Lateral-flow immunoassays
and laboratory diagnostic tests like
enzyme-linked immunosorbent assays (ELISAs) are powerful diagnostic
tools to help fight the COVID-19 pandemic using them as antigen or
antibody tests. However, the need emerges for alternative bioanalytical
systems that combine their favorable featuressimple, rapid,
and cost-efficient point-of-care (POC) analysis of lateral-flow immunoassays
and higher reliability of laboratory testswhile eliminating
their disadvantages (limited sensitivity and specificity of lateral-flow
assays and prolonged time and work expenditure of laboratory analysis).
An additional need met by only a few tests is multiplexing, allowing
for the analysis of several immunorecognition patterns at the same
time. We herein present a strategy to combine all desirable attributes
of the different test types by means of a flow-based chemiluminescence
microarray immunoassay. Laminated polycarbonate microarray chips were
developed for easy production and subsequent application in the fully
automated microarray analysis platform MCR-R, where a novel flow cell
design minimizes the sample volume to 40 μL. This system was
capable of detecting IgG antibodies to SARS-CoV-2 with 100% sensitivity
and specificity using recombinant antigens for the SARS-CoV-2 spike
S1 protein, nucleocapsid protein, and receptor binding domain. The
analysis was accomplished within under 4 min from serum, plasma, and
whole blood, making it also useful in POC settings. Additionally,
we showed the possibility of serosurveillance after infection or vaccination
to monitor formerly unnoticed breakthrough infections in the population
as well as to detect the need for booster vaccination after the natural
decline of the antibody titer below detectable levels. This will help
in answering pressing questions on the importance of the antibody
response to SARS-CoV-2 that so far remain open. Additionally, even
the sequential detection of IgM and IgG antibodies was possible, allowing
for statements on the time response of an infection. While our serodiagnostic
application focuses on SARS-CoV-2, the same approach is easily adjusted
to other diseases, making it a powerful tool for future serological
testing.