TY - JOUR
T1 - Comparative performance of multiplex salivary and commercially available serologic assays to detect SARS-CoV-2 IgG and neutralization titers
AU - Heaney, Christopher D.
AU - Pisanic, Nora
AU - Randad, Pranay R.
AU - Kruczynski, Kate
AU - Howard, Tyrone
AU - Zhu, Xianming
AU - Littlefield, Kirsten
AU - Patel, Eshan U.
AU - Shrestha, Ruchee
AU - Laeyendecker, Oliver
AU - Shoham, Shmuel
AU - Sullivan, David
AU - Gebo, Kelly
AU - Hanley, Daniel
AU - Redd, Andrew D.
AU - Quinn, Thomas C.
AU - Casadevall, Arturo
AU - Zenilman, Jonathan M.
AU - Pekosz, Andrew
AU - Bloch, Evan M.
AU - Tobian, Aaron A.R.
N1 - Publisher Copyright:
© 2021
PY - 2021/12
Y1 - 2021/12
N2 - Oral fluid (hereafter saliva) offers a non-invasive sampling method for detection of SARS-CoV-2 antibodies. However, data comparing performance of salivary tests against commercially-available serologic and neutralizing antibody (nAb) assays are lacking. This study compared the performance of a laboratory-developed multiplex salivary SARS-CoV-2 IgG assay targeting antibodies to nucleocapsid (N), receptor binding domain (RBD) and spike (S) antigens to three commercially-available SARS-CoV-2 serologic enzyme immunoassays (EIAs) (Ortho Vitros, Euroimmun, and BioRad) and nAb. Paired saliva and plasma samples were collected from 101 eligible COVID-19 convalescent plasma (CCP) donors >14 days since PCR+ confirmed diagnosis. Concordance was evaluated using positive (PPA) and negative (NPA) percent agreement, and Cohen's kappa coefficient. The range between salivary and plasma EIAs for SARS-CoV-2-specific N was PPA: 54.4–92.1% and NPA: 69.2–91.7%, for RBD was PPA: 89.9–100% and NPA: 50.0–84.6%, and for S was PPA: 50.6–96.6% and NPA: 50.0–100%. Compared to a plasma nAb assay, the multiplex salivary assay PPA ranged from 62.3% (N) and 98.6% (RBD) and NPA ranged from 18.8% (RBD) to 96.9% (S). Combinations of N, RBD, and S and a summary algorithmic index of all three (N/RBD/S) in saliva produced ranges of PPA: 87.6–98.9% and NPA: 50–91.7% with the three EIAs and ranges of PPA: 88.4–98.6% and NPA: 21.9–34.4% with the nAb assay. A multiplex salivary SARS-CoV-2 IgG assay demonstrated variable, but comparable performance to three commercially-available plasma EIAs and a nAb assay, and may be a viable alternative to assist in monitoring population-based seroprevalence and vaccine antibody response.
AB - Oral fluid (hereafter saliva) offers a non-invasive sampling method for detection of SARS-CoV-2 antibodies. However, data comparing performance of salivary tests against commercially-available serologic and neutralizing antibody (nAb) assays are lacking. This study compared the performance of a laboratory-developed multiplex salivary SARS-CoV-2 IgG assay targeting antibodies to nucleocapsid (N), receptor binding domain (RBD) and spike (S) antigens to three commercially-available SARS-CoV-2 serologic enzyme immunoassays (EIAs) (Ortho Vitros, Euroimmun, and BioRad) and nAb. Paired saliva and plasma samples were collected from 101 eligible COVID-19 convalescent plasma (CCP) donors >14 days since PCR+ confirmed diagnosis. Concordance was evaluated using positive (PPA) and negative (NPA) percent agreement, and Cohen's kappa coefficient. The range between salivary and plasma EIAs for SARS-CoV-2-specific N was PPA: 54.4–92.1% and NPA: 69.2–91.7%, for RBD was PPA: 89.9–100% and NPA: 50.0–84.6%, and for S was PPA: 50.6–96.6% and NPA: 50.0–100%. Compared to a plasma nAb assay, the multiplex salivary assay PPA ranged from 62.3% (N) and 98.6% (RBD) and NPA ranged from 18.8% (RBD) to 96.9% (S). Combinations of N, RBD, and S and a summary algorithmic index of all three (N/RBD/S) in saliva produced ranges of PPA: 87.6–98.9% and NPA: 50–91.7% with the three EIAs and ranges of PPA: 88.4–98.6% and NPA: 21.9–34.4% with the nAb assay. A multiplex salivary SARS-CoV-2 IgG assay demonstrated variable, but comparable performance to three commercially-available plasma EIAs and a nAb assay, and may be a viable alternative to assist in monitoring population-based seroprevalence and vaccine antibody response.
KW - COVID-19
KW - Multiplex immunoassay
KW - Neutralizing antibody
KW - SARS-CoV-2
KW - Saliva
KW - Serologic assays
UR - http://www.scopus.com/inward/record.url?scp=85117591115&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85117591115&partnerID=8YFLogxK
U2 - 10.1016/j.jcv.2021.104997
DO - 10.1016/j.jcv.2021.104997
M3 - Article
C2 - 34695724
AN - SCOPUS:85117591115
SN - 1386-6532
VL - 145
JO - Journal of Clinical Virology
JF - Journal of Clinical Virology
M1 - 104997
ER -