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Fotis, Christos; Meimetis, Nikolaos; Tsolakos, Nikos; Politou, Marianna; Akinosoglou, Karolina; Pliaka, Vaia; Minia, Angeliki; Terpos, Evangelos; Trougakos, Ioannis P; Mentis, Andreas; Marangos, Markos; Panayiotakopoulos, George; Dimopoulos, Meletios A; Gogos, Charalampos; Spyridonidis, Alexandros; Alexopoulos, Leonidas G
Scientific reports, 03/2021, Letnik: 11, Številka: 1Journal Article
There is a plethora of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) serological tests based either on nucleocapsid phosphoprotein (N), S1-subunit of spike glycoprotein (S1) or receptor binding domain (RBD). Although these single-antigen based tests demonstrate high clinical performance, there is growing evidence regarding their limitations in epidemiological serosurveys. To address this, we developed a Luminex-based multiplex immunoassay that detects total antibodies (IgG/IgM/IgA) against the N, S1 and RBD antigens and used it to compare antibody responses in 1225 blood donors across Greece. Seroprevalence based on single-antigen readouts was strongly influenced by both the antigen type and cut-off value and ranged widely 0.8% (95% CI 0.4-1.5%)-7.5% (95% CI 6.0-8.9%). A multi-antigen approach requiring partial agreement between RBD and N or S1 readouts (RBD&N|S1 rule) was less affected by cut-off selection, resulting in robust seroprevalence estimation 0.6% (95% CI 0.3-1.1%)-1.2% (95% CI 0.7-2.0%) and accurate identification of seroconverted individuals.
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