Performance of a Point of Care Test for Detecting IgM and IgG Antibodies Against SARS-CoV-2 and Seroprevalence in Blood Donors and Health Care Workers in Panama

• Main Authors: Alcibiades Villarreal, Giselle Rangel, Xu Zhang, Digna Wong, Gabrielle Britton, Patricia L. Fernandez, Ambar Pérez, Diana Oviedo, Carlos Restrepo, María B. Carreirra, Dilcia Sambrano, Gilberto A. Eskildsen, Carolina De La Guardia, Julio Flores-Cuadra, Jean-Paul Carrera, Yamitzel Zaldivar, Danilo Franco, Sandra López-Vergès, Dexi Zhang, Fangjing Fan, Baojun Wang, Xavier Sáez-Llorens, Rodrigo DeAntonio, Ivonne Torres-Atencio, Isabel Blanco, Fernando Diaz Subía, Laiss Mudarra, Aron Benzadon, Walter Valverde, Lineth López, Nicolás Hurtado, Neyla Rivas, Julio Jurado, Aixa Carvallo, Juan Rodriguez, Yaseikiry Perez, Johanna Morris, Odemaris Luque, David Cortez, Eduardo Ortega-Barria, Rao Kosagisharaf, Ricardo Lleonart, Chong Li, Amador Goodridge
• Format: Article
• Language: English
• Published: Frontiers Media S.A. 2021-03-01
• Series: Frontiers in Medicine
• Subjects: COVID-19; Panama; serology; biomarker; immunochromatographic assay; diagnosis
• Online Access: https://www.frontiersin.org/articles/10.3389/fmed.2021.616106/full

Novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the etiologic agent of the ongoing coronavirus disease 2019 (COVID-19) pandemic, which has reached 28 million cases worldwide in 1 year. The serological detection of antibodies against the virus will play a pivotal role in complementing molecular tests to improve diagnostic accuracy, contact tracing, vaccine efficacy testing, and seroprevalence surveillance. Here, we aimed first to evaluate a lateral flow assay's ability to identify specific IgM and IgG antibodies against SARS-CoV-2 and second, to report the seroprevalence estimates of these antibodies among health care workers and healthy volunteer blood donors in Panama. We recruited study participants between April 30th and July 7th, 2020. For the test validation and performance evaluation, we analyzed serum samples from participants with clinical symptoms and confirmed positive RT-PCR for SARS-CoV-2, and a set of pre-pandemic serum samples. We used two by two table analysis to determine the test positive and negative percentage agreement as well as the Kappa agreement value with a 95% confidence interval. Then, we used the lateral flow assay to determine seroprevalence among serum samples from COVID-19 patients, potentially exposed health care workers, and healthy volunteer donors. Our results show this assay reached a positive percent agreement of 97.2% (95% CI 84.2–100.0%) for detecting both IgM and IgG. The assay showed a Kappa of 0.898 (95%CI 0.811–0.985) and 0.918 (95% CI 0.839–0.997) for IgM and IgG, respectively. The evaluation of serum samples from hospitalized COVID-19 patients indicates a correlation between test sensitivity and the number of days since symptom onset; the highest positive percent agreement [87% (95% CI 67.0–96.3%)] was observed at ≥15 days post-symptom onset (PSO). We found an overall antibody seroprevalence of 11.6% (95% CI 8.5–15.8%) among both health care workers and healthy blood donors. Our findings suggest this lateral flow assay could contribute significantly to implementing seroprevalence testing in locations with active community transmission of SARS-CoV-2.