Evaluation of eleven immunochromatographic assays for SARS-CoV-2 detection: investigating the dengue cross-reaction

Abstract

COVID-19 disease is spread worldwide and diagnostic techniques have been studied in order to contain the pandemic. Immunochromatographic (IC) assays are feasible and a low-cost alternative especially in low and middle-income countries, which lack structure to perform certain diagnostic techniques. Here we evaluate the sensitivity and specificity of eleven different IC tests in 145 serum samples from confirmed cases of COVID-19 using RT-PCR and 100 negative serum samples from blood donors collected in February 2019. We also evaluated the cross-reactivity with dengue using 20 serum samples from patients with confirmed diagnosis for dengue collected in early 2019 through four different tests. We found high sensitivity (92%), specificity (100%) and an almost perfect agreement (Kappa 0.92) of IC assay, especially when we evaluated IgG and IgM combined after 10 days from the onset of symptoms with RT-PCR. However, we detected cross-reactivity between dengue and COVID-19 mainly with IgM antibodies (5 to 20% of cross-reaction) and demonstrated the need for better studies about diagnostic techniques for these diseases.

Low Risk of Serological Cross-Reactivity between the Dengue Virus and SARS-CoV-2-IgG Antibodies Using Advanced Detection Assays

“…The assumption of cross-reaction between SARS-CoV-2 and DENV was reported in several studies. However, most of these studies have built this assumption based on the antigenic cross-reactivity using the LFA and a few based on ELISA results detecting NS1 antigens [9][10][11][12]. Therefore, we investigated the possible serological cross-reaction between SARS-CoV-2 and DENV us- ing more advanced serological assays, which are the CL-900i automated analyzer and the ELISA test.…”

“…Several other studies have reported serological crossreactivity of the immune responses between SARS-CoV-2 and DENV [2,9]. Most of the available studies are based on point-of-care rapid testing kits [11][12][13][14]. However, some rapid test kits have low specificity and can generate false positives [15].…”