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SARS-CoV-2 Serology Testing in an Asymptomatic, At-Risk Population: Methods, Results, Pitfalls
Theodore Heyming1,2, Kellie Bacon1, Bryan Lara1
1Children's Hospital of Orange County, Orange, CA 92868, USA.
Insights
This study found a low seroprevalence of 0.35% for SARS-CoV-2 antibodies in pediatric healthcare workers. Antibody test discrepancies suggest the rapid Wytcote kit is unreliable for screening.
Area of Science:
- Infectious Diseases
- Epidemiology
- Immunology
Background:
- The COVID-19 pandemic necessitated understanding SARS-CoV-2 transmission, especially in healthcare settings.
- Pediatric healthcare workers (HCWs) are crucial for maintaining child health services.
- Assessing antibody seroprevalence in HCWs informs infection control and public health strategies.
Purpose of the Study:
- To determine the seroprevalence of SARS-CoV-2 antibodies among pediatric HCWs.
- To evaluate the performance of different antibody detection kits.
- To assess the feasibility of using serologic testing for epidemiologic surveillance.
Main Methods:
- Conducted a seroprevalence study from May 14 to July 13, 2020, involving pediatric HCWs.
- Utilized Wytcote Superbio SARS-CoV-2 IgM/IgG Antibody Fast Detection Kit and Abbott Architect SARS-CoV-2 IgG assay.
- Performed RT-PCR and respiratory panel PCR for confirmation of active or recent infections.
Main Results:
- A low seroprevalence of 0.35% for SARS-CoV-2 antibodies was observed.
- The Wytcote rapid kit indicated 19.7% positive serology, while the Abbott assay showed only one positive IgG result.
- Only two participants tested positive for SARS-CoV-2 via RT-PCR.
Conclusions:
- Significant discordance between antibody tests raises concerns about the Wytcote rapid kit's reliability for screening.
- The study highlights the low SARS-CoV-2 seroprevalence in this pediatric HCW population during the specified period.
- The methodology demonstrated potential for future epidemiologic surveillance of infectious diseases.
Abstract:
The primary aim of this study was to determine the seroprevalence of SARS-CoV-2 antibodies in a population of pediatric healthcare workers (HCWs). This study was conducted 14 May-13 July 2020. Study participants included pediatric HCWs at a pediatric hospital with either direct patient contact or close proximity to patient-care areas. SARS-CoV-2 antibodies were assessed via the Wytcote Superbio SARS-CoV-2 IgM/IgG Antibody Fast Detection Kit and the Abbott Architect SARS-CoV-2 IgG assay. Participants underwent RT-PCR testing upon entry to the study and following rapid IgM+/IgG+ results; respiratory panel PCR (RP-PCR) was performed following IgM+ results. A total of 57 of 289 (19.7%) of participants demonstrated positive serology as assessed by the Wytcote rapid kit (12 on Day 1 and 45 throughout the study). However, only one of these participants demonstrated IgG+ serology via the Abbott assay. Two participants tested SARS-CoV-2+ via RT-PCR testing. One individual was adenovirus+ and enterovirus/rhinovirus+. In our study population, we observed a seroprevalence of SARS-CoV-2 antibodies of 0.35%. The lack of concordance between antibody tests suggests that the Wytcote rapid test kit may not be of use as a screening tool. However, the feasibility of the overall process indicates that a similar methodology may have potential for future epidemiologic surveillance.
