Public knowledge of SARS-CoV-2 serological and viral lineage laboratory testing and result interpretation: A GENCOV study cross-sectional survey

Gregory Morgan; Laurent Briollais; Marc Clausen; Selina Casalino; Chloe Mighton; Sunakshi Chowdhary; Erika Frangione; Chun Yiu Jordan Fung; Saranya Arnoldo; Erin Bearss; Alexandra Binnie; Bjug Borgundvaag; Marc Dagher; Luke Devine; Steven M Friedman; Zeeshan Khan; Allison McGeer; Shelley L McLeod; David Richardson; Seth Stern; Ahmed Taher; Iris Wong; Natasha Zarei; Yvonne Bombard; Jordan Lerner-Ellis; Jennifer Taher

doi:10.1016/j.clinbiochem.2023.110607

Public knowledge of SARS-CoV-2 serological and viral lineage laboratory testing and result interpretation: A GENCOV study cross-sectional survey

Clin Biochem. 2023 Aug:118:110607. doi: 10.1016/j.clinbiochem.2023.110607. Epub 2023 Jul 4.

Authors

Gregory Morgan¹, Laurent Briollais², Marc Clausen³, Selina Casalino⁴, Chloe Mighton⁵, Sunakshi Chowdhary⁴, Erika Frangione⁴, Chun Yiu Jordan Fung⁴, Saranya Arnoldo⁶, Erin Bearss⁷, Alexandra Binnie⁸, Bjug Borgundvaag⁹, Marc Dagher¹⁰, Luke Devine¹¹, Steven M Friedman¹², Zeeshan Khan¹³, Allison McGeer¹⁴, Shelley L McLeod¹⁵, David Richardson⁸, Seth Stern¹³, Ahmed Taher¹⁶, Iris Wong¹³, Natasha Zarei¹³, Yvonne Bombard⁵, Jordan Lerner-Ellis¹, Jennifer Taher¹⁷

Affiliations

¹ Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada; Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.
² Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada.
³ Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
⁴ Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada; Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada.
⁵ Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
⁶ Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada; William Osler Health System, Brampton, ON, Canada.
⁷ Mount Sinai Academic Family Health Team, Mount Sinai Hospital, Toronto, ON, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.
⁸ William Osler Health System, Brampton, ON, Canada.
⁹ Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada; Department of Emergency Medicine, Mount Sinai Hospital, Toronto, ON, Canada.
¹⁰ Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada; Women's College Hospital, Toronto, ON, Canada.
¹¹ Division of General Internal Medicine, Mount Sinai Hospital, Toronto, ON, Canada; Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
¹² Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada; Emergency Medicine, University Health Network, Toronto, ON, Canada.
¹³ Mackenzie Health, Richmond Hill, ON, Canada.
¹⁴ Department of Microbiology, Mount Sinai Hospital, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
¹⁵ Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada; Schwartz/Reisman Emergency Medicine Institute, Sinai Health System, Toronto, ON, Canada.
¹⁶ Mackenzie Health, Richmond Hill, ON, Canada; Division of Emergency Medicine, University of Toronto, Toronto, ON, Canada.
¹⁷ Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada. Electronic address: Jennifer.Taher@sinaihealth.ca.

PMID: 37406717
DOI: 10.1016/j.clinbiochem.2023.110607

Abstract

Objectives: Concepts related to SARS-CoV-2 laboratory testing and result interpretation can be challenging to understand. A cross-sectional survey of COVID-19 positive adults residing in Ontario, Canada was conducted to explore how well people understand SARS-CoV-2 laboratory tests and their associated results.

Design and methods: Participants were recruited through fliers or by prospective recruitment of outpatients and hospitalized inpatients with COVID-19. Enrolled participants included consenting adults with a positive SARS-CoV-2 polymerase chain reaction test result. An 11-item questionnaire was developed by researchers, nurses, and physicians in the study team and was administered online between April 2021 to May 2022 upon enrolment into the study.

Results: Responses were obtained from 940 of 1106 eligible participants (85% participation rate). Most respondents understood 1) that antibody results should not influence adherence to social distancing measures (n = 602/888, 68%), 2) asymptomatic SARS-CoV-2 infection following test positivity (n = 698/888, 79%), 3) serological test sensitivity in relation to post-infection timeline (n = 540/891, 61%), and 4) limitations of experts' knowledge related to SARS-CoV-2 serology (n = 693/887, 78%). Conversely, respondents demonstrated challenges understanding 1) conflicting molecular and serological test results and their relationship with immune protection (n = 162/893, 18%) and 2) the impact of SARS-CoV-2 variants on vaccine effectiveness (n = 235/891, 26%). Analysis of responses stratified by sociodemographic variables identified that respondents who were either: 1) female, 2) more educated, 3) aged 18-44, 4) from a high-income household, or 5) healthcare workers responded expectedly more often.

Conclusions: We have highlighted concepts related to SARS-CoV-2 laboratory tests and associated results which may be challenging to understand. The findings of this study enable us to identify 1) misconceptions related to various SARS-CoV-2 test results, 2) groups of individuals at risk, and 3) strategies to improve people's understanding of their test results.

Keywords: COVID-19; Result interpretation; Serological testing; Viral lineage.

MeSH terms

Adult
COVID-19 Testing
COVID-19* / diagnosis
COVID-19* / epidemiology
Cross-Sectional Studies
Female
Humans
Prospective Studies
SARS-CoV-2*

Supplementary concepts

SARS-CoV-2 variants