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Cross-Reactivity of SARS-CoV-2 Laboratory Diagnostics to Endemic Diseases in Africa: A Diagnostic Accuracy Study

Title: Cross-Reactivity of SARS-CoV-2 Laboratory Diagnostics to Endemic Diseases in Africa: A Diagnostic Accuracy Study
Authors: Diagne, Cheikh Tidiane; Ndiaye, Oumar; Talla, Cheikh; Dia, Fatou; Faye, Rokhaya; Diouf, Babacar; Tall, Billo; Mbengue, Alassane; Diop, Mamadou; Diallo, Khardiata; Cisse, Vivianne Marie Pierre; Ndoye, Amadou Moustapha; Barry, Aliou; Niang, Makhtar; Loucoubar, Cheikh; Dia, Ndongo; Bei, Amy, K.; Fitchett, Joseph, R. A.; Taieb, Fabien; Faye, Ousmane; Peeling, Rosanna, W.; Vigan-Womas, Inés; Sall, Amadou
Contributors: Institut Pasteur de Dakar; Pasteur Network (Réseau International des Instituts Pasteur); Département de virologie - Virology Department Dakar; Pasteur Network (Réseau International des Instituts Pasteur)-Pasteur Network (Réseau International des Instituts Pasteur); Pôle Epidémiologie, Recherche clinique et Science des données Dakar, Sénégal; Pôle Immunophysiopathologie et Maladies Infectieuses; Service des Maladies Infectieuses et Tropicales (SMIT); CHU de Fann; Biostatistique, Bio-informatique et Modélisation - Biostatistics, Bioinformatics and Modelling Group Dakar; Yale School of Public Health (YSPH); Mologic Ltd, , Bedford Technology Park, Thurleigh, United Kingdom; Chan School of Public Health; London School of Hygiene and Tropical Medicine (LSHTM)
Source: https://hal.science/hal-03904624 ; 2022.
Publisher Information: CCSD
Publication Year: 2022
Collection: Réseau International des Instituts Pasteur, Paris: HAL-RIIP
Subject Terms: SARS-CoV-2; Diagnostic tests; Serology; ELISA; Senegal; [SDV]Life Sciences [q-bio]
Description: Background: Serology is a great tool to assess the level of immunity against SARS-CoV-2 in settings with limited access to molecular diagnostics. However, African populations displays a particular immunological profile with massive circulation of infectious agents from different aetiologies that can affect assays performance.Methods: We evaluated the OMEGA Diagnostics COVID-19 ELISA-IgG and the ID Screen® SARS-CoV-2-N IgG Indirect in Senegal using a panel of 636 blood samples covering several African-endemic diseases and healthy donors to determine test sensitivity and specificity. The sensitivity panel of sera includes 461 serum samples collected from 91 patients hospitalized for COVID-19 disease. COVID-19 cases were confirmed by qRT-PCR and samples were collected on an interval of three days until viral clearance. In addition, 272 sera obtained from COVID-19 negative individuals were selected from a well-documented biobank of sera collected before the COVID-19 outbreak.Finding: High-cross reactivity have been found in individuals with a history of exposure to Chikungunya, HIV, malaria (Plasmodium falciparum), rheumatoid factor as well as healthy donors with respective specificities of 55%, 41.8%, 70%, 70% and 75%. ELISA experiments with commercial assays targeting either SARS-CoV-2 Nucleocapsid protein and Spike 2 protein or nucleocapsid protein only suggest that cross-reactivity might be directed against Spike 2 protein and not Nucleocapsid protein. Further samples characterisation reveals that anti-malaria IgG is the leading cause of such poor specificities, but exposure to other diseases contributed as well.Interpretation: We anticipate that COVID-19 seroprevalence can be biased if assays are not contextualized. Since malaria is endemic in African settings, we propose that a particular attention must be given in serological surveillance of COVID-19 or anti-SARS-CoV-2 antibodies quantification as vaccines are being rolled out.
Document Type: report
Language: English
DOI: 10.2139/ssrn.3916756
Availability: https://hal.science/hal-03904624; https://hal.science/hal-03904624v1/document; https://hal.science/hal-03904624v1/file/SSRN-id3916756.pdf; https://doi.org/10.2139/ssrn.3916756
Rights: info:eu-repo/semantics/OpenAccess
Accession Number: edsbas.DA1EB49A
Database: BASE