@article{Atchison:2023:cid/ciac629,
author = {Atchison, C and Moshe, M and Brown, J and Whitaker, M and Wong, N and Bharath, A and Mckendry, R and Darzi, A and Ashby, D and Donnelly, C and Riley, S and Elliott, P and Barclay, W and Cooke, G and Ward, H},
doi = {cid/ciac629},
journal = {Clinical Infectious Diseases},
pages = {658--666},
title = {Validity of self-testing at home with rapid SARS-CoV-2 antibody detection by lateral flow immunoassay},
url = {http://dx.doi.org/10.1093/cid/ciac629},
volume = {76},
year = {2023}
}

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TY  - JOUR
AB  - Background: We explore severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody lateral flow immunoassay (LFIA) performance under field conditions compared to laboratory-based ELISA and live virus neutralisation. Methods: In July 2021, 3758 participants performed, at home, a self-administered LFIA on finger-prick blood, reported and submitted a photograph of the result, and provided a self-collected capillary blood sample for assessment of IgG antibodies using the Roche Elecsys® Anti-SARS-CoV-2 assay. We compared the self-reported LFIA result to the quantitative Roche assay and checked the reading of the LFIA result with an automated image analysis (ALFA). In a subsample of 250 participants, we compared the results to live virus neutralisation. Results: Almost all participants (3593/3758, 95.6%) had been vaccinated or reported prior infection. Overall, 2777/3758 (73.9%) were positive on self-reported LFIA, 2811/3457 (81.3%) positive by LFIA when ALFA-reported, and 3622/3758 (96.4%) positive on Roche (using the manufacturer reference standard threshold for positivity of 0.8 U ml−1). Live virus neutralisation was detected in 169 of 250 randomly selected samples (67.6%); 133/169 were positive with self-reported LFIA (sensitivity 78.7%; 95% CI 71.8, 84.6), 142/155 (91.6%; 86.1, 95.5) with ALFA, and 169 (100%; 97.8, 100.0) with Roche. There were 81 samples with no detectable virus neutralisation; 47/81 were negative with self-reported LFIA (specificity 58.0%; 95% CI 46.5, 68.9), 34/75 (45.3%; 33.8, 57.3) with ALFA, and 0/81 (0%; 0.0, 4.5) with Roche. Conclusions: Self-administered LFIA is less sensitive than a quantitative antibody test, but the positivity in LFIA correlates better than the quantitative ELISA with virus neutralisation.
AU  - Atchison,C
AU  - Moshe,M
AU  - Brown,J
AU  - Whitaker,M
AU  - Wong,N
AU  - Bharath,A
AU  - Mckendry,R
AU  - Darzi,A
AU  - Ashby,D
AU  - Donnelly,C
AU  - Riley,S
AU  - Elliott,P
AU  - Barclay,W
AU  - Cooke,G
AU  - Ward,H
DO  - cid/ciac629
EP  - 666
PY  - 2023///
SN  - 1058-4838
SP  - 658
TI  - Validity of self-testing at home with rapid SARS-CoV-2 antibody detection by lateral flow immunoassay
T2  - Clinical Infectious Diseases
UR  - http://dx.doi.org/10.1093/cid/ciac629
UR  - http://hdl.handle.net/10044/1/98622
VL  - 76
ER  - 

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