TY - JOUR
TI - Accurate SARS-CoV-2 seroprevalence surveys require robust multi-antigen assays
AU - Fotis, C.
AU - Meimetis, N.
AU - Tsolakos, N.
AU - Politou, M.
AU - Akinosoglou, K.
AU - Pliaka, V.
AU - Minia, A.
AU - Terpos, E.
AU - Trougakos, I.P.
AU - Mentis, A.
AU - Marangos, M.
AU - Panayiotakopoulos, G.
AU - Dimopoulos, M.A.
AU - Gogos, C.
AU - Spyridonidis, A.
AU - Alexopoulos, L.G.
JO - Scientific Reports
PY - 2021
VL - 11
TODO - 1
SP - null
PB - Institute of Geographic Sciences and Natural Resources Research
SN - 2045-2322
TODO - 10.1038/s41598-021-86035-2
TODO - antigen;  coronavirus spike glycoprotein;  immunoglobulin A;  immunoglobulin G;  immunoglobulin M;  nucleocapsid phosphoprotein, SARS-CoV-2;  phosphoprotein;  spike protein, SARS-CoV-2;  virus antibody, adolescent;  adult;  aged;  blood;  diagnosis;  female;  human;  immunoassay;  immunology;  isolation and purification;  male;  middle aged;  procedures;  sensitivity and specificity;  serology;  virology;  young adult, Adolescent;  Adult;  Aged;  Antibodies, Viral;  Antigens;  Coronavirus Nucleocapsid Proteins;  COVID-19;  Female;  Humans;  Immunoassay;  Immunoglobulin A;  Immunoglobulin G;  Immunoglobulin M;  Male;  Middle Aged;  Phosphoproteins;  SARS-CoV-2;  Sensitivity and Specificity;  Serologic Tests;  Spike Glycoprotein, Coronavirus;  Young Adult
TODO - There is a plethora of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) serological tests based either on nucleocapsid phosphoprotein (N), S1-subunit of spike glycoprotein (S1) or receptor binding domain (RBD). Although these single-antigen based tests demonstrate high clinical performance, there is growing evidence regarding their limitations in epidemiological serosurveys. To address this, we developed a Luminex-based multiplex immunoassay that detects total antibodies (IgG/IgM/IgA) against the N, S1 and RBD antigens and used it to compare antibody responses in 1225 blood donors across Greece. Seroprevalence based on single-antigen readouts was strongly influenced by both the antigen type and cut-off value and ranged widely [0.8% (95% CI 0.4–1.5%)–7.5% (95% CI 6.0–8.9%)]. A multi-antigen approach requiring partial agreement between RBD and N or S1 readouts (RBD&N|S1 rule) was less affected by cut-off selection, resulting in robust seroprevalence estimation [0.6% (95% CI 0.3–1.1%)–1.2% (95% CI 0.7–2.0%)] and accurate identification of seroconverted individuals. © 2021, The Author(s).
ER -