A quantitative assay for detection of SARS-CoV-2 neutralizing antibodies

J Clin Virol. 2022 Feb:147:105064. doi: 10.1016/j.jcv.2021.105064. Epub 2022 Jan 2.

Abstract

Objectives: Serological assays for SARS-CoV-2 have a critical role not only in diagnosis of COVID-19, but also in assessing the degree and duration of response of specific antibodies against the virus obtained through infection or vaccination. We present the results obtained with a competitive immunoenzymatic method (Chorus SARS-CoV-2 "Neutralizing" Ab) for quantitative determination of total neutralizing anti-S1 SARS-CoV-2 antibodies (IgG, IgM, and IgA) in human serum obtained on a disposable device with the Chorus TRIO instrument using a recombinant strong neutralizing antibody as tracer.

Methods: A total of 694 sera were evaluated for SARS-CoV-2 neutralizing antibodies: 407 uninfected, 201 symptomatic subjects, 37 post-infection patients, and 49 vaccinated. Sixty-eight of the previous sera were used to compare the Chorus SARS-CoV-2 "Neutralizing" Ab results with those obtained with micro-neutralization of the Alpha and original variants. A set of 74 positive sera for other respiratory infections were analyzed to evaluate the possible cross reaction to SARS-CoV-2 virus.

Results: Of the 694 samples, only 3 had discordant results between micro-neutralization and values measured by Chorus SARS-CoV-2 "Neutralizing" Ab: 1 false negative and 2 false positives. Values of sensitivity and specificity were very high: percent positive agreement (sensitivity) 99.6% (95% CI: 97.7 - 99.9) and percent negative agreement (specificity) 99.6% (95% CI: 98.0 -99.9). Concordance was high with a Gwet's Ac1 of 0.992. No significant differences were observed between the alpha and original variants.

Conclusions: The Chorus SARS-CoV-2 "Neutralizing" Ab test was highly sensitive and specific, and varies from most other currently available tests since it analyzes only antibodies with viral-neutralizing capacity.

Keywords: COVID-19; Diagnostic assay; Immunoassay; Neutralizing antibodies; SARS-CoV-2.

MeSH terms

  • Antibodies, Neutralizing
  • Antibodies, Viral
  • COVID-19 Serological Testing
  • COVID-19*
  • Humans
  • SARS-CoV-2*
  • Sensitivity and Specificity
  • Spike Glycoprotein, Coronavirus

Substances

  • Antibodies, Neutralizing
  • Antibodies, Viral
  • Spike Glycoprotein, Coronavirus