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J Appl Lab Med . Sensitive Serology Measurements in the Saliva of Individuals with COVID-19 Symptoms Using a Multiplexed Immunoassay

tetano

Editor, Senior Moderator
J Appl Lab Med


. 2022 Sep 30;jfac073.
doi: 10.1093/jalm/jfac073. Online ahead of print.
Sensitive Serology Measurements in the Saliva of Individuals with COVID-19 Symptoms Using a Multiplexed Immunoassay


Dorsa Sohaei[SUP] 1 2 [/SUP], Antigona Ulndreaj[SUP] 3 [/SUP], Anu Mathew[SUP] 4 [/SUP], Christopher Campbell[SUP] 4 [/SUP], Martin Stengelin[SUP] 4 [/SUP], George Sigal[SUP] 4 [/SUP], Jessica Joe[SUP] 4 [/SUP], Daniel Romero[SUP] 4 [/SUP], Nikhil Padmanabhan[SUP] 4 [/SUP], Annie Ren[SUP] 1 [/SUP], Atefeh Ghorbani[SUP] 1 3 [/SUP], Antoninus Soosaipillai[SUP] 5 [/SUP], Vathany Kulasingam[SUP] 1 2 [/SUP], Ioannis Prassas[SUP] 3 5 [/SUP], Eleftherios P Diamandis[SUP] 1 2 3 [/SUP]



Affiliations

Abstract

Background: There are numerous benefits to performing salivary serology measurements for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative pathogen for coronavirus disease 2019 (COVID-19). Here, we used a sensitive multiplex serology assay to quantitate salivary IgG against 4 SARS-CoV-2 antigens: nucleocapsid, receptor-binding domain, spike, and N-terminal domain.
Methods: We used single samples from 90 individuals with COVID-19 diagnosis collected at 0 to 42 days postsymptom onset (PSO) and from 15 uninfected control subjects. The infected individuals were segmented in 4 groups (0-7 days, 8-14 days, 15-21 days, and >21 days) based on days PSO, and values were compared to controls.
Results: Compared to controls, infected individuals showed higher levels of antibodies against all antigens starting from 8 days PSO. When applying cut-offs with at least 93.3% specificity at every time interval segment, nucleocapsid protein serology had the best sensitivity at 0 to 7 days PSO (60% sensitivity [35.75% to 80.18%], ROC area under the curve [AUC] = 0.73, P = 0.034). Receptor-binding domain serology had the best sensitivity at 8 to 14 days PSO (83.33% sensitivity [66.44%-92.66%], ROC AUC = 0.90, P < 0.0001), and all assays except for N-terminal domain had 92% sensitivity (75.03%-98.58%) at >14 days PSO.
Conclusions: This study shows that our multiplexed immunoassay can distinguish infected from uninfected individuals and reliably (93.3% specificity) detect seroconversion (in 60% of infected individuals) as early as the first week PSO, using easy-to-collect saliva samples.
 
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