Efficient high-throughput SARS-CoV-2 testing to detect asymptomatic carriers

Shental, Noam; Levy, Shlomia; Wuvshet, Vered; Skorniakov, Shosh; Shalem, Bar; Ottolenghi, Aner; Greenshpan, Yariv; Steinberg, Rosalie; Edri, Avishay; Gillis, Roni; Goldhirsh, Michal; Moscovici, Khen; Sachren, Sinai; Friedman, Lilach M.; Nesher, Lior; Shemer‐Avni, Yonat; Porgador, Angel; Hertz, Tomer

doi:10.1126/sciadv.abc5961

Cited by 176 publications

(166 citation statements)

References 36 publications

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“…Nevertheless, it must be acknowledged that we recruited more than half of the resident population in only 4 days and identified 101 asymptomatic individuals, representing ∼0.7% of the assessed population, who may have spread the infection and may have possibly never been diagnosed. Also, only 5% of citizens had to undergo molecular testing, which shows that this strategy may be cost-effective during outbreaks, even compared with using RT-PCR on pooled samples [ 21 , 22 ], with the additional advantage of providing seroprevalence data. Seropositive patients may also be tested using more sensitive techniques, such as droplet digital PCR [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Seroprevalence of SARS-CoV-2-specific Antibodies in the Town of Ariano Irpino (Avellino, Campania, Italy): a population-based Study

et al. 2021

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The Italian municipality of Ariano Irpino (Avellino, Campania, Italy) was locked down by the regional authorities from March until April 2020 after several citizens tested positive for SARS coronavirus 2 (SARS-CoV-2). A serological mass screening campaign targeting the Ariano Irpino population using the Roche Cobas Elecsys anti-SARS-CoV-2 assay was organized by the Zoo-Prophylactic Institute of Southern Italy (Portici, Italy) and conducted in cooperation with the Local Health Unit (Azienda Sanitaria Locale – ASL – Avellino, Avellino, Italy), the Department of Public Health of University Federico II (Naples, Italy) and Department of Health Services of Azienda Ospedaliera dei Colli-Cotugno and Monaldi Hospital (Naples, Italy) in May 2020. A total of 13,218 asymptomatic individuals were reviewed in this analysis. A total of 738 citizens tested positive for anti-SARS-CoV-2 antibodies (398 females, 340 males). The overall prevalence in the sample was 5.6% (95% CI: 5.2–6.0). Among seropositive citizens, 101 cases tested positive on RT-PCR (0.76% of the overall population). Among citizens aged 14–18, 18–65 and >65 years, the seroprevalence was equal to 6.1 (95% CI: 4.1–8.7), 5.6 (95% CI: 5.1–6.1) and 4% (95% CI: 3.3–4.8), respectively. In the pediatric cohort (<14 years old), seroprevalence was 13% (95% CI: 10.2–16.2). A serological-based screening strategy could be a cost-effective public health intervention to tackle the COVID-19 pandemic.

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Section: Discussionmentioning

confidence: 99%

Seroprevalence of SARS-CoV-2-specific Antibodies in the Town of Ariano Irpino (Avellino, Campania, Italy): a population-based Study

et al. 2021

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“…SARS-CoV-2 has spread across the globe rapidly, causing a worldwide pandemic 1 . Infection with this highly contagious respiratory virus can be asymptomatic or present as COVID19, a disease with varying levels of severity and a broad range of not fully understood symptoms that may include fever, cough, anosmia, gastrointestinal symptoms, hypercoagulability, inflammatory complications, acute respiratory distress syndrome, which may also lead to death 2 – 5 . Owing to the rapidly evolving nature of pandemics, the true extent of spread of SARS-CoV-2 will likely not be fully realized until late in–or even after—the pandemic.…”

Section: Introductionmentioning

confidence: 99%

Standardization of ELISA protocols for serosurveys of the SARS-CoV-2 pandemic using clinical and at-home blood sampling

et al. 2021

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The extent of SARS-CoV-2 infection throughout the United States population is currently unknown. High quality serology is key to avoiding medically costly diagnostic errors, as well as to assuring properly informed public health decisions. Here, we present an optimized ELISA-based serology protocol, from antigen production to data analyses, that helps define thresholds for IgG and IgM seropositivity with high specificities. Validation of this protocol is performed using traditionally collected serum as well as dried blood on mail-in blood sampling kits. Archival (pre-2019) samples are used as negative controls, and convalescent, PCR-diagnosed COVID-19 patient samples serve as positive controls. Using this protocol, minimal cross-reactivity is observed for the spike proteins of MERS, SARS1, OC43 and HKU1 viruses, and no cross reactivity is observed with anti-influenza A H1N1 HAI. Our protocol may thus help provide standardized, population-based data on the extent of SARS-CoV-2 seropositivity, immunity and infection.

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“…In response, public health officials are searching for innovative ways to increase testing capacity in the face of limited resources. One approach that could be rapidly deployed to increase SARS-CoV-2 testing capacity is pooled sample testing, a method that involves mixing multiple samples and testing them as a single unit, thereby decreasing the resources required to test multiple samples [1][2][3]. The number of samples that may be pooled, i.e.…”

Section: Introductionmentioning

confidence: 99%

Recommendations for sample pooling on the Cepheid GeneXpert® system using the Cepheid Xpert® Xpress SARS-CoV-2 assay

et al. 2020

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The coronavirus disease 2019 (Covid-19) pandemic, caused by SARS-CoV-2, has resulted in a global testing supply shortage. In response, pooled testing has emerged as a promising strategy that can immediately increase testing capacity. In pooled sample testing, multiple samples are combined (or pooled) together and tested as a single unit. If the pool is positive, the individual samples can then be individually tested to identify the positive case(s). Here, we provide support for the adoption of sample pooling with the point-of-care Cepheid Xpert® Xpress SARS-CoV-2 molecular assay. Corroborating previous findings, the limit of detection of this assay was comparable to laboratory-developed reverse-transcription quantitative PCR SARS-CoV-2 tests, with observed detection below 100 copies/mL. The Xpert® Xpress assay detected SARS-CoV-2 after samples with minimum viral loads of 461 copies/mL were pooled in groups of six. Based on these data, we recommend the adoption of pooled testing with the Xpert® Xpress SARS-CoV-2 assay where warranted based on public health needs. The suggested number of samples per pool, or the pooling depth, is unique for each point-of-care testing site and can be determined by the positive test rates. To statistically determine appropriate pooling depth, we have calculated the pooling efficiency for numerous combinations of pool sizes and test rates. This information is included as a supplemental dataset that we encourage public health authorities to use as a guide to make recommendations that will maximize testing capacity and resource conservation.

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Efficient high-throughput SARS-CoV-2 testing to detect asymptomatic carriers

Cited by 176 publications

References 36 publications

Seroprevalence of SARS-CoV-2-specific Antibodies in the Town of Ariano Irpino (Avellino, Campania, Italy): a population-based Study

Seroprevalence of SARS-CoV-2-specific Antibodies in the Town of Ariano Irpino (Avellino, Campania, Italy): a population-based Study

Standardization of ELISA protocols for serosurveys of the SARS-CoV-2 pandemic using clinical and at-home blood sampling

Recommendations for sample pooling on the Cepheid GeneXpert® system using the Cepheid Xpert® Xpress SARS-CoV-2 assay

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