To
tackle the COVID-19 outbreak, which is caused by severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2), there is an unmet
need for highly accurate diagnostic tests at all stages of infection
with rapid results and high specificity. Here, we present a label-free
nanoplasmonic biosensor-based, multiplex screening test for COVID-19
that can quantitatively detect 10 different biomarkers (6 viral nucleic
acid genes, 2 spike protein subunits, and 2 antibodies) with a limit
of detection in the aM range, all within one biosensor platform. Our
newly developed nanoplasmonic biosensors demonstrate high specificity,
which is of the upmost importance to avoid false responses. As a proof
of concept, we show that our detection approach has the potential
to quantify both IgG and IgM antibodies directly from COVID-19-positive
patient plasma samples in a single instrument run, demonstrating the
high-throughput capability of our detection approach. Most importantly,
our assay provides receiving operating characteristics, areas under
the curve of 0.997 and 0.999 for IgG and IgM, respectively. The calculated
p
-value determined through the Mann–Whitney nonparametric
test is <0.0001 for both antibodies when the test of COVID-19-positive
patients (
n
= 80) is compared with that of healthy
individuals (
n
= 72). Additionally, the screening
test provides a calculated sensitivity (true positive rate) of 100%
(80/80), a specificity (true negative rate) >96% (77/80), a positive
predictive value of 98% at 5% prevalence, and a negative predictive
value of 100% at 5% prevalence. We believe that our very sensitive,
multiplex, high-throughput testing approach has potential applications
in COVID-19 diagnostics, particularly in determining virus progression
and infection severity for clinicians for an appropriate treatment,
and will also prove to be a very effective diagnostic test when applied
to diseases beyond the COVID-19 pandemic.