Point-of-care SARS-CoV-2 serological assays for enhanced case finding in a UK inpatient population.

Pallett, S J C, Denny, S J, Patel, A, Charani, E, Mughal, N, Stebbing, J, Davies, G W and Moore, L S P (2021) Point-of-care SARS-CoV-2 serological assays for enhanced case finding in a UK inpatient population. Scientific reports, 11 (1). p. 5860. ISSN 2045-2322. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Abstract

Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) has become a global pandemic. Case identification is currently made by real-time polymerase chain reaction (PCR) during the acute phase and largely restricted to healthcare laboratories. Serological assays are emerging but independent validation is urgently required to assess their utility. We evaluated five different point-of-care (POC) SARS-CoV-2 antibody test kits against PCR, finding concordance across the assays (n = 15). We subsequently tested 200 patients using the OrientGene COVID-19 IgG/IgM Rapid Test Cassette and find a sensitivity of 74% in the early infection period (day 5-9 post symptom onset), with 100% sensitivity not seen until day 13, demonstrating inferiority to PCR testing in the infectious period. Negative rate was 96%, but in validating the serological tests uncovered potential false-negatives from PCR testing late-presenting cases. A positive predictive value (PPV) of 37% in the general population precludes any use for general screening. Where a case definition is applied however, the PPV is substantially improved (95.4%), supporting use of serology testing in carefully targeted, high-risk populations. Larger studies in specific patient cohorts, including those with mild infection are urgently required to inform on the applicability of POC serological assays to help control the spread of SARS-CoV-2 and improve case finding of patients that may experience late complications.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: QW Microbiology. Immunology
QY Clinical pathology
QZ Pathology. Oncology
W Public health. Health statistics. Occupational health. Health education
WC Communicabable diseases
WO Surgery
Divisions: Clinical Support > Infection Control
Related URLs:
Depositing User: Jamie Edgar
Date Deposited: 26 Mar 2021 12:34
Last Modified: 26 Mar 2021 12:34
URI: http://www.repository.uhblibrary.co.uk/id/eprint/4137

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