Abstract

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. PCR and serological testing was performed on 394 individuals. 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’s kappa statistic ranged from 0.86 to 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. 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.

Details

Title
Analytic comparison between three high-throughput commercial SARS-CoV-2 antibody assays reveals minor discrepancies in a high-incidence population
Author
Nasrallah, Gheyath K 1 ; Dargham, Soha R 2 ; Shurrab Farah 1 ; Al-Sadeq, Duaa W 1 ; Al-Jighefee Hadeel 1 ; Chemaitelly Hiam 2 ; Zaina, Al Kanaani 3 ; Abdullatif, Al Khal 3 ; Einas, Al Kuwari 3 ; Coyle, Peter 3 ; Jeremijenko, Andrew 3 ; Kaleeckal Anvar Hassan 3 ; Latif Ali Nizar 3 ; Shaik, Riyazuddin Mohammad 3 ; Rahim Hanan F Abdul 4 ; Yassine, Hadi M 1 ; Al Kuwari Mohamed G 5 ; Qotba Hamda 5 ; Al Romaihi Hamad Eid 6 ; Tang, Patrick 7 ; Bertollini Roberto 6 ; Al-Thani, Mohamed H 6 ; Althani, Asmaa A 1 ; Abu-Raddad, Laith J 8 

 Qatar University, Biomedical Research Center, QU Health, Doha, Qatar (GRID:grid.412603.2) (ISNI:0000 0004 0634 1084); Qatar University, Department of Biomedical Science, College of Health Sciences, QU Health, Doha, Qatar (GRID:grid.412603.2) (ISNI:0000 0004 0634 1084) 
 Cornell University, Infectious Disease Epidemiology Group, Weill Cornell Medicine - Qatar, Qatar Foundation - Education City, Doha, Qatar (GRID:grid.418818.c) (ISNI:0000 0001 0516 2170); Cornell University, World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine – Qatar, Qatar Foundation – Education City, Doha, Qatar (GRID:grid.418818.c) (ISNI:0000 0001 0516 2170) 
 Hamad Medical Corporation, Doha, Qatar (GRID:grid.413548.f) (ISNI:0000 0004 0571 546X) 
 Qatar University, College of Health Sciences, QU Health, Doha, Qatar (GRID:grid.412603.2) (ISNI:0000 0004 0634 1084) 
 Primary Health Care Corporation, Doha, Qatar (GRID:grid.498624.5) (ISNI:0000 0004 4676 5308) 
 Ministry of Public Health, Doha, Qatar (GRID:grid.498619.b) 
 Sidra Medicine, Department of Pathology, Doha, Qatar (GRID:grid.498619.b) 
 Cornell University, Infectious Disease Epidemiology Group, Weill Cornell Medicine - Qatar, Qatar Foundation - Education City, Doha, Qatar (GRID:grid.418818.c) (ISNI:0000 0001 0516 2170); Cornell University, World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine – Qatar, Qatar Foundation – Education City, Doha, Qatar (GRID:grid.418818.c) (ISNI:0000 0001 0516 2170); Cornell University, Department of Population Health Sciences, Weill Cornell Medicine, New York, USA (GRID:grid.5386.8) (ISNI:000000041936877X) 
Publication year
2021
Publication date
2021
Publisher
Nature Publishing Group
e-ISSN
20452322
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2537006526
Copyright
© The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.