Nasrallah, Gheyath K; Dargham, Soha R; Shurrab, Farah; Al-Sadeq, Duaa W; Al-Jighefee, Hadeel; Chemaitelly, Hiam; Kanaani, Zaina Al; Khal, Abdullatif Al; Kuwari, Einas Al; Coyle, Peter; +14 more... Jeremijenko, Andrew; Kaleeckal, Anvar Hassan; Latif, Ali Nizar; Shaik, Riyazuddin Mohammad; Abdul Rahim, Hanan F; Yassine, Hadi M; Al Kuwari, Mohamed G; Qotba, Hamda; Romaihi, Hamad Eid Al; Tang, Patrick; Bertollini, Roberto; Al-Thani, Mohamed; Althani, Asmaa A; Abu-Raddad, Laith J; (2020) Are commercial antibody assays substantially underestimating SARS-CoV-2 ever infection? An analysis on a population-based sample in a high exposure setting. medRxiv preprint. DOI: https://doi.org/10.1101/2020.12.14.20248163
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Abstract
Abstract Background Performance of three automated commercial serological IgG-based assays was investigated for assessing SARS-CoV-2 ever (past or current) infection in a population-based sample in a high exposure setting. Methods PCR and serological testing was performed on 394 individuals. Results SARS-CoV-2-IgG seroprevalence was 42.9% (95% CI 38.1%-47.8%), 40.6% (95% CI 35.9%-45.5%), and 42.4% (95% CI 37.6%-47.3%) using the CL-900i, VidasIII, and Elecsys assays, respectively. Between the three assays, overall, positive, and negative percent agreements ranged between 93.2%-95.7%, 89.3%-92.8%, and 93.8%-97.8%, respectively; Cohen kappa statistic ranged from 0.86-0.91; and 35 specimens (8.9%) showed discordant results. Among all individuals, 12.5% (95% CI 9.6%-16.1%) had current infection, as assessed by PCR. Of these, only 34.7% (95% CI 22.9%-48.7%) were seropositive by at least one assay. A total of 216 individuals (54.8%; 95% CI 49.9%-59.7%) had evidence of ever infection using antibody testing and/or PCR during or prior to this study. Of these, only 78.2%, 74.1%, and 77.3% were seropositive in the CL-900i, VidasIII, and Elecsys assays, respectively. Conclusions All three assays had comparable performance and excellent agreement, but missed at least 20% of individuals with past or current infection. Commercial antibody assays can substantially underestimate ever infection, more so when infection rates are high.
Item Type | Article |
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Faculty and Department | Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology (-2023) |
Research Centre | Covid-19 Research |
Elements ID | 154664 |