Wellcome Open Research (Jun 2020)
Antibody testing for COVID-19: A report from the National COVID Scientific Advisory Panel [version 1; peer review: 2 approved]
- Emily R. Adams,
- Mark Ainsworth,
- Rekha Anand,
- Monique I. Andersson,
- Kathryn Auckland,
- J. Kenneth Baillie,
- Eleanor Barnes,
- Sally Beer,
- John I. Bell,
- Tamsin Berry,
- Sagida Bibi,
- Miles Carroll,
- Senthil K. Chinnakannan,
- Elizabeth Clutterbuck,
- Richard J. Cornall,
- Derrick W. Crook,
- Thushan de Silva,
- Wanwisa Dejnirattisai,
- Kate E. Dingle,
- Christina Dold,
- Alexis Espinosa,
- David W. Eyre,
- Helen Farmer,
- Maria Fernandez Mendoza,
- Dominique Georgiou,
- Sarah J. Hoosdally,
- Alastair Hunter,
- Katie Jefferey,
- Dominic F. Kelly,
- Paul Klenerman,
- Julian Knight,
- Clarice Knowles,
- Andrew J. Kwok,
- Ullrich Leuschner,
- Robert Levin,
- Chang Liu,
- César López-Camacho,
- Jose Martinez,
- Philippa C. Matthews,
- Hannah McGivern,
- Alexander J. Mentzer,
- Jonathan Milton,
- Juthathip Mongkolsapaya,
- Shona C. Moore,
- Marta S. Oliveira,
- Fiona Pereira,
- Elena Perez,
- Timothy Peto,
- Rutger J. Ploeg,
- Andrew Pollard,
- Tessa Prince,
- David J. Roberts,
- Justine K. Rudkin,
- Veronica Sanchez,
- Gavin R. Screaton,
- Malcolm G. Semple,
- Jose Slon-Campos,
- Donal T. Skelly,
- Elliot Nathan Smith,
- Alberto Sobrinodiaz,
- Julie Staves,
- David I. Stuart,
- Piyada Supasa,
- Tomas Surik,
- Hannah Thraves,
- Pat Tsang,
- Lance Turtle,
- A. Sarah Walker,
- Beibei Wang,
- Charlotte Washington,
- Nicholas Watkins,
- James Whitehouse,
- National COVID Testing Scientific Advisory Panel
Affiliations
- Emily R. Adams
- Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
- Mark Ainsworth
- Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
- Rekha Anand
- NHS Blood and Transplant Birmingham, Vincent Drive, Birmingham, B15 2SG, UK
- Monique I. Andersson
- Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
- Kathryn Auckland
- Nuffield Department of Medicine and NIHR Oxford Biomedical Research Centre,, University of Oxford, Oxford, OX3 9DU, UK
- J. Kenneth Baillie
- Roslin Institute, University of Edinburgh, Edinburgh, EH25 9RJ, UK
- Eleanor Barnes
- Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
- Sally Beer
- Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
- John I. Bell
- Nuffield Department of Medicine and NIHR Oxford Biomedical Research Centre,, University of Oxford, Oxford, OX3 9DU, UK
- Tamsin Berry
- Department of Health and Social Care, UK Government, London, UK
- Sagida Bibi
- Department of Paediatrics, Oxford Vaccine Group, University of Oxford, Oxford, OX3 7LE, UK
- Miles Carroll
- Nuffield Department of Medicine and NIHR Oxford Biomedical Research Centre,, University of Oxford, Oxford, OX3 9DU, UK
- Senthil K. Chinnakannan
- Nuffield Department of Medicine and NIHR Oxford Biomedical Research Centre,, University of Oxford, Oxford, OX3 9DU, UK
- Elizabeth Clutterbuck
- Department of Paediatrics, Oxford Vaccine Group, University of Oxford, Oxford, OX3 7LE, UK
- Richard J. Cornall
- Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
- Derrick W. Crook
- Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
- Thushan de Silva
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2RX, UK
- Wanwisa Dejnirattisai
- Nuffield Department of Medicine and NIHR Oxford Biomedical Research Centre,, University of Oxford, Oxford, OX3 9DU, UK
- Kate E. Dingle
- Nuffield Department of Medicine and NIHR Oxford Biomedical Research Centre,, University of Oxford, Oxford, OX3 9DU, UK
- Christina Dold
- Department of Paediatrics, Oxford Vaccine Group, University of Oxford, Oxford, OX3 7LE, UK
- Alexis Espinosa
- Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
- David W. Eyre
- Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
- Helen Farmer
- Department of Health and Social Care, UK Government, London, UK
- Maria Fernandez Mendoza
- Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
- Dominique Georgiou
- Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
- Sarah J. Hoosdally
- Nuffield Department of Medicine and NIHR Oxford Biomedical Research Centre,, University of Oxford, Oxford, OX3 9DU, UK
- Alastair Hunter
- NHS Blood and Transplant Basildon, Burnt Mills Industrial Estate, Basildon, SS13 1FH, UK
- Katie Jefferey
- Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
- Dominic F. Kelly
- Department of Paediatrics, Oxford Vaccine Group, University of Oxford, Oxford, OX3 7LE, UK
- Paul Klenerman
- Nuffield Department of Medicine and NIHR Oxford Biomedical Research Centre,, University of Oxford, Oxford, OX3 9DU, UK
- Julian Knight
- Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
- Clarice Knowles
- Department of Health and Social Care, UK Government, London, UK
- Andrew J. Kwok
- Nuffield Department of Medicine and NIHR Oxford Biomedical Research Centre,, University of Oxford, Oxford, OX3 9DU, UK
- Ullrich Leuschner
- NHS Blood and Transplant Oxford, John Radcliffe Hospital, Oxford, UK
- Robert Levin
- Worthing Hospital, Worthing, BN11 2DH, UK
- Chang Liu
- Nuffield Department of Medicine and NIHR Oxford Biomedical Research Centre,, University of Oxford, Oxford, OX3 9DU, UK
- César López-Camacho
- Nuffield Department of Medicine and NIHR Oxford Biomedical Research Centre,, University of Oxford, Oxford, OX3 9DU, UK
- Jose Martinez
- Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
- Philippa C. Matthews
- Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
- Hannah McGivern
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, OX3 9DU, UK
- Alexander J. Mentzer
- Nuffield Department of Medicine and NIHR Oxford Biomedical Research Centre,, University of Oxford, Oxford, OX3 9DU, UK
- Jonathan Milton
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, OX3 9DU, UK
- Juthathip Mongkolsapaya
- Nuffield Department of Medicine and NIHR Oxford Biomedical Research Centre,, University of Oxford, Oxford, OX3 9DU, UK
- Shona C. Moore
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
- Marta S. Oliveira
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, OX3 9DU, UK
- Fiona Pereira
- Imperial College London, London, SW7 2AZ, UK
- Elena Perez
- Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
- Timothy Peto
- Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
- Rutger J. Ploeg
- Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
- Andrew Pollard
- Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
- Tessa Prince
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
- David J. Roberts
- NHS Blood and Transplant Oxford, John Radcliffe Hospital, Oxford, UK
- Justine K. Rudkin
- Nuffield Department of Medicine and NIHR Oxford Biomedical Research Centre,, University of Oxford, Oxford, OX3 9DU, UK
- Veronica Sanchez
- Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
- Gavin R. Screaton
- Nuffield Department of Medicine and NIHR Oxford Biomedical Research Centre,, University of Oxford, Oxford, OX3 9DU, UK
- Malcolm G. Semple
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
- Jose Slon-Campos
- Nuffield Department of Medicine and NIHR Oxford Biomedical Research Centre,, University of Oxford, Oxford, OX3 9DU, UK
- Donal T. Skelly
- Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
- Elliot Nathan Smith
- Department of Health and Social Care, UK Government, London, UK
- Alberto Sobrinodiaz
- Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
- Julie Staves
- Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
- David I. Stuart
- Nuffield Department of Medicine and NIHR Oxford Biomedical Research Centre,, University of Oxford, Oxford, OX3 9DU, UK
- Piyada Supasa
- Nuffield Department of Medicine and NIHR Oxford Biomedical Research Centre,, University of Oxford, Oxford, OX3 9DU, UK
- Tomas Surik
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, OX3 9DU, UK
- Hannah Thraves
- Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
- Pat Tsang
- NHS Blood and Transplant Oxford, John Radcliffe Hospital, Oxford, UK
- Lance Turtle
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
- A. Sarah Walker
- Nuffield Department of Medicine and NIHR Oxford Biomedical Research Centre,, University of Oxford, Oxford, OX3 9DU, UK
- Beibei Wang
- Nuffield Department of Medicine and NIHR Oxford Biomedical Research Centre,, University of Oxford, Oxford, OX3 9DU, UK
- Charlotte Washington
- NHS Blood and Transplant Birmingham, Vincent Drive, Birmingham, B15 2SG, UK
- Nicholas Watkins
- NHS Blood and Transplant Cambridge, Long Road, Cambridge, CB2 0PT, UK
- James Whitehouse
- Department of Health and Social Care, UK Government, London, UK
- National COVID Testing Scientific Advisory Panel
- DOI
- https://doi.org/10.12688/wellcomeopenres.15927.1
- Journal volume & issue
-
Vol. 5
Abstract
Background: The COVID-19 pandemic caused >1 million infections during January-March 2020. There is an urgent need for reliable antibody detection approaches to support diagnosis, vaccine development, safe release of individuals from quarantine, and population lock-down exit strategies. We set out to evaluate the performance of ELISA and lateral flow immunoassay (LFIA) devices. Methods: We tested plasma for COVID (severe acute respiratory syndrome coronavirus 2; SARS-CoV-2) IgM and IgG antibodies by ELISA and using nine different LFIA devices. We used a panel of plasma samples from individuals who have had confirmed COVID infection based on a PCR result (n=40), and pre-pandemic negative control samples banked in the UK prior to December-2019 (n=142). Results: ELISA detected IgM or IgG in 34/40 individuals with a confirmed history of COVID infection (sensitivity 85%, 95%CI 70-94%), vs. 0/50 pre-pandemic controls (specificity 100% [95%CI 93-100%]). IgG levels were detected in 31/31 COVID-positive individuals tested ≥10 days after symptom onset (sensitivity 100%, 95%CI 89-100%). IgG titres rose during the 3 weeks post symptom onset and began to fall by 8 weeks, but remained above the detection threshold. Point estimates for the sensitivity of LFIA devices ranged from 55-70% versus RT-PCR and 65-85% versus ELISA, with specificity 95-100% and 93-100% respectively. Within the limits of the study size, the performance of most LFIA devices was similar. Conclusions: Currently available commercial LFIA devices do not perform sufficiently well for individual patient applications. However, ELISA can be calibrated to be specific for detecting and quantifying SARS-CoV-2 IgM and IgG and is highly sensitive for IgG from 10 days following first symptoms.
