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Mlcochova P, Collier D, Ritchie A, Assennato SM, Hosmillo M, Goel N, Meng B, Chatterjee K, Mendoza V, Temperton N, Kiss L, James LC, Ciazynska KA, Xiong X, Briggs JA, Nathan JA, Mescia F, Bergamaschi L, Zhang H, Barmpounakis P, Demeris N, Skells R, Lyons PA, Bradley J, Baker S, Allain JP, Smith KG, Bousfield R, Wilson M, Sparkes D, Amoroso G, Gkrania-Klotsas E, Hardwick S, Boyle A, Goodfellow I, Gupta RK. Combined Point-of-Care Nucleic Acid and Antibody Testing for SARS-CoV-2 following Emergence of D614G Spike Variant. Cell Rep Med 2020; 1:100099. [PMID: 32905045 PMCID: PMC7462534 DOI: 10.1016/j.xcrm.2020.100099] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/05/2020] [Accepted: 08/27/2020] [Indexed: 12/20/2022]
Abstract
Rapid COVID-19 diagnosis in the hospital is essential, although this is complicated by 30%-50% of nose/throat swabs being negative by SARS-CoV-2 nucleic acid amplification testing (NAAT). Furthermore, the D614G spike mutant dominates the pandemic and it is unclear how serological tests designed to detect anti-spike antibodies perform against this variant. We assess the diagnostic accuracy of combined rapid antibody point of care (POC) and nucleic acid assays for suspected COVID-19 disease due to either wild-type or the D614G spike mutant SARS-CoV-2. The overall detection rate for COVID-19 is 79.2% (95% CI 57.8-92.9) by rapid NAAT alone. The combined point of care antibody test and rapid NAAT is not affected by D614G and results in very high sensitivity for COVID-19 diagnosis with very high specificity.
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Affiliation(s)
- Petra Mlcochova
- Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID), Cambridge, UK
- Department of Medicine, University of Cambridge, Cambridge, UK
| | - Dami Collier
- Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID), Cambridge, UK
- Department of Medicine, University of Cambridge, Cambridge, UK
- Division of Infection and Immunity, University College London, London WC1E 6BT, UK
| | - Allyson Ritchie
- Diagnostics for the Real World EU, Chesterford Research Park, UK
| | | | - Myra Hosmillo
- Department of Pathology, University of Cambridge, Cambridge, UK
| | - Neha Goel
- Diagnostics for the Real World EU, Chesterford Research Park, UK
| | - Bo Meng
- Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID), Cambridge, UK
- Department of Medicine, University of Cambridge, Cambridge, UK
| | | | - Vivien Mendoza
- NIHR Cambridge Clinical Research Facility, Cambridge, UK
| | - Nigel Temperton
- Viral Pseudotype Unit, Medway School of Pharmacy, University of Kent, Kent, UK
| | - Leo Kiss
- Medical Research Council Laboratory of Molecular Biology, Cambridge, UK
| | - Leo C. James
- Medical Research Council Laboratory of Molecular Biology, Cambridge, UK
| | | | - Xiaoli Xiong
- Medical Research Council Laboratory of Molecular Biology, Cambridge, UK
| | - John A.G. Briggs
- Medical Research Council Laboratory of Molecular Biology, Cambridge, UK
| | - James A. Nathan
- Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID), Cambridge, UK
- Department of Medicine, University of Cambridge, Cambridge, UK
| | - Federica Mescia
- Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID), Cambridge, UK
- Department of Medicine, University of Cambridge, Cambridge, UK
| | - Laura Bergamaschi
- Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID), Cambridge, UK
- Department of Medicine, University of Cambridge, Cambridge, UK
| | - Hongyi Zhang
- Clinical Microbiology & Public Health Laboratory, Cambridge University NHS Hospitals Foundation Trust, Cambridge, UK
| | - Petros Barmpounakis
- Department of Statistics, Athens University of Economics and Business, Athens, Greece
| | - Nikos Demeris
- Department of Statistics, Athens University of Economics and Business, Athens, Greece
- Cambridge Clinical Trials Unit-Cancer Theme, University of Cambridge, Cambridge, UK
| | - Richard Skells
- NIHR Cambridge Clinical Research Facility, Cambridge, UK
- Cambridge Clinical Trials Unit-Cancer Theme, University of Cambridge, Cambridge, UK
| | - Paul A. Lyons
- Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID), Cambridge, UK
- Department of Medicine, University of Cambridge, Cambridge, UK
| | - John Bradley
- Division of Infection and Immunity, University College London, London WC1E 6BT, UK
- National Institutes for Health Research Cambridge Biomedical Research Centre, Cambridge, UK
| | - Steven Baker
- Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID), Cambridge, UK
- Department of Medicine, University of Cambridge, Cambridge, UK
| | | | - Kenneth G.C. Smith
- Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID), Cambridge, UK
- Department of Medicine, University of Cambridge, Cambridge, UK
| | - Rachel Bousfield
- Department of Infectious Diseases, Cambridge University NHS Hospitals Foundation Trust, Cambridge, UK
| | - Michael Wilson
- Department of Infectious Diseases, Cambridge University NHS Hospitals Foundation Trust, Cambridge, UK
| | - Dominic Sparkes
- Department of Infectious Diseases, Cambridge University NHS Hospitals Foundation Trust, Cambridge, UK
| | - Glenn Amoroso
- Department of Emergency Medicine, Cambridge University NHS Hospitals Foundation Trust, Cambridge, UK
| | - Effrosyni Gkrania-Klotsas
- Department of Infectious Diseases, Cambridge University NHS Hospitals Foundation Trust, Cambridge, UK
| | - Susie Hardwick
- Department of Emergency Medicine, Cambridge University NHS Hospitals Foundation Trust, Cambridge, UK
| | - Adrian Boyle
- Department of Emergency Medicine, Cambridge University NHS Hospitals Foundation Trust, Cambridge, UK
| | - Ian Goodfellow
- Department of Pathology, University of Cambridge, Cambridge, UK
| | - Ravindra K. Gupta
- Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID), Cambridge, UK
- Department of Medicine, University of Cambridge, Cambridge, UK
- Department of Infectious Diseases, Cambridge University NHS Hospitals Foundation Trust, Cambridge, UK
- Africa Health Research Institute, Durban, South Africa
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