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Validity of self-testing at home with rapid SARS-CoV-2 antibody detection by lateral flow immunoassay.


ABSTRACT:

Background

We explore SARS-CoV-2 antibody lateral flow immunoassay (LFIA) performance under field conditions compared to laboratory-based electrochemiluminescence immunoassay (ECLIA) and live virus neutralisation.

Methods

In July 2021, 3758 participants performed, at home, a self-administered Fortress LFIA on finger-prick blood, reported and submitted a photograph of the result, and provided a self-collected capillary blood sample for assessment of IgG antibodies using the Roche Elecsys® Anti-SARS-CoV-2 ECLIA. We compared the self-reported LFIA result to the quantitative ECLIA and checked the reading of the LFIA result with an automated image analysis (ALFA). In a subsample of 250 participants, we compared the results to live virus neutralisation.

Results

Almost all participants (3593/3758, 95.6%) had been vaccinated or reported prior infection. Overall, 2777/3758 (73.9%) were positive on self-reported LFIA, 2811/3457 (81.3%) positive by LFIA when ALFA-reported, and 3622/3758 (96.4%) positive on ECLIA (using the manufacturer reference standard threshold for positivity of 0.8 U ml-1). Live virus neutralisation was detected in 169 of 250 randomly selected samples (67.6%); 133/169 were positive with self-reported LFIA (sensitivity 78.7%; 95% CI 71.8, 84.6), 142/155 (91.6%; 86.1, 95.5) with ALFA, and 169 (100%; 97.8, 100.0) with ECLIA. There were 81 samples with no detectable virus neutralisation; 47/81 were negative with self-reported LFIA (specificity 58.0%; 95% CI 46.5, 68.9), 34/75 (45.3%; 33.8, 57.3) with ALFA, and 0/81 (0%; 0.0, 4.5) with ECLIA.

Conclusions

Self-administered LFIA is less sensitive than a quantitative antibody test, but the positivity in LFIA correlates better than the quantitative ECLIA with virus neutralisation.

SUBMITTER: Atchison CJ 

PROVIDER: S-EPMC9384551 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

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Publications

Validity of Self-testing at Home With Rapid Severe Acute Respiratory Syndrome Coronavirus 2 Antibody Detection by Lateral Flow Immunoassay.

Atchison Christina J CJ   Moshe Maya M   Brown Jonathan C JC   Whitaker Matthew M   Wong Nathan C K NCK   Bharath Anil A AA   McKendry Rachel A RA   Darzi Ara A   Ashby Deborah D   Donnelly Christl A CA   Riley Steven S   Elliott Paul P   Barclay Wendy S WS   Cooke Graham S GS   Ward Helen H  

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 20230201 4


<h4>Background</h4>We explore severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody lateral flow immunoassay (LFIA) performance under field conditions compared to laboratory-based electrochemiluminescence immunoassay (ECLIA) and live virus neutralization.<h4>Methods</h4>In July 2021, 3758 participants performed, at home, a self-administered Fortress LFIA on finger-prick blood, reported and submitted a photograph of the result, and provided a self-collected capillary blood sample  ...[more]

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