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Eryilmaz M, Goncharov A, Han GR, Joung HA, Ballard ZS, Ghosh R, Zhang Y, Di Carlo D, Ozcan A. A Paper-Based Multiplexed Serological Test to Monitor Immunity against SARS-COV-2 Using Machine Learning. ACS NANO 2024; 18:16819-16831. [PMID: 38888985 PMCID: PMC11223469 DOI: 10.1021/acsnano.4c02434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 05/21/2024] [Accepted: 05/31/2024] [Indexed: 06/20/2024]
Abstract
The rapid spread of SARS-CoV-2 caused the COVID-19 pandemic and accelerated vaccine development to prevent the spread of the virus and control the disease. Given the sustained high infectivity and evolution of SARS-CoV-2, there is an ongoing interest in developing COVID-19 serology tests to monitor population-level immunity. To address this critical need, we designed a paper-based multiplexed vertical flow assay (xVFA) using five structural proteins of SARS-CoV-2, detecting IgG and IgM antibodies to monitor changes in COVID-19 immunity levels. Our platform not only tracked longitudinal immunity levels but also categorized COVID-19 immunity into three groups: protected, unprotected, and infected, based on the levels of IgG and IgM antibodies. We operated two xVFAs in parallel to detect IgG and IgM antibodies using a total of 40 μL of human serum sample in <20 min per test. After the assay, images of the paper-based sensor panel were captured using a mobile phone-based custom-designed optical reader and then processed by a neural network-based serodiagnostic algorithm. The serodiagnostic algorithm was trained with 120 measurements/tests and 30 serum samples from 7 randomly selected individuals and was blindly tested with 31 serum samples from 8 different individuals, collected before vaccination as well as after vaccination or infection, achieving an accuracy of 89.5%. The competitive performance of the xVFA, along with its portability, cost-effectiveness, and rapid operation, makes it a promising computational point-of-care (POC) serology test for monitoring COVID-19 immunity, aiding in timely decisions on the administration of booster vaccines and general public health policies to protect vulnerable populations.
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Affiliation(s)
- Merve Eryilmaz
- Electrical
& Computer Engineering Department, Bioengineering Department, California NanoSystems
Institute (CNSI), Department of Surgery, University of California, Los Angeles, California 90095 United States
| | - Artem Goncharov
- Electrical
& Computer Engineering Department, Bioengineering Department, California NanoSystems
Institute (CNSI), Department of Surgery, University of California, Los Angeles, California 90095 United States
| | - Gyeo-Re Han
- Electrical
& Computer Engineering Department, Bioengineering Department, California NanoSystems
Institute (CNSI), Department of Surgery, University of California, Los Angeles, California 90095 United States
| | - Hyou-Arm Joung
- Electrical
& Computer Engineering Department, Bioengineering Department, California NanoSystems
Institute (CNSI), Department of Surgery, University of California, Los Angeles, California 90095 United States
| | - Zachary S. Ballard
- Electrical
& Computer Engineering Department, Bioengineering Department, California NanoSystems
Institute (CNSI), Department of Surgery, University of California, Los Angeles, California 90095 United States
| | - Rajesh Ghosh
- Electrical
& Computer Engineering Department, Bioengineering Department, California NanoSystems
Institute (CNSI), Department of Surgery, University of California, Los Angeles, California 90095 United States
| | - Yijie Zhang
- Electrical
& Computer Engineering Department, Bioengineering Department, California NanoSystems
Institute (CNSI), Department of Surgery, University of California, Los Angeles, California 90095 United States
| | - Dino Di Carlo
- Electrical
& Computer Engineering Department, Bioengineering Department, California NanoSystems
Institute (CNSI), Department of Surgery, University of California, Los Angeles, California 90095 United States
| | - Aydogan Ozcan
- Electrical
& Computer Engineering Department, Bioengineering Department, California NanoSystems
Institute (CNSI), Department of Surgery, University of California, Los Angeles, California 90095 United States
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Chong YP, Choy KW, Doerig C, Lim CX. SARS-CoV-2 Testing Strategies in the Diagnosis and Management of COVID-19 Patients in Low-Income Countries: A Scoping Review. Mol Diagn Ther 2023; 27:303-320. [PMID: 36705912 PMCID: PMC9880944 DOI: 10.1007/s40291-022-00637-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2022] [Indexed: 01/28/2023]
Abstract
The accuracy of diagnostic laboratory tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can impact downstream clinical procedures in managing and controlling the outbreak of coronavirus disease 2019 (COVID-19). To assess the effectiveness of laboratory tools for managing COVID-19 patients in low-income countries (LICs), we systematically searched the PubMed, Embase, Scopus and CINHAL databases for reports published between January 2020 and June 2022. We found that 22 of 1303 articles reported the performance of various SARS-CoV-2 detection tools across 10 LICs. These tools were (1) real-time reverse transcriptase polymerase chain reaction (RT-PCR); (2) reverse transcription loop-mediated isothermal amplification (RT-LAMP); (3) rapid diagnostic tests (RDTs); (4) enzyme-linked immunosorbent assay (ELISA); and (5) dot-blot immunoassay. The detection of COVID-19 is largely divided into two main streams-direct virus (antigen) detection and serology (immunoglobulin)-based detection. Point-of-care testing using antigen-based RDTs is preferred in LICs because of cost effectiveness and simplicity in the test procedures. The nucleic acid amplification technology (RT-PCR and RT-LAMP) has the highest diagnostic performance among the available tests, but it is not broadly used in this context due to costs and shortage of facilities/trained staff. The serology-based test method is affected by antibody interferences and varying amounts of SARS-CoV-2 immunoglobulins expressed at different stages of disease onset. We further discuss the effectiveness and shortcomings of each of these tools in the diagnosis and management of COVID-19. Using the LICs as the study model, our findings highlight ways to improve the quality and turnaround time of COVID-19 testing in resource-constrained settings, notably through local/international collaborative efforts to refine the molecular-based or immunoassay-based testing technologies.
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Affiliation(s)
- Yuh Ping Chong
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, 3083, Australia.
| | - Kay Weng Choy
- Northern Pathology Victoria, Northern Health, Epping, VIC, 3076, Australia
| | - Christian Doerig
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, 3083, Australia
| | - Chiao Xin Lim
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, 3083, Australia.
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Sisay A, Hartnack S, Tiruneh A, Desalegn Y, Tesfaye A, Desta AF. Evaluating diagnostic accuracies of Panbio™ test and RT-PCR for the detection of SARS-CoV-2 in Addis Ababa, Ethiopia using Bayesian Latent-Class Models (BLCM). PLoS One 2022; 17:e0268160. [PMID: 36260547 PMCID: PMC9581363 DOI: 10.1371/journal.pone.0268160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 10/04/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Rapid diagnostics are vital for curving the transmission and control of the COVID-19 pandemic. Although many commercially available antigen-based rapid diagnostic tests (Ag-RDTs) for the detection of SARS-CoV-2 are recommended by the WHO, their diagnostic performance has not yet been assessed in Ethiopia. So far, the vast majority of studies assessing diagnostic accuracies of rapid antigen tests considered RT-PCR as a reference standard, which inevitably leads to bias when RT-PCR is not 100% sensitive and specific. Thus, this study aimed to evaluate the diagnostic performance of Panbio™ jointly with the RT-PCR for the detection of SARS-CoV-2. METHODS A prospective cross-sectional study was done from July to September 2021 in Addis Ababa, Ethiopia, during the third wave of the pandemic involving two health centers and two hospitals. Diagnostic sensitivity and specificity of Panbio™ and RT-PCR were obtained using Bayesian Latent-Class Models (BLCM). RESULTS 438 COVID-19 presumptive clients were enrolled, 239 (54.6%) were females, of whom 196 (44.7%) had a positive RT-PCR and 158 (36.1%) were Panbio™ positive. The Panbio™ and RT-PCR had a sensitivity (95% CrI) of 99.6 (98.4-100) %, 89.3 (83.2-97.6) % and specificity (95% CrI) of 93.4 (82.3-100) %, and 99.1 (97.5-100) %, respectively. Most of the study participants, 318 (72.6%) exhibited COVID-19 symptoms; the most reported was cough 191 (43.6%). CONCLUSION As expected the RT-PCR performed very well with a near-perfect specificity and a high, but not perfect sensitivity. The diagnostic performance of Panbio™ is coherent with the WHO established criteria of having a sensitivity ≥80% for Ag-RDTs. Both tests displayed high diagnostic accuracies in patients with and without symptoms. Hence, we recommend the use of the Panbio™ for both symptomatic and asymptomatic individuals in clinical settings for screening purposes.
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Affiliation(s)
- Abay Sisay
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Microbial, Cellular and Molecular Biology, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- * E-mail: ,
| | - Sonja Hartnack
- Section of Epidemiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Abebaw Tiruneh
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Addis Ababa Public Health Research and Emergency Management Laboratory, Addis Ababa Health Bureau, Addis Ababa, Ethiopia
| | - Yasin Desalegn
- Addis Ababa Public Health Research and Emergency Management Laboratory, Addis Ababa Health Bureau, Addis Ababa, Ethiopia
| | - Abraham Tesfaye
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Diagnostic Unit, Center for Innovative Drug Development and Therapeutic Trials for Africa, CDT-Africa, Addis Ababa, Ethiopia
| | - Adey Feleke Desta
- Department of Microbial, Cellular and Molecular Biology, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Kalia R, Kaila R, Kahar P, Khanna D. Laboratory and Point-of-Care Testing for COVID-19: A Review of Recent Developments. Cureus 2022; 14:e28530. [PMID: 36185888 PMCID: PMC9517582 DOI: 10.7759/cureus.28530] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 08/28/2022] [Indexed: 11/25/2022] Open
Abstract
With the emergence of Coronavirus infection called COVID-19, testing is essential for containment and mitigation purposes. In a pandemic, control is essential to limit the spread of any virus. Initially, contact tracing was not available which ultimately led to the 2020 pandemic. However, with the development of COVID-19 rapid testing, the rate of infections has lessened and has allowed for some return to normalcy. In this review, we discuss the various antibody, antigens, and molecular tests that have been given emergency authorization (EA) from the Food and Drug Administration (FDA). Moreover, we will discuss the various point-of-care tests as well as the specificity and sensitivity that are associated with each testing kit. With appropriate testing, we can be aware of how the virus spreads and how prevalent it remains.
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Lin YC, Chen WY, Hwu ET, Hu WP. In-Silico Selection of Aptamer Targeting SARS-CoV-2 Spike Protein. Int J Mol Sci 2022; 23:ijms23105810. [PMID: 35628622 PMCID: PMC9143595 DOI: 10.3390/ijms23105810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 05/11/2022] [Accepted: 05/18/2022] [Indexed: 11/16/2022] Open
Abstract
Aptamers are single-stranded, short DNA or RNA oligonucleotides that can specifically bind to various target molecules. To diagnose the infected cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in time, numerous conventional methods are applied for viral detection via the amplification and quantification of DNA or antibodies specific to antigens on the virus. Herein, we generated a large number of mutated aptamer sequences, derived from a known sequence of receptor-binding domain (RBD)-1C aptamer, specific to the RBD of SARS-CoV-2 spike protein (S protein). Structural similarity, molecular docking, and molecular dynamics (MD) were utilized to screen aptamers and characterize the detailed interactions between the selected aptamers and the S protein. We identified two mutated aptamers, namely, RBD-1CM1 and RBD-1CM2, which presented better docking results against the S protein compared with the RBD-1C aptamer. Through the MD simulation, we further confirmed that the RBD-1CM1 aptamer can form the most stable complex with the S protein based on the number of hydrogen bonds formed between the two biomolecules. Based on the experimental data of quartz crystal microbalance (QCM), the RBD-1CM1 aptamer could produce larger signals in mass change and exhibit an improved binding affinity to the S protein. Therefore, the RBD-1CM1 aptamer, which was selected from 1431 mutants, was the best potential candidate for the detection of SARS-CoV-2. The RBD-1CM1 aptamer can be an alternative biological element for the development of SARS-CoV-2 diagnostic testing.
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Affiliation(s)
- Yu-Chao Lin
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung 404333, Taiwan;
- School of Medicine, China Medical University, Taichung 404333, Taiwan
| | - Wen-Yih Chen
- Department of Chemical and Materials Engineering, National Central University, Jhong-Li 32001, Taiwan;
| | - En-Te Hwu
- Department of Health Technology, Technical University of Denmark, 2800 Lyngby, Denmark;
| | - Wen-Pin Hu
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung 41354, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 40447, Taiwan
- Correspondence:
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Medical laboratory waste generation rate, management practices and associated factors in Addis Ababa, Ethiopia. PLoS One 2022; 17:e0266888. [PMID: 35482740 PMCID: PMC9049513 DOI: 10.1371/journal.pone.0266888] [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: 08/06/2021] [Accepted: 03/30/2022] [Indexed: 11/19/2022] Open
Abstract
Background Biomedical wastes (BMWs) generated from medical laboratories are hazardous and can endanger both humans and the environment. Highly infectious biomedical wastes are produced at an unacceptably high rate from health laboratories in developing countries with poor management systems, such as Ethiopia. The purpose of this study was to assess the rate of biomedical waste generation, management practices, and associated factors in public healthcare medical laboratories in Addis Ababa, Ethiopia. Materials and methods From July 13 to September 25, 2020, a health institution-based cross-sectional study was conducted in 6 hospital laboratories and 20 health centres laboratories in Addis Ababa, Ethiopia. Data on socio-demographic characteristics, knowledge and practice of biomedical waste management and generation rate were collected d in health facilities using pre tested data collection tools. SPSS version 20 was used to manage the data. To identify independent predictors of the dependent variable, descriptive statistics, Pearson correlation, linear, and logistic regression analysis were used. The strength of the association was determined using an odds ratio with a 95% confidence interval. Results In this study, the mean ± SD daily generation rate of biomedical wastes was 4.9 ± 3.13 kg/day per medical laboratory. Nineteen medical laboratories (74.3%) had proper biomedical waste management practice, which is significantly associated with professionals’ knowledge of biomedical waste management policies and guidelines, the availability of separate financial sources for biomedical waste management, and the level of training of professionals. Conclusion The study found that medical laboratories in Addis Ababa’s public healthcare facilities generate a significant amount of biomedical waste. Nearly two-thirds of hospitals performed proper waste segregation, collection, storage, and treatment procedures for biomedical waste generated in their laboratories. However, there was a poor transportation and disposal method. As a result, paying special attention and implementing the current national guidelines for biomedical waste management is recommended.
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Sisay A, Abera A, Dufera B, Endrias T, Tasew G, Tesfaye A, Hartnack S, Beyene D, Desta AF. Diagnostic accuracy of three commercially available one step RT-PCR assays for the detection of SARS-CoV-2 in resource limited settings. PLoS One 2022; 17:e0262178. [PMID: 35051204 PMCID: PMC8775315 DOI: 10.1371/journal.pone.0262178] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 12/17/2021] [Indexed: 12/24/2022] Open
Abstract
Background COVID-19 is an ongoing public health pandemic regardless of the countless efforts made by various actors. Quality diagnostic tests are important for early detection and control. Notably, several commercially available one step RT-PCR based assays have been recommended by the WHO. Yet, their analytic and diagnostic performances have not been well documented in resource-limited settings. Hence, this study aimed to evaluate the diagnostic sensitivities and specificities of three commercially available one step reverse transcriptase-polymerase chain reaction (RT-PCR) assays in Ethiopia in clinical setting. Methods A cross-sectional study was conducted from April to June, 2021 on 279 respiratory swabs originating from community surveillance, contact cases and suspect cases. RNA was extracted using manual extraction method. Master-mix preparation, amplification and result interpretation was done as per the respective manufacturer. Agreements between RT-PCRs were analyzed using kappa values. Bayesian latent class models (BLCM) were fitted to obtain reliable estimates of diagnostic sensitivities, specificities of the three assays and prevalence in the absence of a true gold standard. Results Among the 279 respiratory samples, 50(18%), 59(21.2%), and 69(24.7%) were tested positive by TIB, Da An, and BGI assays, respectively. Moderate to substantial level of agreement was reported among the three assays with kappa value between 0 .55 and 0.72. Based on the BLCM relatively high specificities (95% CI) of 0.991(0.973–1.000), 0.961(0.930–0.991) and 0.916(0.875–0.952) and considerably lower sensitivities with 0.813(0.658–0.938), 0.836(0.712–0.940) and 0.810(0.687–0.920) for TIB MOLBIOL, Da An and BGI respectively were found. Conclusions While all the three RT-PCR assays displayed comparable sensitivities, the specificities of TIB MOLBIOL and Da An were considerably higher than BGI. These results help adjust the apparent prevalence determined by the three RT-PCRs and thus support public health decisions in resource limited settings and consider alternatives as per their prioritization matrix.
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Affiliation(s)
- Abay Sisay
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Microbial, Cellular and Molecular Biology, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- * E-mail:
| | - Adugna Abera
- Department of Microbial, Cellular and Molecular Biology, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Boja Dufera
- Department of Microbial, Cellular and Molecular Biology, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Tujuba Endrias
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Geremew Tasew
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Abraham Tesfaye
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Diagnostic Unit, Center for Innovative Drug Development and Therapeutic Trials for Africa, CDT- Africa, Addis Ababa, Ethiopia
| | - Sonja Hartnack
- Section of Epidemiology, University of Zurich, Zurich, Switzerland
| | - Dereje Beyene
- Department of Microbial, Cellular and Molecular Biology, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Adey Feleke Desta
- Department of Microbial, Cellular and Molecular Biology, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Deshpande PS, Abraham IE, Pitamberwale A, Dhote RH. Review of Clinical Performance of Serology Based Commercial Diagnostic Assays for Detection of Severe Acute Respiratory Syndrome Coronavirus 2 Antibodies. Viral Immunol 2022; 35:82-111. [PMID: 35007431 DOI: 10.1089/vim.2020.0313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, which caused the coronavirus disease 2019 (COVID-19) pandemic as declared by the World Health Organization, has created havoc worldwide. The highly transmissible infection can be contained only by accurate diagnosis, quarantining, and exercising social distancing. Therefore, quick and massive deployment of SARS-CoV-2 testing plays a crucial role in the identification and isolation of infected patients. Reverse transcription-polymerase chain reaction is the gold standard for COVID-19 detection; however, it needs expertise, facilities, and time. Hence, for the ease of population-wide screening, serology-based diagnostic assays were introduced. These can help determine the prevalence of infection, understand the epidemiology of the disease, and assist in suitable public health interventions while being user-friendly and less time consuming. Although serological testing kits in markets soared, their sensitivity and specificity were questioned in reports from different parts of the world. In this article, we have reviewed 40 Food and Drug Administration (FDA) and CE-approved clinically evaluated serological kits (8 enzyme-linked immunosorbent assay [ELISA] kits, 10 chemiluminescent immunoassay [CLIA] kits, and 22 lateral flow immunoassay [LFIA] kits) for their sensitivity and specificity and discussed the apparent reasons behind their performance. We observed appreciable sensitivity in the kits detecting total antibodies compared to the kits targeting single isotype antibodies. Tests that determined antibodies against nucleocapsid protein were found to be more sensitive and those detecting antibodies against spike protein were found to have greater specificity. This study was conducted to help the decision-making while acquiring antibody kits and concurrently to be mindful of their shortcomings.
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Affiliation(s)
- Poonam S Deshpande
- Biochemistry Division, Department of Chemistry, Fergusson College, Pune, India
| | - Irene E Abraham
- Biochemistry Division, Department of Chemistry, Fergusson College, Pune, India
| | - Anjali Pitamberwale
- Biochemistry Division, Department of Chemistry, Fergusson College, Pune, India
| | - Radhika H Dhote
- Biochemistry Division, Department of Chemistry, Fergusson College, Pune, India
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Gracienta TJ, Herardi R, Santosa F, Pasiak TF, Tjang YS. Diagnostic accuracy of antibody-based rapid diagnostic tests in detecting coronavirus disease 2019: systematic review. Arch Med Sci 2022; 18:949-957. [PMID: 35832707 PMCID: PMC9266800 DOI: 10.5114/aoms/135910] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 04/19/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The rapid transmission of coronavirus disease 2019 (COVID-19) requires a fast, accurate, and affordable detection method. Despite doubts of their diagnostic accuracy, rapid diagnostic tests (RDTs) are used worldwide due to their practicality. This systematic review aims to determine the diagnostic accuracy of antibody-based RDTs in detecting COVID-19. MATERIAL AND METHODS A literature search was carried out on five journal databases using the PRISMA-P 2015 method. We included all studies published up to February 2021. The risk of bias was evaluated using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Diagnostic Test Accuracy Studies. Data regarding peer-review status, study design, test kit information, immunoglobulin class, target antigen, and the number of samples were extracted and tabulated. We estimated the pooled sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) with a 95% confidence interval. RESULTS Thirty-three studies met the eligibility criteria. The pooled data results showed that the combined detection method of IgM or IgG had the highest sensitivity and NPV, which were 73.41% (95% CI: 72.22-74.57) and 75.34% (95% CI: 74.51-76.16), respectively. The single IgG detection method had the highest specificity and PPV of 96.68% (95% CI: 96.25-97.07) and 95.97% (95% CI: 95.47-96.42%), respectively. CONCLUSIONS Antibody-based RDTs are not satisfactory as primary diagnostic tests but have utility as a screening tool.
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Affiliation(s)
| | - Ryan Herardi
- Faculty of Medicine, Universitas Pembangunan Nasional Veteran Jakarta, Indonesia
| | - Frans Santosa
- Faculty of Medicine, Universitas Pembangunan Nasional Veteran Jakarta, Indonesia
| | | | - Yanto Sandy Tjang
- Faculty of Medicine, Universitas Pembangunan Nasional Veteran Jakarta, Indonesia
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