SARS-CoV-2 antibody point-of-care testing in dialysis and kidney transplant patients with COVID-19.
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Published version
Author(s)
Type
Journal Article
Abstract
Rationale & Objective: A number of serologic tests for immunoglobulin G (IgG) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are now commercially available, including multiple lateral flow immunoassays (LFIAs), which have the advantage of being inexpensive and easy to use, without the reliance on laboratory facilities. However, data on the development of humoral immunity to SARS-CoV-2 in patients with kidney disease is limited, and the utility of an LFIA to test for antibodies in these patients has not been assessed. Study Design: Observational study. Setting & Participants: 60 patients (40 hemodialysis and 20 kidney transplant recipients) with SARS-CoV-2 infection confirmed by viral reverse transcriptase-polymerase chain reaction (RT-PCR) testing and 88 historic negative-control samples (collected before September 2019). Test: A commercially available LFIA to test for SARS-CoV-2 IgG in patients with infection confirmed by viral RT-PCR testing. Outcomes: Sensitivity and specificity of the LFIA to detect SARS-CoV-2 IgG in dialysis patients and transplant recipients. Results: 56/58 (96.6%) patients (38/39 hemodialysis and 18/19 transplant recipients) tested positive for SARS-CoV-2 IgG. 5/7 (71.4%) patients who were negative on preliminary testing had detectable IgG when retested more than 21 days postdiagnosis. Median times to first and second tests after diagnosis were 17 (interquartile range, 15-20) and 35 (interquartile range, 30-39) days, respectively. Calculation of test characteristics gave sensitivity of 96.6% (95% CI, 88.3%-99.4%) and specificity of 97.7% (95% CI, 92.0-99.6%). Limitations: Possible exposure to other beta-coronaviruses that may cross-react with the antigen used in the LFIA cannot be excluded. Conclusions: Symptomatic dialysis patients and transplant recipients commonly develop an immune response against SARS-CoV-2 infection that can be detected using an LFIA. Used diligently, an LFIA could be used to help screen the dialysis populations or confirm exposure on a patient level, especially in facilities in which laboratory resources are limited.
Date Issued
2021-01
Date Acceptance
2020-12-01
Citation
Kidney Medicine, 2021, 3 (1), pp.54-59.e1
ISSN
2590-0595
Publisher
Elsevier
Start Page
54
End Page
59.e1
Journal / Book Title
Kidney Medicine
Volume
3
Issue
1
Copyright Statement
© 2021 Published byElsevier Inc. on behalf of theNational Kidney Foundation,Inc. This is an open accessarticle under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Sponsor
Imperial Health Charity
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/33521621
PII: S2590-0595(20)30253-3
Grant Number
FA1920_7
Subjects
COVID-19
SARS-CoV-2 antibodies
hemodialysis
lateral flow immunoassays (LFIAs)
transplant
Publication Status
Published
Coverage Spatial
United States
Date Publish Online
2020-12-03