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Publication Detail
Cross-Reactivity of Two SARS-CoV-2 Serological Assays in a Setting Where Malaria Is Endemic
  • Publication Type:
    Journal article
  • Publication Sub Type:
  • Authors:
    Steinhardt LC, Ige F, Iriemenam NC, Greby SM, Hamada Y, Uwandu M, Aniedobe M, Stafford KA, Abimiku A, Mba N, Agala N, Okunoye O, Mpamugo A, Swaminathan M, Onokevbagbe E, Olaleye T, Odoh I, Marston BJ, Okoye M, Abubakar I, Rangaka MX, Rogier E, Audu R
  • Publisher:
    American Society for Microbiology
  • Publication date:
  • Journal:
    Journal of Clinical Microbiology
  • Status:
  • Country:
    United States
  • Print ISSN:
  • PII:
  • Language:
Background: Accurate SARS-CoV-2 serological assays are critical for COVID-19 serosurveillance. However, previous studies have indicated possible cross-reactivity of these assays, including in malaria-endemic areas.Methods: We tested 213 well-characterized pre-pandemic samples from Nigeria using two SARS-CoV-2 serological assays: Abbott Architect IgG and Euroimmun NCP IgG assay, both targeting SARS-CoV-2 nucleocapsid protein. To assess antibody binding strength, an avidity assay was performed on these samples and on plasma from SARS-CoV-2 PCR-positive persons.Results: Thirteen (6.1%) of 212 samples run on the Abbott assay and 38 (17.8%) of 213 run on the Euroimmun assay were positive. Anti-Plasmodium IgG levels were significantly higher among false-positives for both Abbott and Euroimmun; no association was found with active P. falciparum infection. An avidity assay using various concentratIons of urea wash in the Euroimmun assay reduced loosely-bound IgG: of 37 positive/borderline pre-pandemic samples, 46%, 86%, 89%, and 97% became negative using 2M, 4M, 5M, and 8M urea washes, respectively. The wash slightly reduced avidity of antibodies from SARS-CoV-2 patients within 28 days of PCR confirmation; thereafter avidity increased for all urea concentrations except 8M.Conclusions: This validation found moderate to substantial cross-reactivity on two SARS-CoV-2 serological assays using samples from a malaria-endemic setting. A simple urea wash appeared to alleviate issues of cross-reactivity.
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