Open AccessEarly detection of neutralizing antibodies against SARS-CoV-2 in COVID-19 patients in Thailand
Author(s) -
Opass Putcharoen,
Supaporn Wacharapluesadee,
Wan Ni Chia,
Leilani Paitoonpong,
Chee Wah Tan,
Gompol Suwanpimolkul,
Watsamon Jantarabenjakul,
Chanida Ruchisrisarod,
Phanni Wanthong,
Jiratchaya Sophonphan,
Pajaree Chariyavilaskul,
LinFa Wang,
Thiravat Hemachudha
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0246864
Subject(s) - interquartile range , medicine , antibody , covid-19 , confidence interval , neutralization , gastroenterology , immunology , neutralizing antibody , virology , infectious disease (medical specialty) , disease
Background The presence of neutralizing antibodies (NAbs) is an indicator of protective immunity for most viral infections. A newly developed surrogate viral neutralization assay (sVNT) offers the ability to detect total receptor binding domain-targeting NAbs in an isotype-independent manner, increasing the test sensitivity. Thus, specimens with low IgM/ IgG antibody levels showed strong neutralization activity in sVNT. Methods This study aimed to measure the %inhibition of NAbs measured by sVNT in PCR-confirmed COVID-19 patients. The sensitivity of sVNT for the diagnosis of SARS-CoV-2 infection and its kinetics were determined. Results Ninety-seven patients with PCR-confirmed SARS-CoV-2 infection were included in this study. Majority of the patients were 21–40 years old (67%) and 63% had mild symptoms. The sensitivity of sVNT for the diagnosis of SARS-CoV-2 infection was 99% (95% confidence interval (CI) 94.4–100%) and the specificity was 100% (95% CI 98.3–100%). The negative predictive value of sVNT from the samples collected before and after 7 days of symptom onset was 99.5% (95% CI 97.4–100%) and 100% (95% CI 93.8–100%), respectively. The level of inhibition at days 8–14 were significantly higher than days 0–7 (p<0.001). The median %inhibition values by severity of COVID-19 symptoms were 79.9% (interquartile range (IQR) 49.7–91.8%); 89.0% (IQR 71.2–92.4%); and 86.6% (IQR 69.5–92.8%), for mild, moderate and severe/critical symptoms respectively. The median level of sVNT %inhibition of severe was significantly higher than the mild group (p = 0.05). Conclusion The sVNT is a practical and robust serological test for SARS-CoV-2 infection and does not require specialized biosafety containment. It can be used clinically to aid diagnosis in both early and late infection especially in cases when the real-time RT-PCR results in weakly negative or weakly positive, and to determine the protective immune response from SARS-CoV-2 infection in patients.