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Padoan A, Talli I, Cosma C, Moz S, Furlan G, Navaglia F, Marchioro L, Zaninotto M, Basso D, Plebani M. Analytical and clinical evaluations of SNIBE Maglumi chemiluminescent immunoassay for the detection of SARS-CoV-2 antigen in salivary samples. Clin Chem Lab Med 2024; 62:572-577. [PMID: 37787733 DOI: 10.1515/cclm-2023-0947] [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: 08/29/2023] [Accepted: 09/21/2023] [Indexed: 10/04/2023]
Abstract
OBJECTIVES In this study, we describe the analytical and clinical performances of the SNIBE Maglumi SARS-CoV-2 antigen fully-automated chemiluminescent immunoassay (MAG-CLIA) on salivary samples. METHODS Limit of detection (LOD), linearity and precision were tested for values close to or below the declared LOD. Clinical performance of MAG-CLIA was evaluated on leftover salivary samples from the healthcare workers (HCW) surveillance program, at the University-Hospital of Padova. Salivary samples were analyzed by Lumipulse G SARS-CoV-2 Ag, and in case where the values exceeded 0.41 ng/L, further testing was conducted using TaqPathTM COVID-19 RT-PCR (Applied Biosystems, Thermo Fisher Scientific). RESULTS The estimated MAG-CLIA LOD was 3 ng/L, with repeatability of 7.5 %. Good linearity was demonstrated by diluting two samples at 52.7 ng/L and 211.4 ng/L. Of the 228 HCW samples, 59/228 (25.9 %) were positive, 169/228 (74.1 %) were negative. MAG-CLIA SARS-CoV-2 sAg median level (and interquartile range [IQR]) was 5.03 ng/L (<0.001-35.8 ng/L) for positive and <0.001 ng/L (<0.001 ng/L) for negative samples. MAG-CLIA AUC was 0.795 (95 % CI: 0.720-0.871). Using the best cut-off, 3.5 ng/L, sensitivity and specificity were 57.1 % (95 % CI: 42.2-71.2 %) and 97.0 % (95 % CI: 93.2-99.0 %), respectively. The agreement with the molecular assay was 88.1 % (Cohen's kappa 0.606 [SE=0.066, p<0.001]). CONCLUSIONS The analytical performances of MAG-CLIA are satisfactory, also when values below LOD were tested. In saliva samples, although specificity was elevated, clinical performance was not comparable with that on nasopharyngeal swabs (NPS).
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Affiliation(s)
- Andrea Padoan
- Department of Medicine (DIMED), University of Padova, Padova, Italy
- Laboratory Medicine Unit, University-Hospital of Padova, Padova, Italy
- QI.LAB.MED., Spin-off of the University of Padova, Padova, Italy
| | - Ilaria Talli
- Department of Medicine (DIMED), University of Padova, Padova, Italy
- Laboratory Medicine Unit, University-Hospital of Padova, Padova, Italy
| | - Chiara Cosma
- Department of Medicine (DIMED), University of Padova, Padova, Italy
- Laboratory Medicine Unit, University-Hospital of Padova, Padova, Italy
- QI.LAB.MED., Spin-off of the University of Padova, Padova, Italy
| | - Stefania Moz
- Laboratory Medicine Unit, University-Hospital of Padova, Padova, Italy
| | - Giulia Furlan
- QI.LAB.MED., Spin-off of the University of Padova, Padova, Italy
| | - Filippo Navaglia
- Laboratory Medicine Unit, University-Hospital of Padova, Padova, Italy
| | - Lucio Marchioro
- Laboratory Medicine Unit, University-Hospital of Padova, Padova, Italy
- QI.LAB.MED., Spin-off of the University of Padova, Padova, Italy
| | - Martina Zaninotto
- Laboratory Medicine Unit, University-Hospital of Padova, Padova, Italy
- QI.LAB.MED., Spin-off of the University of Padova, Padova, Italy
| | - Daniela Basso
- Department of Medicine (DIMED), University of Padova, Padova, Italy
- Laboratory Medicine Unit, University-Hospital of Padova, Padova, Italy
- QI.LAB.MED., Spin-off of the University of Padova, Padova, Italy
| | - Mario Plebani
- Department of Medicine (DIMED), University of Padova, Padova, Italy
- Laboratory Medicine Unit, University-Hospital of Padova, Padova, Italy
- QI.LAB.MED., Spin-off of the University of Padova, Padova, Italy
- Clinical Biochemistry and Clinical Molecular Biology, School of Medicine, University of Padova, Padova, Italy
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Porru S, Monaco MGL, Spiteri G, Carta A, Caliskan G, Violán C, Torán-Monserrat P, Vimercati L, Tafuri S, Boffetta P, Violante FS, Sala E, Sansone E, Gobba F, Casolari L, Wieser A, Janke C, Tardon A, Rodriguez-Suarez MM, Liviero F, Scapellato ML, dell'Omo M, Murgia N, Mates D, Calota VC, Strhársky J, Mrázová M, Pira E, Godono A, Magnano GC, Negro C, Verlato G. Incidence and Determinants of Symptomatic and Asymptomatic SARS-CoV-2 Breakthrough Infections After Booster Dose in a Large European Multicentric Cohort of Health Workers-ORCHESTRA Project. J Epidemiol Glob Health 2023; 13:577-588. [PMID: 37480426 PMCID: PMC10468456 DOI: 10.1007/s44197-023-00139-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 07/05/2023] [Indexed: 07/24/2023] Open
Abstract
BACKGROUND SARS-CoV-2 breakthrough infections (BI) after vaccine booster dose are a relevant public health issue. METHODS Multicentric longitudinal cohort study within the ORCHESTRA project, involving 63,516 health workers (HW) from 14 European settings. The study investigated the cumulative incidence of SARS-CoV-2 BI after booster dose and its correlation with age, sex, job title, previous infection, and time since third dose. RESULTS 13,093 (20.6%) BI were observed. The cumulative incidence of BI was higher in women and in HW aged < 50 years, but nearly halved after 60 years. Nurses experienced the highest BI incidence, and administrative staff experienced the lowest. The BI incidence was higher in immunosuppressed HW (28.6%) vs others (24.9%). When controlling for gender, age, job title and infection before booster, heterologous vaccination reduced BI incidence with respect to the BNT162b2 mRNA vaccine [Odds Ratio (OR) 0.69, 95% CI 0.63-0.76]. Previous infection protected against asymptomatic infection [Relative Risk Ratio (RRR) of recent infection vs no infection 0.53, 95% CI 0.23-1.20] and even more against symptomatic infections [RRR 0.11, 95% CI 0.05-0.25]. Symptomatic infections increased from 70.5% in HW receiving the booster dose since < 64 days to 86.2% when time elapsed was > 130 days. CONCLUSIONS The risk of BI after booster is significantly reduced by previous infection, heterologous vaccination, and older ages. Immunosuppression is relevant for increased BI incidence. Time elapsed from booster affects BI severity, confirming the public health usefulness of booster. Further research should focus on BI trend after 4th dose and its relationship with time variables across the epidemics.
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Affiliation(s)
- Stefano Porru
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37134, Verona, Italy
- Occupational Medicine Unit, University Hospital of Verona, 37134, Verona, Italy
| | | | - Gianluca Spiteri
- Occupational Medicine Unit, University Hospital of Verona, 37134, Verona, Italy.
| | - Angela Carta
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37134, Verona, Italy
- Occupational Medicine Unit, University Hospital of Verona, 37134, Verona, Italy
| | - Gulser Caliskan
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37134, Verona, Italy
| | - Concepción Violán
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Unitat de Suport a la Recerca Metropolitana Nord, Mare de Déu de Guadalupe 2, Planta 1ª, Mataro, 08303, Barcelona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Camí de les Escoles, S/N, Badalona, 08916, Barcelona, Spain
| | - Pere Torán-Monserrat
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Unitat de Suport a la Recerca Metropolitana Nord, Mare de Déu de Guadalupe 2, Planta 1ª, Mataro, 08303, Barcelona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Camí de les Escoles, S/N, Badalona, 08916, Barcelona, Spain
| | - Luigi Vimercati
- Interdisciplinary Department of Medicine, University of Bari, 70124, Bari, Italy
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, University of Bari, 70124, Bari, Italy
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | | | - Emma Sala
- Unit of Occupational Health, Hygiene, Toxicology and Prevention, University Hospital ASST Spedali Civili, 25123, Brescia, Italy
| | - Emanuele Sansone
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Unit of Occupational Health and Industrial Hygiene, University of Brescia, 25123, Brescia, Italy
| | - Fabriziomaria Gobba
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125, Modena, Italy
| | - Loretta Casolari
- Health Surveillance Service, University Hospital of Modena, 41125, Modena, Italy
| | - Andreas Wieser
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
- German Center for Infection Research (DZIF), Partner Site , 81377, Munich, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, 80799, Munich, Germany
- Max Von Pettenkofer Institute, Faculty of Medicine, LMU Munich, 80336, Munich, Germany
| | - Christian Janke
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, 80802, Munich, Germany
| | - Adonina Tardon
- University of Oviedo, Health Research Institute of Asturias (ISPA) and CIBERESP, Asturias, Spain
| | | | - Filippo Liviero
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padua, Italy
- University Hospital of Padova, 35128, Padua, Italy
| | - Maria Luisa Scapellato
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padua, Italy
- University Hospital of Padova, 35128, Padua, Italy
| | - Marco dell'Omo
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, Department of Medicine and Surgery, University of Perugia, 06123, Perugia, Italy
| | - Nicola Murgia
- Department of Environmental and Prevention Sciences, University of Ferrara, 44121, Ferrara, Italy
| | - Dana Mates
- National Institute of Public Health, Bucharest, Romania
| | | | - Jozef Strhársky
- Medical Microbiology Department, Regional Authority of Public Health, 97556, Banská Bystrica, Slovakia
| | - Mariana Mrázová
- Public Health Institute, St. Elizabeth University of Health and Social Work, 81106, Bratislava, Slovakia
| | - Enrico Pira
- Department of Public Health and Pediatrics, University of Torino, 10126, Turin, Italy
| | - Alessandro Godono
- Department of Public Health and Pediatrics, University of Torino, 10126, Turin, Italy
| | - Greta Camilla Magnano
- Department of Medical Sciences, Unit of Occupational Medicine, University of Trieste, 34129, Trieste, Italy
| | - Corrado Negro
- Department of Medical Sciences, Unit of Occupational Medicine, University of Trieste, 34129, Trieste, Italy
| | - Giuseppe Verlato
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37134, Verona, Italy
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Aita A, Navaglia F, Moz S, Contran N, Barbaro F, Cattelan AM, Padoan A, Cosma C, Faggian D, Plebani M, Basso D. New insights into SARS-CoV-2 Lumipulse G salivary antigen testing: accuracy, safety and short TAT enhance surveillance. Clin Chem Lab Med 2023; 61:323-331. [PMID: 36282616 DOI: 10.1515/cclm-2022-0849] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 09/26/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVES The rapid, accurate and safe detection of SARS-CoV-2 is the key to improving surveillance and infection containment. The aim of the present study was to ascertain whether, after heat/chemical inactivation, SARS-CoV-2 N antigen chemiluminescence (CLEIA) assay in saliva remains a valid alternative to molecular testing. METHODS In 2022, 139 COVID-19 inpatients and 467 healthcare workers were enrolled. In 606 self-collected saliva samples (Salivette), SARS-CoV-2 was detected by molecular (TaqPath rRT-PCR) and chemiluminescent Ag assays (Lumipulse G). The effect of sample pre-treatment (extraction solution-ES or heating) on antigen recovery was verified. RESULTS Salivary SARS-CoV-2 antigen assay was highly accurate (AUC=0.959, 95% CI: 0.943-0.974), with 90% sensitivity and 92% specificity. Of the 254 antigen positive samples, 29 were false positives. We demonstrated that heterophilic antibodies could be a cause of false positive results. A significant antigen concentration decrease was observed after ES treatment (p=0.0026), with misclassification of 43 samples. Heat had a minimal impact, after treatment the correct classification of cases was maintained. CONCLUSIONS CLEIA SARS-CoV-2 salivary antigen provides accurate, timely and high-throughput results that remain accurate also after heat inactivation, thus ensuring a safer work environment. This supports the use of salivary antigen detection by CLEIA in surveillance programs.
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Affiliation(s)
- Ada Aita
- Department of Medicine - DIMED, University of Padova, Padova, Italy
| | - Filippo Navaglia
- Laboratory Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Stefania Moz
- Laboratory Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Nicole Contran
- Laboratory Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Francesco Barbaro
- Tropical and Infectious Diseases Unit, University Hospital of Padova, Padova, Italy
| | - Anna Maria Cattelan
- Tropical and Infectious Diseases Unit, University Hospital of Padova, Padova, Italy
| | - Andrea Padoan
- Department of Medicine - DIMED, University of Padova, Padova, Italy
- Laboratory Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Chiara Cosma
- Laboratory Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Diego Faggian
- Laboratory Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Mario Plebani
- Department of Medicine - DIMED, University of Padova, Padova, Italy
| | - Daniela Basso
- Department of Medicine - DIMED, University of Padova, Padova, Italy
- Laboratory Medicine Unit, University Hospital of Padova, Padova, Italy
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Lippi G, Favresse J, Gromiha MM, SoRelle JA, Plebani M, Henry BM. Ad interim recommendations for diagnosing SARS-CoV-2 infection by the IFCC SARS-CoV-2 variants working group. Clin Chem Lab Med 2022; 60:975-981. [PMID: 35452576 DOI: 10.1515/cclm-2022-0345] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 04/10/2022] [Indexed: 12/28/2022]
Abstract
This document, endorsed by the IFCC Working Group on SARS-CoV-2 Variants, aims to update previous indications for diagnosing acute SARS-CoV-2 infection, taking into consideration the evidence that has emerged after the origin and spread of new lineages and sub-lineages of the virus characterized by mutated genetics and altered biochemical, biological and clinical characteristics. These indications encompass the use of different diagnostic strategies in specific clinical settings, such as high risk of SARS-CoV-2 infection (symptomatic patients), low risk of SARS-CoV-2 infection (asymptomatic subjects) at hospital admission/contact tracing, testing in asymptomatic subjects, in epidemiologic surveys and/or population screening, along with tentative indications for identification of new lineages and/or sub-lineages of SARS-CoV-2.
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Affiliation(s)
- Giuseppe Lippi
- IFCC SARS-CoV-2 Variants Working Group, Verona, Italy
- IFCC Task Force on COVID-19, Verona, Italy
- Section of Clinical Biochemistry and School of Medicine, University of Verona, Verona, Italy
| | - Julien Favresse
- IFCC SARS-CoV-2 Variants Working Group, Verona, Italy
- Department of Laboratory Medicine, Clinique St-Luc Bouge, Namur, Belgium
| | - Michael M Gromiha
- IFCC SARS-CoV-2 Variants Working Group, Verona, Italy
- Department of Biotechnology, Bhupat and Jyoti Mehta School of Biosciences, Indian Institute of Technology Madras, Chennai, India
| | - Jeffrey A SoRelle
- IFCC SARS-CoV-2 Variants Working Group, Verona, Italy
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Mario Plebani
- IFCC SARS-CoV-2 Variants Working Group, Verona, Italy
- Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Brandon M Henry
- IFCC SARS-CoV-2 Variants Working Group, Verona, Italy
- Clinical Laboratory, Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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