Title Nucleoprotein-based ELISA for detection of SARS-COV-2 IgG antibodies: Could an old assay be suitable for serodiagnosis of the new coronavirus?
Author Tozetto-Mendoza, Tania Regina; Kanunfre, Kelly Aparecida; Vilas-Boas, Lucy Santos; Sanchez Espinoza, Evelyn Patricia; Paiao, Heuder Gustavo Oliveira; Rocha, Mussya Cisotto; de Paula, Anderson Vicente; de Oliveira, Maura Salaroli; Zampelli, Daniella Bosco; Vieira, Jose Mauro Jr; Buss, Lewis; Costa, Silvia Figueiredo; Sabino, Ester Cerdeira; Witkin, Steven S; Okay, Thelma Suely; Mendes-Correa, Maria Cassia
Journal J Virol Methods Publication Year/Month 2021-Apr
PMID 33453299 PMCID PMC7804377
Affiliation + expend 1.LIM-52, Institute of Tropical Medicine, School of Medicine, Clinical Hospital, University of Sao Paulo, Brazil. Electronic address: tozetto@usp.br.

OBJECTIVES: We evaluated the performance of a nucleoprotein-based enzyme-linked immunosorbent assay (ELISA) for detection of IgG antibodies to SARS-CoV-2. METHODS: The ELISA was based on serum IgG reactivity to a 46-kDa protein derived from the recombinant SARS-CoV2 nucleoprotein. Assay sensitivity was assessed using serum samples from 134 COVID-19 confirmed cases obtained > 15 days after symptom onset. Specificity was determined by testing sera from 94 healthy controls. Cross-reactivity was evaluated with sera from 96 individuals with previous dengue or zika virus-confirmed infections, with 44 sera from individuals with confirmed infections to other respiratory viruses or with bacterial and fungal infections that cause pneumonia and with 40 sera negative for SARS-CoV-2 nucleoprotein by commercial ELISA kits. RESULTS: The majority of subjects were male and >/= 60 years old. Assay sensitivity was 90.3 % (95 % confidence interval 84.1 %-94.2 %) and specificity was 97.9 % (92.6 %-99.4 %). There was no cross-reactivity with sera from individuals diagnosed with dengue, zika virus, influenza virus, rhinovirus, adenovirus, respiratory syncytial virus, seasonal coronavirus, Mycobacterium tuberculosis, Staphylococcus (S. aureus and coagulase-negative), Streptococcus pneumoniae, Klebsiella pneumoniae and the fungus Aspergillus fumigatus. The level of concordance of our test with results from commercial ELISA kits was 100 %. CONCLUSION: The nucleoprotein-based ELISA was specific for detection of IgG anti-nucleoprotein antibodies to SARS-CoV-2. It utilizes a frequently employed low expense assay protocol and is easier to perform than other currently available commercial SARS-CoV2 antibody detection tests.

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