EVALUATION OF ELEVEN IMMUNOCHROMATOGRAPHIC ASSAYS FOR SARS-CoV-2 DETECTION: INVESTIGATING DENGUE CROSS-REACTION

Abstract

Background: COVID-19 disease (Coronavirus disease 2019) caused by SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2) is widespread worldwide, affecting more than 11 million people globally (July 6th, 2020). Diagnostic techniques have been studied in order to contain the pandemic. Immunochromatographic (IC) assays are feasible and low cost alternative for monitoring the spread of COVID-19 in the population. Methods: Here we evaluate the sensitivity and specificity of eleven different immunochromatografic tests in 98 serum samples from confirmed cases of COVID-19 through RT-PCR and 100 negative serum samples from blood donors collected in February 2019. Considering the endemic situation of Dengue in Brazil, 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. Results: Our results demonstrated agreement between immunochromatographic assays and RT-PCR, especially after 10 days since the onset of symptoms. The evaluation of IgG and IgM antibodies combined demonstrated a strong level of agreement (0.85) of IC assays and RT-PCR. It was observed cross-reactivity between Dengue and COVID-19 using four different IC assays for COVID-19 diagnosis. The specificity of IC assays to detected COVID-19 IgM antibodies using Dengue serum samples varied from 80% to 85%; the specificity of IgG detection was 100% and total antibody was 95%. Conclusions: We found high sensitivity, specificity and good agreement of IC assays, especially after 10 days onset of symptoms. However, we detected cross-reactivity between Dengue and COVID-19 mainly with IgM antibodies demonstrating 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 using more advanced serological assays, which are the CL-900i automated analyzer and the ELISA test.…”

“…Several other studies have reported serological cross-reactivity 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 ].…”

Manifestações clínicas da coinfecção entre covid-19 e dengue em adultos: revisão integrativa

“…A evidência da coinfecção entre Dengue e COVID-19 foi apresentada nos estudos, com ocorrência de 38,4% a 44,6% dos casos de pessoas que contraíram a COVID-19 e desenvolveram a Dengue ou vice versa (14) . Referente à idade dos participantes foram: jovens 18 a 26 anos (16,20,24,26) , adultos jovens de 31 a 37 anos (15,17,21,(24)(25) , adultos de 41 a 57 anos (14,15,(23)(24)(25) , além de idosos de 60 a 80 anos (20,22,27,35) . A Covid-19 simulou resultados falso positivos de Dengue (23) em decorrência da janela sorológica e do processo de soro conversão, o que dificultou o diagnóstico clínico e o tratamento efetivo.…”

No evidence of significant cross-reactivity between the dengue virus (DENV) and SARS-CoV-2 IgG antibodies

“…There has been reported cases of cross-reaction between SARS-CoV-2 and DENV and available studies have analysed this relationship mostly on rapid tests and a few on ELISA (6-9). A study analysed 55 SARS-CoV-2 positive samples on lateral flow rapid test and ELISA for dengue specifics antibodies and 95 dengue positive pre-pandemic samples on ELISA for S protein of SARS-CoV-2.…”

“…There is a limited number of studies analysing the serological cross-reactivity between SARS-CoV-2 and DENV, most of the available studies are based on the POC rapid testing kits (6-9). However, some rapid test kits have low specificity and can generate false positives (10).…”