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两种严重急性呼吸综合征冠状病毒2血清学检测方法在疟疾流行地区的交叉反应性

Cross-Reactivity of Two SARS-CoV-2 Serological Assays in a Setting Where Malaria Is Endemic.

作者信息

Steinhardt Laura C, Ige Fehintola, Iriemenam Nnaemeka C, Greby Stacie M, Hamada Yohhei, Uwandu Mabel, Aniedobe Maureen, Stafford Kristen A, Abimiku Alash'le, Mba Nwando, Agala Ndidi, Okunoye Olumide, Mpamugo Augustine, Swaminathan Mahesh, Onokevbagbe Edewede, Olaleye Temitope, Odoh Ifeanyichukwu, Marston Barbara J, Okoye McPaul, Abubakar Ibrahim, Rangaka Molebogeng X, Rogier Eric, Audu Rosemary

机构信息

Malaria Branch, Division of Malaria and Parasitic Diseases, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Center for Human Virology and Genomics, Microbiology Department, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria.

出版信息

J Clin Microbiol. 2021 Jun 18;59(7):e0051421. doi: 10.1128/JCM.00514-21.

Abstract

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 areas where malaria is endemic. We tested 213 well-characterized prepandemic 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. 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- IgG levels were significantly higher among false positives for both Abbott and Euroimmun; no association was found with active Plasmodium falciparum infection. An avidity assay using various concentrations of urea wash in the Euroimmun assay reduced loosely bound IgG: of 37 positive/borderline prepandemic samples, 46%, 86%, 89%, and 97% became negative using 2 M, 4 M, 5 M, and 8 M 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 8 M. This validation found moderate to substantial cross-reactivity on two SARS-CoV-2 serological assays using samples from a setting where malaria is endemic. A simple urea wash appeared to alleviate issues of cross-reactivity.

摘要

准确的严重急性呼吸综合征冠状病毒2(SARS-CoV-2)血清学检测对于新型冠状病毒肺炎(COVID-19)血清学监测至关重要。然而,先前的研究表明这些检测可能存在交叉反应,包括在疟疾流行地区。我们使用两种针对SARS-CoV-2核衣壳蛋白的SARS-CoV-2血清学检测方法,即雅培Architect IgG检测和欧蒙NCP IgG检测,对来自尼日利亚的213份特征明确的疫情前样本进行了检测。为了评估抗体结合强度,对这些样本以及SARS-CoV-2聚合酶链反应(PCR)阳性者的血浆进行了亲和力检测。在雅培检测中检测的212份样本中有13份(6.1%)呈阳性,在欧蒙检测中检测的213份样本中有38份(17.8%)呈阳性。雅培和欧蒙检测的假阳性样本中的抗IgG水平均显著更高;未发现与恶性疟原虫现症感染有关联。在欧蒙检测中使用不同浓度尿素洗涤的亲和力检测减少了松散结合的IgG:在37份阳性/临界疫情前样本中,分别使用2M、4M、5M和8M尿素洗涤后,46%、86%、89%和97%的样本变为阴性。这种洗涤略微降低了PCR确诊后28天内SARS-CoV-2患者抗体的亲和力;此后,除8M外,所有尿素浓度下的亲和力均增加。这项验证发现,在使用疟疾流行地区的样本进行的两种SARS-CoV-2血清学检测中存在中度至显著的交叉反应。一种简单的尿素洗涤似乎缓解了交叉反应问题。

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