clinical Medicine, University of Oslo, NO-0424 Oslo, Norway
- International Centre for Diarrheal Diseases Research, Dhaka 1212, Bangladesh
- International Vaccine Institute, Seoul 08826, Republic of Korea
| | - K. Zaman
- International Centre for Diarrheal Diseases Research, Dhaka 1212, Bangladesh
| | | | - Firdausi Qadri
- International Centre for Diarrheal Diseases Research, Dhaka 1212, Bangladesh
| | | | - Rajib Biswas
- International Centre for Diarrheal Diseases Research, Dhaka 1212, Bangladesh
| | - Shaumik Islam
- International Centre for Diarrheal Diseases Research, Dhaka 1212, Bangladesh
| | | | - Warda Haque
- International Centre for Diarrheal Diseases Research, Dhaka 1212, Bangladesh
| | - Synne Sandbu
- Norwegian Institute of Public Health, NO-0213 Oslo, Norway
| | | | - Susanne Dudman
- Department of Microbiology, Institute of Clinical Medicine, University of Oslo, NO-0424 Oslo, Norway
- Oslo University Hospital, NO-0424 Oslo, Norway
- Correspondence: (J.Ø.); (S.D.)
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11
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Modified ARCHITECT ® serologic assays enable plasma-level performance from dried blood spot samples. Biotechniques 2022; 73:193-203. [PMID: 36240056 DOI: 10.2144/btn-2022-0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Dried blood spots (DBSs) provide an alternative sample input for serologic testing. We evaluated DBSs for the ARCHITECT® hepatitis B surface antigen (HBsAg) NEXT, hepatitis B e-antigen (HBeAg), anti-hepatitis B core antigen (anti-HBc II), HIV antigen/antibody (Ag/Ab) Combo and AdviseDx SARS-CoV-2 IgG II assays. Assay performance with DBSs was assessed with or without assay modification and compared with on-market assay with plasma samples. DBS stability was also determined. HBsAg NEXT and HIV Ag/Ab Combo assays using DBSs showed sensitivity and specificity comparable to that of on-market assays. Modified HBeAg, anti-HBc II and SARS-CoV-2 IgG II DBS assays achieved performance comparable to on-market assays. Use of DBSs as input for high-throughput serologic assays is expected to have significant implications for improving population surveillance and increasing access to diagnostic testing.
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12
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Cholette F, Fabia R, Harris A, Ellis H, Cachero K, Schroeder L, Mesa C, Lacap P, Arnold C, Galipeau Y, Langlois MA, Colwill K, Gingras AC, McGeer A, Giles E, Day J, Osiowy C, Durocher Y, Hankins C, Mazer B, Drebot M, Kim J. Comparative performance data for multiplex SARS-CoV-2 serological assays from a large panel of dried blood spot specimens. Heliyon 2022; 8:e10270. [PMID: 36060461 PMCID: PMC9420314 DOI: 10.1016/j.heliyon.2022.e10270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 08/06/2022] [Accepted: 08/09/2022] [Indexed: 11/02/2022] Open
Abstract
The extent of the COVID-19 pandemic will be better understood through serosurveys and SARS-CoV-2 antibody testing. Dried blood spot (DBS) samples will play a central role in large scale serosurveillance by simplifying biological specimen collection and transportation, especially in Canada. Direct comparative performance data on multiplex SARS-CoV-2 assays resulting from identical DBS samples are currently lacking. In our study, we aimed to provide performance data for the BioPlex 2200 SARS-CoV-2 IgG (Bio-Rad), V-PLEX SARS-CoV-2 Panel 2 IgG (MSD), and Elecsys Anti-SARS-CoV-2 (Roche) commercial assays, as well as for two highly scalable in-house assays (University of Ottawa and Mount Sinai Hospital protocols) to assess their suitability for DBS-based SARS-CoV-2 DBS serosurveillance. These assays were evaluated against identical panels of DBS samples collected from convalescent COVID-19 patients (n = 97) and individuals undergoing routine sexually transmitted and bloodborne infection (STBBI) testing prior to the COVID-19 pandemic (n = 90). Our findings suggest that several assays are suitable for serosurveillance (sensitivity >97% and specificity >98%). In contrast to other reports, we did not observe an improvement in performance using multiple antigen consensus-based rules to establish overall seropositivity. This may be due to our DBS panel which consisted of samples collected from convalescent COVID-19 patients with significant anti-spike, -receptor binding domain (RBD), and -nucleocapsid antibody titers. This study demonstrates that biological specimens collected as DBS coupled with one of several readily available assays are useful for large-scale COVID-19 serosurveillance.
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13
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Diagnostic performance of the SARS-CoV-2 S1RBD IgG ELISA (ImmunoDiagnostics) for the quantitative detection of SARS-CoV-2 antibodies on dried blood spots. J Clin Virol 2022; 155:105270. [PMID: 36027822 PMCID: PMC9388275 DOI: 10.1016/j.jcv.2022.105270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 08/02/2022] [Accepted: 08/17/2022] [Indexed: 11/21/2022]
Abstract
Dried Blood Spots (DBS) are broadly used in SARS-CoV-2 surveillance studies, reporting either the presence or absence of SARS-CoV-2 antibodies. However, quantitative follow-up has become increasingly important to monitor humoral vaccine responses. Therefore, we aimed to evaluate the performance of DBS for the detection of anti-spike SARS-CoV-2 antibody concentrations using a commercially available assay, reporting in a standardised unitage (International Units/mL; IU/mL). To assess the sensitivity and specificity of the ImmunoDiagnostics ELISA on serum and DBS for SARS-CoV-2 antibody detection, we analysed 72 paired DBS and serum samples. The SARS-CoV-2 S1 IgG ELISA kit (EUROIMMUN) on serum was used as the reference method. We performed a statistical assessment to optimise the cut-off value for DBS and serum and assessed the correlation between DBS and serum antibody concentrations. We found that anti-spike SARS-CoV-2 antibody concentrations detected in DBS are highly correlated to those detected in paired serum (Pearson correlation 0.98; p-value < 0.0001), allowing to assess serum antibody concentration using DBS. The optimal cut-off for antibody detection on DBS was found to be 26 IU/mL, with 98.1% sensitivity and 100% specificity. For serum, the optimal cut-off was 14 IU/mL, with 100% sensitivity and 100% specificity. Therefore, we conclude that the ImmunoDiagnostics ELISA kit has optimal performance in the detection of SARS-CoV-2 antibodies on both DBS and serum. This makes DBS ideal for large-scale follow-up of humoral SARS-CoV-2 immune responses, as it is an easy but valuable sampling method for quantification of SARS-CoV-2 antibodies, compared to serum.
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14
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Jacobson TA, Kler JS, Bae Y, Chen J, Ladror DT, Iyer R, Nunes DA, Montgomery ND, Pleil JD, Funk WE. A state-of-the-science review and guide for measuring environmental exposure biomarkers in dried blood spots. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2022:10.1038/s41370-022-00460-7. [PMID: 35963945 PMCID: PMC9375076 DOI: 10.1038/s41370-022-00460-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 07/14/2022] [Accepted: 07/21/2022] [Indexed: 05/11/2023]
Abstract
BACKGROUND Dried blood spot (DBS) sampling is a simple, cost-effective, and minimally invasive alternative to venipuncture for measuring exposure biomarkers in public health and epidemiological research. DBS sampling provides advantages in field-based studies conducted in low-resource settings and in studies involving infants and children. In addition, DBS samples are routinely collected from newborns after birth (i.e., newborn dried blood spots, NDBS), with many states in the United States permitting access to archived NDBS samples for research purposes. OBJECTIVES We review the state of the science for analyzing exposure biomarkers in DBS samples, both archived and newly collected, and provide guidance on sample collection, storage, and blood volume requirements associated with individual DBS assays. We discuss recent progress regarding analytical methods, analytical sensitivity, and specificity, sample volume requirements, contamination considerations, estimating extracted blood volumes, assessing stability and analyte recovery, and hematocrit effects. METHODS A systematic search of PubMed (MEDLINE), Embase (Elsevier), and CINAHL (EBSCO) was conducted in March 2022. DBS method development and application studies were divided into three main chemical classes: environmental tobacco smoke, trace elements (including lead, mercury, cadmium, and arsenic), and industrial chemicals (including endocrine-disrupting chemicals and persistent organic pollutants). DBS method development and validation studies were scored on key quality-control and performance parameters by two members of the review team. RESULTS Our search identified 47 published reports related to measuring environmental exposure biomarkers in human DBS samples. A total of 28 reports (37 total studies) were on methods development and validation and 19 reports were primarily the application of previously developed DBS assays. High-performing DBS methods have been developed, validated, and applied for detecting environmental exposures to tobacco smoke, trace elements, and several important endocrine-disrupting chemicals and persistent organic pollutants. Additional work is needed for measuring cadmium, arsenic, inorganic mercury, and bisphenol A in DBS and NDBS samples. SIGNIFICANCE We present an inventory and critical review of available assays for measuring environmental exposure biomarkers in DBS and NDBS samples to help facilitate this sampling medium as an emerging tool for public health (e.g., screening programs, temporal biomonitoring) and environmental epidemiology (e.g., field-based studies).
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Affiliation(s)
- Tyler A Jacobson
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jasdeep S Kler
- University of Michigan Medical School, Ann Arbor, MI, USA
| | - Yeunook Bae
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jiexi Chen
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Daniel T Ladror
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Ramsunder Iyer
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Denise A Nunes
- Galter Health Sciences Library, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Nathan D Montgomery
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Joachim D Pleil
- Department of Environmental Sciences and Engineering, Gillings School of Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - William E Funk
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
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15
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Moat SJ, Hillier S, de Souza S, Perry M, Cottrell S, Lench A, Payne H, Jolles S. Maternal SARS-CoV-2 sero-surveillance using newborn dried blood spot (DBS) screening specimens highlights extent of low vaccine uptake in pregnant women. Hum Vaccin Immunother 2022; 18:2089498. [PMID: 35731129 PMCID: PMC9620996 DOI: 10.1080/21645515.2022.2089498] [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: 12/24/2022] Open
Abstract
SARS-CoV-2 vaccine uptake in pregnant women is believed to be low and lags behind the general population contributing to increased hospital admissions, and poor maternal and fetal outcomes. However, there is a paucity of information on the SARS-CoV-2 serostatus of pregnant women to help inform policy planning and assess impact of interventions to improve vaccine uptake in this at-risk group. We analyzed 8,683 residual, anonymized newborn screening dried bloodspot (DBS) specimens during a 15-month period (October 2020 to December 2021) in Wales (UK) for SARS-CoV-2 IgG-antibodies. We compared newborn DBS antibody-positive rates to the percentage number of pregnant women vaccinated and the percentage number of antibody-positive adults. In December 2021, 47.8% of women in Wales had received two doses of the vaccine by their delivery date; however, only 41.1% of DBS specimens had high antibody concentrations. Results indicate that a proportion of pregnant women remain at higher-risk of COVID complications, particularly given the reduction in antibody neutralization of Omicron versus the Delta variant. Our study demonstrates the utility of newborn screening DBS specimens to monitor SARS-CoV-2 serostatus in pregnant women representing maternal vaccination and natural infection in almost real-time, defining the immunity gap and impact of any interventions.
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Affiliation(s)
- Stuart J Moat
- Department of Medical Biochemistry, Immunology & Toxicology, University Hospital Wales, Cardiff, UK.,School of Medicine, Cardiff University, University Hospital Wales, Cardiff, UK
| | | | | | - Malorie Perry
- Vaccine Preventable Disease Programme and Communicable Disease Surveillance Centre, Public Health Wales NHS Trust, Cardiff, UK
| | - Simon Cottrell
- Vaccine Preventable Disease Programme and Communicable Disease Surveillance Centre, Public Health Wales NHS Trust, Cardiff, UK
| | - Alex Lench
- Vaccine Preventable Disease Programme and Communicable Disease Surveillance Centre, Public Health Wales NHS Trust, Cardiff, UK
| | - Heather Payne
- Health and Social Services Group, Population Healthcare Division, Welsh Government, Cardiff, UK
| | - Stephen Jolles
- Immunodeficiency Centre for Wales, University Hospital Wales, Cardiff, UK
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16
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Lahdentausta L, Kivimäki A, Oksanen L, Tallgren M, Oksanen S, Sanmark E, Salminen A, Geneid A, Sairanen M, Paju S, Saksela K, Pussinen P, Pietiäinen M. Blood and saliva SARS-CoV-2 antibody levels in self-collected dried spot samples. Med Microbiol Immunol 2022; 211:173-183. [PMID: 35697945 PMCID: PMC9191541 DOI: 10.1007/s00430-022-00740-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 05/06/2022] [Indexed: 11/01/2022]
Abstract
We examined the usefulness of dried spot blood and saliva samples in SARS-CoV-2 antibody analyses. We analyzed 1231 self-collected dried spot blood and saliva samples from healthcare workers. Participants filled in a questionnaire on their COVID-19 exposures, infections, and vaccinations. Anti-SARS-CoV-2 IgG, IgA, and IgM levels were determined from both samples using the GSP/DELFIA method. The level of exposure was the strongest determinant of all blood antibody classes and saliva IgG, increasing as follows: (1) no exposure (healthy, non-vaccinated), (2) exposed, (3) former COVID-19 infection, (4) one vaccination, (5) two vaccinations, and (6) vaccination and former infection. While the blood IgG assay had a 99.5% sensitivity and 75.3% specificity to distinguish participants with two vaccinations from all other types of exposure, the corresponding percentages for saliva IgG were 85.3% and 65.7%. Both blood and saliva IgG-seropositivity proportions followed similar trends to the exposures reported in the questionnaires. Self-collected dry blood and saliva spot samples combined with the GSP/DELFIA technique comprise a valuable tool to investigate an individual's immune response to SARS-CoV-2 exposure or vaccination. Saliva IgG has high potential to monitor vaccination response wane, since the sample is non-invasive and easy to collect.
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Affiliation(s)
- Laura Lahdentausta
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, 00014, Helsinki, Finland.
| | - Anne Kivimäki
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, 00014, Helsinki, Finland
| | - Lotta Oksanen
- Department of Otorhinolaryngology and Phoniatrics-Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, 00029, Helsinki, Finland
| | | | | | - Enni Sanmark
- Department of Otorhinolaryngology and Phoniatrics-Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, 00029, Helsinki, Finland
| | - Aino Salminen
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, 00014, Helsinki, Finland
| | - Ahmed Geneid
- Department of Otorhinolaryngology and Phoniatrics-Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, 00029, Helsinki, Finland
| | | | - Susanna Paju
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, 00014, Helsinki, Finland
| | - Kalle Saksela
- Department of Virology, University of Helsinki and Helsinki University Hospital, 00014, Helsinki, Finland
| | - Pirkko Pussinen
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, 00014, Helsinki, Finland.,Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
| | - Milla Pietiäinen
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, 00014, Helsinki, Finland.,VTT Technical Research Centre of Finland, 02044, Espoo, Finland
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17
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Development and Implementation of Dried Blood Spot-Based COVID-19 Serological Assays for Epidemiologic Studies. Microbiol Spectr 2022; 10:e0247121. [PMID: 35612315 PMCID: PMC9241704 DOI: 10.1128/spectrum.02471-21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Serological surveillance studies of infectious diseases provide population-level estimates of infection and antibody prevalence, generating crucial insight into population-level immunity, risk factors leading to infection, and effectiveness of public health measures. These studies traditionally rely on detection of pathogen-specific antibodies in samples derived from venipuncture, an expensive and logistically challenging aspect of serological surveillance. During the COVID-19 pandemic, guidelines implemented to prevent the spread of SARS-CoV-2 infection made collection of venous blood logistically difficult at a time when SARS-CoV-2 serosurveillance was urgently needed. Dried blood spots (DBS) have generated interest as an alternative to venous blood for SARS-CoV-2 serological applications due to their stability, low cost, and ease of collection; DBS samples can be self-generated via fingerprick by community members and mailed at ambient temperatures. Here, we detail the development of four DBS-based SARS-CoV-2 serological methods and demonstrate their implementation in a large serological survey of community members from 12 cities in the East Bay region of the San Francisco metropolitan area using at-home DBS collection. We find that DBS perform similarly to plasma/serum in enzyme-linked immunosorbent assays and commercial SARS-CoV-2 serological assays. In addition, we show that DBS samples can reliably detect antibody responses months postinfection and track antibody kinetics after vaccination. Implementation of DBS enabled collection of valuable serological data from our study population to investigate changes in seroprevalence over an 8-month period. Our work makes a strong argument for the implementation of DBS in serological studies, not just for SARS-CoV-2, but any situation where phlebotomy is inaccessible. IMPORTANCE Estimation of community-level antibody responses to SARS-CoV-2 from infection or vaccination is critical to inform public health responses. Traditional studies of antibodies rely on collection of blood via venipuncture, an invasive procedure not amenable to pandemic-related social-distancing measures. Dried blood spots (DBS) are an alternative to venipuncture, since they can be self-collected by study participants at home and do not require refrigeration for shipment or storage. However, DBS-based assays to measure antibody levels to SARS-CoV-2 have not been widely utilized. Here, we show that DBS are comparable to blood as a sampling method for antibody responses to SARS-CoV-2 infection and vaccination over time measured using four distinct serological assays. The DBS format enabled antibody surveillance in a longitudinal cohort where study participants self-collected samples, ensuring the participants’ safety during an ongoing pandemic. Our work demonstrates that DBS are an excellent sampling method for measuring antibody responses whenever venipuncture is impractical.
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18
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Scurr MJ, Zelek WM, Lippiatt G, Somerville M, Burnell SEA, Capitani L, Davies K, Lawton H, Tozer T, Rees T, Roberts K, Evans M, Jackson A, Young C, Fairclough L, Tighe P, Wills M, Westwell AD, Morgan BP, Gallimore A, Godkin A. Whole blood-based measurement of SARS-CoV-2-specific T cells reveals asymptomatic infection and vaccine immunogenicity in healthy subjects and patients with solid-organ cancers. Immunology 2022; 165:250-259. [PMID: 34775604 PMCID: PMC8653009 DOI: 10.1111/imm.13433] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/05/2021] [Accepted: 11/03/2021] [Indexed: 12/23/2022] Open
Abstract
Accurate assessment of SARS-CoV-2 immunity is critical in evaluating vaccine efficacy and devising public health policies. Whilst the exact nature of effective immunity remains incompletely defined, SARS-CoV-2-specific T-cell responses are a critical feature that will likely form a key correlate of protection against COVID-19. Here, we developed and optimized a high-throughput whole blood-based assay to determine the T-cell response associated with prior SARS-CoV-2 infection and/or vaccination amongst 231 healthy donors and 68 cancer patients. Following overnight in vitro stimulation with SARS-CoV-2-specific peptides, blood plasma samples were analysed for TH 1-type cytokines. Highly significant differential IFN-γ+ /IL-2+ SARS-CoV-2-specific T-cell responses were seen amongst previously infected COVID-19-positive healthy donors in comparison with unknown / naïve individuals (p < 0·0001). IFN-γ production was more effective at identifying asymptomatic donors, demonstrating higher sensitivity (96·0% vs. 83·3%) but lower specificity (84·4% vs. 92·5%) than measurement of IL-2. A single COVID-19 vaccine dose induced IFN-γ and/or IL-2 SARS-CoV-2-specific T-cell responses in 116 of 128 (90·6%) healthy donors, reducing significantly to 27 of 56 (48·2%) when measured in cancer patients (p < 0·0001). A second dose was sufficient to boost T-cell responses in the majority (90·6%) of cancer patients, albeit IFN-γ+ responses were still significantly lower overall than those induced in healthy donors (p = 0·034). Three-month post-vaccination T-cell responses also declined at a faster rate in cancer patients. Overall, this cost-effective standardizable test ensures accurate and comparable assessments of SARS-CoV-2-specific T-cell responses amenable to widespread population immunity testing, and identifies individuals at greater need of booster vaccinations.
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Affiliation(s)
- Martin J. Scurr
- Division of Infection & ImmunitySchool of MedicineCardiff UniversityCardiffUK
- ImmunoServ LtdCardiffUK
| | - Wioleta M. Zelek
- School of MedicineSystems Immunity University Research InstituteCardiff UniversityCardiffUK
- UK Dementia Research Institute CardiffCardiff UniversityCardiffUK
| | | | - Michelle Somerville
- Division of Infection & ImmunitySchool of MedicineCardiff UniversityCardiffUK
| | | | - Lorenzo Capitani
- Division of Infection & ImmunitySchool of MedicineCardiff UniversityCardiffUK
| | | | | | - Thomas Tozer
- Department of Gastroenterology & HepatologyUniversity Hospital of WalesCardiffUK
| | - Tara Rees
- Department of Gastroenterology & HepatologyUniversity Hospital of WalesCardiffUK
| | - Kerry Roberts
- Department of Gastroenterology & HepatologyUniversity Hospital of WalesCardiffUK
| | | | | | | | | | - Paddy Tighe
- School of Life SciencesUniversity of NottinghamNottinghamUK
| | - Mark Wills
- Department of MedicineAddenbrooke’s HospitalUniversity of CambridgeCambridgeUK
| | - Andrew D. Westwell
- School of Pharmacy and Pharmaceutical SciencesCardiff UniversityCardiffUK
| | - B. Paul Morgan
- School of MedicineSystems Immunity University Research InstituteCardiff UniversityCardiffUK
- UK Dementia Research Institute CardiffCardiff UniversityCardiffUK
| | - Awen Gallimore
- Division of Infection & ImmunitySchool of MedicineCardiff UniversityCardiffUK
- School of MedicineSystems Immunity University Research InstituteCardiff UniversityCardiffUK
| | - Andrew Godkin
- Division of Infection & ImmunitySchool of MedicineCardiff UniversityCardiffUK
- School of MedicineSystems Immunity University Research InstituteCardiff UniversityCardiffUK
- Department of Gastroenterology & HepatologyUniversity Hospital of WalesCardiffUK
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19
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Qualitative and quantitative detection of SARS-CoV-2 antibodies from dried blood spots. Clin Biochem 2022; 117:16-22. [PMID: 34990593 PMCID: PMC8721924 DOI: 10.1016/j.clinbiochem.2021.12.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 12/20/2021] [Accepted: 12/30/2021] [Indexed: 01/13/2023]
Abstract
Introduction Dried blood spot (DBS) sampling is a minimally invasive method for specimen collection with potential multifaceted uses, particularly for serosurveillance of previous SARS-CoV-2 infection. In this study, we assessed DBS as a potential specimen type for assessing IgG and total (including IgG and IgM) antibodies to SARS-CoV-2 in vaccinated and naturally infected patients. Methods Six candidate buffers were assessed for eluting blood from DBS cards. The study utilized one hundred and five paired plasma specimens and DBS specimens from prospectively collected SARS-CoV-2 vaccinated individuals, remnants from those with PCR confirmed SARS-CoV-2 infections, or remnants from those without history of infection or vaccination. All specimens were tested with the Siemens SARS-CoV-2 total assay (COV2T) or IgG assay (sCOVG). Results The lowest backgrounds were observed with water and PBS, and water was used for elution. Relative to plasma samples, DBS samples had a positive percent agreement (PPA) of 94.4% (95% CI: 94.9–100%) for COV2T and 79.2 (68.4–87.0) for sCOVG using the manufacturer’s cutoff. The NPA was 100 % (87.1–100.0 and 85.13–100) for both assays. Dilution studies revealed 100% (95% CI: 90.8–100%) qualitative agreement between specimen types on the COV2T assay and 98.0% (88.0–99.9%) with the sCOVG using study defined cutoffs. Conclusion DBS specimens demonstrated high PPA and NPA relative to plasma for SARS-CoV-2 serological testing. Our data support feasibility of DBS sampling for SARS-CoV-2 serological testing.
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20
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Cicalini I, Rossi C, Natale L, Cufaro MC, Catitti G, Vespa S, De Bellis D, Iannetti G, Lanuti P, Bucci I, Stuppia L, De Laurenzi V, Pieragostino D. Passive Immunity to SARS-CoV-2 at Birth Induced by Vaccination in the First Trimester of Pregnancy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312789. [PMID: 34886515 PMCID: PMC8657259 DOI: 10.3390/ijerph182312789] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 11/29/2021] [Accepted: 11/30/2021] [Indexed: 11/16/2022]
Abstract
As is well known, the COVID-19 infection is affecting the whole world, causing a serious health, social and economic crisis. The viral infection can cause a mild or severe illness, depending on how effectively the virus is countered by the immune system. In this context, the position of pregnant women remains rather unknown. The case described here reports the immune response in a woman in good health and in her newborn son, having undergone complete vaccination during the first trimester of her pregnancy. We performed a serological assay, measuring IgG antibodies to SARS-CoV-2, by a fully automated solid phase DELFIA (time-resolved fluorescence) immunoassay in a few drops of blood, collected by a finger-prick and spotted on filter paper. The dried blood spot (DBS) sample we used is the same type of sample routinely used in a newborn screening program test. Such a simple and minimally invasive approach allowed us to monitor both the mother and the newborn soon after birth for their anti-SARS-CoV-2 IgG levels. The serological test on the DBS carried out on both mother and newborn revealed the presence of anti-SARS-CoV-2 IgG antibodies up to 7 months after vaccination in the mother, and already at 48 h of life in the newborn.
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Affiliation(s)
- Ilaria Cicalini
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (C.R.); (L.N.); (M.C.C.); (G.C.); (S.V.); (D.D.B.); (G.I.); (P.L.); (I.B.); (L.S.); (V.D.L.); (D.P.)
- Department of Innovative Technologies in Medicine and Dentistry, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
- Correspondence: ; Tel.: +39-0871-541333
| | - Claudia Rossi
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (C.R.); (L.N.); (M.C.C.); (G.C.); (S.V.); (D.D.B.); (G.I.); (P.L.); (I.B.); (L.S.); (V.D.L.); (D.P.)
- Department of Psychological, Health and Territory Sciences, School of Medicine and Health Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Luca Natale
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (C.R.); (L.N.); (M.C.C.); (G.C.); (S.V.); (D.D.B.); (G.I.); (P.L.); (I.B.); (L.S.); (V.D.L.); (D.P.)
| | - Maria Concetta Cufaro
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (C.R.); (L.N.); (M.C.C.); (G.C.); (S.V.); (D.D.B.); (G.I.); (P.L.); (I.B.); (L.S.); (V.D.L.); (D.P.)
- Department of Pharmacy, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Giulia Catitti
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (C.R.); (L.N.); (M.C.C.); (G.C.); (S.V.); (D.D.B.); (G.I.); (P.L.); (I.B.); (L.S.); (V.D.L.); (D.P.)
- Department of Medicine and Aging Science, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Simone Vespa
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (C.R.); (L.N.); (M.C.C.); (G.C.); (S.V.); (D.D.B.); (G.I.); (P.L.); (I.B.); (L.S.); (V.D.L.); (D.P.)
- Department of Medicine and Aging Science, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Domenico De Bellis
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (C.R.); (L.N.); (M.C.C.); (G.C.); (S.V.); (D.D.B.); (G.I.); (P.L.); (I.B.); (L.S.); (V.D.L.); (D.P.)
- Department of Innovative Technologies in Medicine and Dentistry, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Giulia Iannetti
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (C.R.); (L.N.); (M.C.C.); (G.C.); (S.V.); (D.D.B.); (G.I.); (P.L.); (I.B.); (L.S.); (V.D.L.); (D.P.)
| | - Paola Lanuti
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (C.R.); (L.N.); (M.C.C.); (G.C.); (S.V.); (D.D.B.); (G.I.); (P.L.); (I.B.); (L.S.); (V.D.L.); (D.P.)
- Department of Medicine and Aging Science, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Ines Bucci
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (C.R.); (L.N.); (M.C.C.); (G.C.); (S.V.); (D.D.B.); (G.I.); (P.L.); (I.B.); (L.S.); (V.D.L.); (D.P.)
- Department of Medicine and Aging Science, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Liborio Stuppia
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (C.R.); (L.N.); (M.C.C.); (G.C.); (S.V.); (D.D.B.); (G.I.); (P.L.); (I.B.); (L.S.); (V.D.L.); (D.P.)
- Department of Psychological, Health and Territory Sciences, School of Medicine and Health Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Vincenzo De Laurenzi
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (C.R.); (L.N.); (M.C.C.); (G.C.); (S.V.); (D.D.B.); (G.I.); (P.L.); (I.B.); (L.S.); (V.D.L.); (D.P.)
- Department of Innovative Technologies in Medicine and Dentistry, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Damiana Pieragostino
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (C.R.); (L.N.); (M.C.C.); (G.C.); (S.V.); (D.D.B.); (G.I.); (P.L.); (I.B.); (L.S.); (V.D.L.); (D.P.)
- Department of Innovative Technologies in Medicine and Dentistry, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
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21
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Meyers E, Heytens S, Formukong A, Vercruysse H, De Sutter A, Geens T, Hofkens K, Janssens H, Nys E, Padalko E, Deschepper E, Cools P. Comparison of Dried Blood Spots and Venous Blood for the Detection of SARS-CoV-2 Antibodies in a Population of Nursing Home Residents. Microbiol Spectr 2021; 9:e0017821. [PMID: 34549995 PMCID: PMC8557917 DOI: 10.1128/spectrum.00178-21] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 07/27/2021] [Indexed: 11/20/2022] Open
Abstract
In the current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, testing for SARS-CoV-2-specific antibodies is paramount for monitoring immune responses in postauthorization vaccination and seroepidemiological studies. However, large-scale and iterative serological testing by venipuncture in older persons can be challenging. Capillary blood sampling using a finger prick and collection on protein saver cards, i.e., dried blood spots (DBSs), has already proven to be a promising alternative. However, elderly persons have reduced cutaneous microvasculature, which may affect DBS-based antibody testing. Therefore, we aimed to evaluate the performance of DBS tests for the detection of SARS-CoV-2 antibodies among nursing homes residents. We collected paired venous blood and DBS samples on two types of protein saver cards (Whatman and EUROIMMUN) from nursing home residents, as well as from staff members as a reference population. Venous blood samples were analyzed for the presence of SARS-CoV-2 IgG antibodies using the Abbott chemiluminescent microparticle immunoassay (CMIA). DBS samples were analyzed by the EUROIMMUN enzyme-linked immunosorbent assay (ELISA) for SARS-CoV-2 IgG antibodies. We performed a statistical assessment to optimize the ELISA cutoff value for the DBS testing using Youden's J index. A total of 273 paired DBS-serum samples were analyzed, of which 129 were positive, as assessed by the reference test. The sensitivities and specificities of DBS testing ranged from 95.0% to 97.1% and from 97.1% to 98.8%, respectively, depending on the population (residents or staff members) and the DBS card type. Therefore, we found that DBS sampling is a valid alternative to venipuncture for the detection of SARS-CoV-2 antibodies among elderly subjects. IMPORTANCE Since the implementation of newly developed SARS-CoV-2 vaccines in the general population, serological tests are of increasing importance. Because DBS samples can be obtained with a finger prick and can be shipped and stored at room temperature, they are optimal for use in large-scale SARS-CoV-2 serosurveillance or postauthorization vaccination studies, even in an elderly study population.
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Affiliation(s)
- Eline Meyers
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Stefan Heytens
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Asangwing Formukong
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Hanne Vercruysse
- Research and Analytics, Liantis Occupational Health Services, Bruges, Belgium
| | - An De Sutter
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Tom Geens
- Research and Analytics, Liantis Occupational Health Services, Bruges, Belgium
| | - Kenneth Hofkens
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Heidi Janssens
- Research and Analytics, Liantis Occupational Health Services, Bruges, Belgium
| | - Eveline Nys
- Laboratory of Medical Microbiology, Ghent University Hospital, Ghent, Belgium
| | - Elizaveta Padalko
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Laboratory of Medical Microbiology, Ghent University Hospital, Ghent, Belgium
| | - Ellen Deschepper
- Biostatistics Unit, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Piet Cools
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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22
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Itell HL, Weight H, Fish CS, Logue JK, Franko N, Wolf CR, McCulloch DJ, Galloway J, Matsen FA, Chu HY, Overbaugh J. SARS-CoV-2 Antibody Binding and Neutralization in Dried Blood Spot Eluates and Paired Plasma. Microbiol Spectr 2021; 9:e0129821. [PMID: 34668728 PMCID: PMC8528110 DOI: 10.1128/spectrum.01298-21] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 09/17/2021] [Indexed: 11/20/2022] Open
Abstract
Wide-scale assessment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific antibodies is critical to understanding population seroprevalence, correlates of protection, and the longevity of vaccine-elicited responses. Most SARS-CoV-2 studies characterize antibody responses in plasma/sera. While reliable and broadly used, these samples pose several logistical restrictions, such as requiring venipuncture for collection and a cold chain for transportation and storage. Dried blood spots (DBS) overcome these barriers as they can be self-collected by fingerstick and mailed and stored at ambient temperature. Here, we evaluate the suitability of DBS for SARS-CoV-2 antibody assays by comparing several antibody responses between paired plasma and DBS from SARS-CoV-2 convalescent and vaccinated individuals. We found that DBS not only reflected plasma antibody binding by enzyme-linked immunosorbent assay (ELISA) and epitope profiles using phage display, but also yielded SARS-CoV-2 neutralization titers that highly correlated with paired plasma. Neutralization measurement was further streamlined by adapting assays to a high-throughput 384-well format. This study supports the adoption of DBS for numerous SARS-CoV-2 binding and neutralization assays. IMPORTANCE Plasma and sera isolated from venous blood represent conventional sample types used for the evaluation of SARS-CoV-2 antibody responses after infection or vaccination. However, collection of these samples is invasive and requires trained personnel and equipment for immediate processing. Once collected, plasma and sera must be stored and shipped at cold temperatures. To define the risk of emerging SARS-CoV-2 variants and the longevity of immune responses to natural infection and vaccination, it will be necessary to measure various antibody features in populations around the world, including in resource-limited areas. A sampling method that is compatible with these settings and is suitable for a variety of SARS-CoV-2 antibody assays is therefore needed to continue to understand and curb the COVID-19 pandemic.
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Affiliation(s)
- Hannah L. Itell
- Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- Molecular and Cellular Biology Graduate Program, University of Washington and Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Haidyn Weight
- Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Carolyn S. Fish
- Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Jennifer K. Logue
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Nicholas Franko
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Caitlin R. Wolf
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | | | - Jared Galloway
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Frederick A. Matsen
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Helen Y. Chu
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Julie Overbaugh
- Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
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23
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Tallantyre EC, Vickaryous N, Anderson V, Asardag AN, Baker D, Bestwick J, Bramhall K, Chance R, Evangelou N, George K, Giovannoni G, Godkin A, Grant L, Harding KE, Hibbert A, Ingram G, Jones M, Kang AS, Loveless S, Moat SJ, Robertson NP, Schmierer K, Scurr MJ, Shah SN, Simmons J, Upcott M, Willis M, Jolles S, Dobson R. COVID-19 Vaccine Response in People with Multiple Sclerosis. Ann Neurol 2021; 91:89-100. [PMID: 34687063 PMCID: PMC8652739 DOI: 10.1002/ana.26251] [Citation(s) in RCA: 105] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/18/2021] [Accepted: 10/18/2021] [Indexed: 12/28/2022]
Abstract
Objective The purpose of this study was to investigate the effect of disease modifying therapies on immune response to severe acute respiratory syndrome‐coronavirus 2 (SARS‐CoV‐2) vaccines in people with multiple sclerosis (MS). Methods Four hundred seventy‐three people with MS provided one or more dried blood spot samples. Information about coronavirus disease 2019 (COVID‐19) and vaccine history, medical, and drug history were extracted from questionnaires and medical records. Dried blood spots were eluted and tested for antibodies to SARS‐CoV‐2. Antibody titers were partitioned into tertiles with people on no disease modifying therapy as a reference. We calculated the odds ratio of seroconversion (univariate logistic regression) and compared quantitative vaccine response (Kruskal Wallis) following the SARS‐CoV‐2 vaccine according to disease modifying therapy. We used regression modeling to explore the effect of vaccine timing, treatment duration, age, vaccine type, and lymphocyte count on vaccine response. Results Compared to no disease modifying therapy, the use of anti‐CD20 monoclonal antibodies (odds ratio = 0.03, 95% confidence interval [CI] = 0.01–0.06, p < 0.001) and fingolimod (odds ratio = 0.04; 95% CI = 0.01–0.12) were associated with lower seroconversion following the SARS‐CoV‐2 vaccine. All other drugs did not differ significantly from the untreated cohort. Both time since last anti‐CD20 treatment and total time on treatment were significantly associated with the response to the vaccination. The vaccine type significantly predicted seroconversion, but not in those on anti‐CD20 medications. Preliminary data on cellular T‐cell immunity showed 40% of seronegative subjects had measurable anti‐SARS‐CoV‐2 T cell responses. Interpretation Some disease modifying therapies convey risk of attenuated serological response to SARS‐CoV‐2 vaccination in people with MS. We provide recommendations for the practical management of this patient group. ANN NEUROL 20219999:n/a–n/a
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Affiliation(s)
- Emma C Tallantyre
- Division of Psychological Medicine and Clinical Neuroscience, School of Medicine, Cardiff University, Cardiff, UK.,Department of Neurology, University Hospital of Wales, Cardiff, UK
| | - Nicola Vickaryous
- Preventive Neurology Unit, Wolfson Institute of Population Health, Queen Mary University London, London, UK
| | - Valerie Anderson
- Division of Psychological Medicine and Clinical Neuroscience, School of Medicine, Cardiff University, Cardiff, UK
| | - Aliye Nazli Asardag
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - David Baker
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Jonathan Bestwick
- Preventive Neurology Unit, Wolfson Institute of Population Health, Queen Mary University London, London, UK
| | - Kath Bramhall
- Immunodeficiency Centre for Wales, University Hospital of Wales, Cardiff, UK
| | - Randy Chance
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Centre for Oral Immunobiology and Regenerative Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Nikos Evangelou
- Department of Clinical Neurology, University of Nottingham, Nottingham, UK
| | - Katila George
- Preventive Neurology Unit, Wolfson Institute of Population Health, Queen Mary University London, London, UK
| | - Gavin Giovannoni
- Preventive Neurology Unit, Wolfson Institute of Population Health, Queen Mary University London, London, UK.,Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Department of Neurology, Barts Health NHS Trust, London, UK
| | - Andrew Godkin
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK.,Department of Gastroenterology and Hepatology, University Hospital of Wales, Cardiff, UK
| | - Leanne Grant
- Immunodeficiency Centre for Wales, University Hospital of Wales, Cardiff, UK
| | | | - Aimee Hibbert
- Department of Clinical Neurology, University of Nottingham, Nottingham, UK
| | - Gillian Ingram
- Department of Neurology, Morriston Hospital, Swansea, UK
| | - Meleri Jones
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Angray S Kang
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Centre for Oral Immunobiology and Regenerative Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Samantha Loveless
- Division of Psychological Medicine and Clinical Neuroscience, School of Medicine, Cardiff University, Cardiff, UK
| | - Stuart J Moat
- Wales Newborn Screening Laboratory, Department of Medical Biochemistry, Immunology and Toxicology, University Hospital of Wales, Cardiff, UK.,School of Medicine, Cardiff University, Cardiff, UK
| | - Neil P Robertson
- Division of Psychological Medicine and Clinical Neuroscience, School of Medicine, Cardiff University, Cardiff, UK.,Department of Neurology, University Hospital of Wales, Cardiff, UK
| | - Klaus Schmierer
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Department of Neurology, Barts Health NHS Trust, London, UK
| | - Martin J Scurr
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK.,ImmunoServ Ltd., Cardiff, UK
| | - Sita Navin Shah
- Preventive Neurology Unit, Wolfson Institute of Population Health, Queen Mary University London, London, UK
| | - Jessica Simmons
- Division of Psychological Medicine and Clinical Neuroscience, School of Medicine, Cardiff University, Cardiff, UK
| | - Matthew Upcott
- Division of Psychological Medicine and Clinical Neuroscience, School of Medicine, Cardiff University, Cardiff, UK
| | - Mark Willis
- Department of Neurology, University Hospital of Wales, Cardiff, UK
| | - Stephen Jolles
- Immunodeficiency Centre for Wales, University Hospital of Wales, Cardiff, UK.,Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Ruth Dobson
- Preventive Neurology Unit, Wolfson Institute of Population Health, Queen Mary University London, London, UK.,Department of Neurology, Barts Health NHS Trust, London, UK
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24
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Rajadhyaksha M, Londhe V. Microsampling: A role to play in Covid-19 diagnosis, surveillance, treatment and clinical trials. Drug Test Anal 2021; 13:1238-1248. [PMID: 34089576 DOI: 10.1002/dta.3107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/29/2021] [Accepted: 06/01/2021] [Indexed: 12/13/2022]
Abstract
The outbreak of the new coronavirus disease changed the world upside down. Every day, millions of people were subjected to diagnostic testing for Covid-19, all over the world. Molecular tests helped in the diagnosis of current infection by detecting the presence of viral genome whereas serological tests helped in detecting the presence of antibody in blood as well as contributed to vaccine development. This testing helped in understanding the immunogenicity, community prevalence, geographical spread and conditions post-infection. However, with the contagious nature of the virus, biological specimen sampling involved the risk of transmission and spread of infection. Clinic or pathology visit was the most concerning part. Trained personnel and resources was another barrier. In this scenario, microsampling played an important role due to its most important advantage of remote, contactless, small volume and self-sampling. Minimum requirements for sample storage and ease of shipment added value in this situation. The highly sensitive instruments and validated assay formats assured the accuracy of results and stability of samples. Microsampling techniques are contributing effectively to the Covid-19 pandemic by reducing the demand for clinical staff in population-level testing. The validated and established applications supported the use of microsampling in diagnosis, therapeutic drug monitoring, development of treatment or vaccines and clinical trials for Covid-19.
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Affiliation(s)
- Madhura Rajadhyaksha
- SPPSPTM, SVKM's Narsee Monjee Institute of Management Studies, Mumbai, India.,Sitec Labs. Ltd., Navi Mumbai, India
| | - Vaishali Londhe
- SPPSPTM, SVKM's Narsee Monjee Institute of Management Studies, Mumbai, India
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25
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Turgeon CT, Sanders KA, Rinaldo P, Granger D, Hilgart H, Matern D, Theel ES. Validation of a multiplex flow immunoassay for detection of IgG antibodies against SARS-CoV-2 in dried blood spots. PLoS One 2021; 16:e0252621. [PMID: 34048503 PMCID: PMC8162624 DOI: 10.1371/journal.pone.0252621] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 05/18/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Dried blood spots (DBS) are an established specimen type for clinical testing given their low cost, ease of collection and storage, and convenient shipping capabilities through the postal system. These attributes are complementary to the expansion of SARS-CoV-2 serologic testing, which may be used to inform community seroprevalence rates. METHODS The Luminex xMAP SARS-CoV-2 Multi-Antigen assay utilizes magnetic beads labeled with three viral antigens (nucleocapsid [NC], receptor binding domain [RBD], spike S1 subunit) to detect anti-viral IgG-class antibodies, and has Food and Drug Administration (FDA) Emergency Use Authorization (EUA) for use in serum and plasma. This assay was modified for use with DBS and validated against paired sera tested by one of two reference assays: the Roche Diagnostics Elecsys anti-SARS-CoV-2 ECLIA or the Euroimmun anti-SARS-CoV-2 IgG ELISA. RESULTS 159 paired DBS and serum specimens analyzed using the modified Luminex xMAP assay on DBS and the reference methods on serum showed an overall concordance of 96.9% (154/159). Use of multivariate pattern recognition software (CLIR) for post-analytical interpretation of the Luminex xMAP DBS assay results, instead of manufacturer provided interpretive thresholds, increased overall qualitative result concordance to 99.4% (158/159) between the modified Luminex xMAP DBS and reference results. CONCLUSIONS Use of DBS for detection of antibodies against SARS-CoV-2 provides comparable results to those obtained using serum. DBS concordance was improved with multivariate pattern recognition software (CLIR). We demonstrate that DBS are a reliable specimen type for SARS-CoV-2 antibody detection using the modified Luminex xMAP assay.
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Affiliation(s)
- Coleman T. Turgeon
- Divisions of Laboratory Genetics and Genomics and Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Karen A. Sanders
- Divisions of Laboratory Genetics and Genomics and Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Piero Rinaldo
- Divisions of Laboratory Genetics and Genomics and Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Dane Granger
- Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Heather Hilgart
- Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Dietrich Matern
- Divisions of Laboratory Genetics and Genomics and Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Elitza S. Theel
- Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, United States of America
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26
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Brinc D, Biondi MJ, Li D, Sun H, Capraru C, Smookler D, Zahoor MA, Casey J, Kulasingam V, Feld JJ. Evaluation of Dried Blood Spot Testing for SARS-CoV-2 Serology Using a Quantitative Commercial Assay. Viruses 2021; 13:962. [PMID: 34067361 PMCID: PMC8224688 DOI: 10.3390/v13060962] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 05/10/2021] [Accepted: 05/19/2021] [Indexed: 12/22/2022] Open
Abstract
Dried blood spots (DBS) are commonly used for serologic testing for viruses and provide an alternative collection method when phlebotomy and/or conventional laboratory testing are not readily available. DBS collection could be used to facilitate widespread testing for SARS-CoV-2 antibodies to document past infection, vaccination, and potentially immunity. We investigated the characteristics of Roche's Anti-SARS-CoV-2 (S) assay, a quantitative commercial assay for antibodies against the spike glycoprotein. Antibody levels were reduced relative to plasma following elution from DBS. Quantitative results from DBS samples were highly correlated with values from plasma (r2 = 0.98), allowing for extrapolation using DBS results to accurately estimate plasma antibody levels. High concordance between plasma and fingerpick DBS was observed in PCR-confirmed COVID-19 patients tested 90 days or more after the diagnosis (45/46 matched; 1/46 mismatched plasma vs. DBS). The assessment of antibody responses to SARS-CoV-2 using DBS may be feasible using a quantitative anti-S assay, although false negatives may rarely occur in those with very low antibody levels.
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Affiliation(s)
- Davor Brinc
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada; (D.B.); (V.K.)
- Department of Clinical Biochemistry, University Health Network, Toronto, ON M5G 2C4, Canada;
| | - Mia J. Biondi
- Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON M5G 2C, Canada; (M.J.B.); (C.C.); (D.S.); (M.A.Z.); (J.C.)
| | - Daniel Li
- Institute of Medical Science, University of Toronto, Toronto, ON M5S 1A8, Canada;
| | - Heng Sun
- Department of Clinical Biochemistry, University Health Network, Toronto, ON M5G 2C4, Canada;
| | - Camelia Capraru
- Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON M5G 2C, Canada; (M.J.B.); (C.C.); (D.S.); (M.A.Z.); (J.C.)
| | - David Smookler
- Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON M5G 2C, Canada; (M.J.B.); (C.C.); (D.S.); (M.A.Z.); (J.C.)
| | - Muhammad Atif Zahoor
- Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON M5G 2C, Canada; (M.J.B.); (C.C.); (D.S.); (M.A.Z.); (J.C.)
| | - Julia Casey
- Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON M5G 2C, Canada; (M.J.B.); (C.C.); (D.S.); (M.A.Z.); (J.C.)
| | - Vathany Kulasingam
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada; (D.B.); (V.K.)
- Department of Clinical Biochemistry, University Health Network, Toronto, ON M5G 2C4, Canada;
| | - Jordan J. Feld
- Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON M5G 2C, Canada; (M.J.B.); (C.C.); (D.S.); (M.A.Z.); (J.C.)
- Institute of Medical Science, University of Toronto, Toronto, ON M5S 1A8, Canada;
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27
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Development and Validation of a Multiplex Microsphere Immunoassay Using Dried Blood Spots for SARS-CoV-2 Seroprevalence: Application in First Responders in Colorado, USA. J Clin Microbiol 2021; 59:JCM.00290-21. [PMID: 33795412 PMCID: PMC8315929 DOI: 10.1128/jcm.00290-21] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 03/26/2021] [Indexed: 01/19/2023] Open
Abstract
Serological testing of large representative populations for antibodies to SARS-CoV-2 is needed to estimate seroprevalence, transmission dynamics, and the duration of antibody responses from natural infection and vaccination. In this study, a high-throughput SARS-CoV-2 multiplex microsphere immunoassay (MMIA) was developed for the receptor binding domain (RBD) and nucleocapsid (N) that was more sensitive than enzyme-linked immunosorbent assay (ELISA) (98% versus 87%). The MMIA was then applied and validated in 264 first responders in Colorado using serum and dried blood spot (DBS) eluates, compared to ELISA, and evaluated for neutralizing antibodies. Four percent (11/264) of first responders were seropositive in July to August 2020. Serum and DBS were highly correlated for anti-RBD and anti-N antibodies (R = 0.83, P < 0.0001 and R = 0.87, P < 0.0001, respectively) by MMIA. The MMIA accurately predicted SARS-CoV-2 neutralizing antibodies using DBS (R = 0.76, P = 0.037). On repeat antibody testing 3 months later, anti-RBD IgG decreased less rapidly than anti-N IgG measured by MMIA, with a median change in geometric median fluorescence intensity of 62% versus 79% (P < 0.01) for anti-RBD and anti-N IgG, respectively. This novel MMIA using DBS could be scalable for rapid and affordable SARS-CoV-2 serosurveillance in the United States and globally.
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