1. Development of a high-throughput SARS-CoV-2 antibody testing pathway using dried blood spot specimens
- Author
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Wiola M. Zelek, Rachael Steven, Matthew J. Wise, B.P. Morgan, Sara Jones, Stuart J. Moat, Kathyryn Bramhall, Chloe George, Christopher Fegan, Stephen Jolles, Mark J. Ponsford, Emily Carne, Annette Thomas, Ian Weeks, Russell Webb, and Tariq El-Shanawany
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Clinical Biochemistry ,Blood volume ,Enzyme-Linked Immunosorbent Assay ,Antibodies, Viral ,Gastroenterology ,Serology ,COVID-19 Serological Testing ,03 medical and health sciences ,0302 clinical medicine ,Dried blood spots ,Internal medicine ,medicine ,Humans ,antibodies ,030212 general & internal medicine ,Newborn screening ,Venipuncture ,biology ,medicine.diagnostic_test ,business.industry ,SARS-CoV-2 ,COVID-19 ,General Medicine ,Phlebotomy ,Dried blood spot ,030104 developmental biology ,Immunoassay ,Immunoglobulin G ,Spike Glycoprotein, Coronavirus ,biology.protein ,Dried Blood Spot Testing ,Antibody ,business ,Research Article - Abstract
Background Serological assays for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) have roles in seroepidemiology, convalescent plasma-testing, antibody durability and vaccine studies. Currently, SARS-CoV-2 serology is performed using serum/plasma collected by venepuncture. Dried blood spot (DBS) testing offers significant advantages as it is minimally invasive, avoids venepuncture with specimens being mailed to the laboratory. Methods A pathway utilizing a newborn screening laboratory infrastructure was developed using an enzyme-linked immunosorbent assay to detect IgG antibodies against the receptor-binding domain of the SARS-CoV-2 spike protein in DBS specimens. Paired plasma and DBS specimens from SARS-CoV-2 antibody-positive and -negative subjects and polymerase chain reaction positive subjects were tested. DBS specimen stability, effect of blood volume and punch location were also evaluated. Results DBS specimens from antibody-negative ( n = 85) and -positive ( n = 35) subjects and polymerase chain reaction positive subjects ( n = 11) had a mean (SD; range) optical density (OD) of 0.14 (0.046; 0.03–0.27), 0.98 (0.41; 0.31–1.64) and 1.12 (0.37; 0.49–1.54), respectively. An action value OD >0.28 correctly assigned all cases. The weighted Deming regression for comparison of the DBS and the plasma assay yielded: y = 0.004041 + 1.005 x, r = 0.991, Sy/ x 0.171, n = 82. Extraction efficiency of antibodies from DBS specimens was >99%. DBS specimens were stable for at least 28 days at ambient room temperature and humidity. Conclusions SARS-CoV-2 IgG receptor-binding domain antibodies can be reliably detected in DBS specimens. DBS serological testing offers lower costs than either point of care or serum/plasma assays that require patient travel, phlebotomy and hospital/clinic resources; the development of a DBS assay may be particularly important for resource poor settings.
- Published
- 2020