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Rapid evaluation of neutralizing antibodies in COVID-19 patients

By Pingping Zhang, Baisheng Li, Wei Min, Xiaohui Wang, Zhencui Li, Yong Zhao, Huan Zhang, Min Jiang, Huanying Zheng, Chao Yang, Wei Zhang, Le Zuo, Qi Gao, Zhengrong Yang, Yanzhao Li, Tiejian Feng, Changqing Lin, Qinghua Hu, Tie Song, Ruifu Yang

Posted 02 Sep 2020
medRxiv DOI: 10.1101/2020.09.01.20185447

The ongoing coronavirus disease 2019 (COVID-19) pandemic calls for a method to rapidly and conveniently evaluate neutralizing antibody (NAb) activity in patients. Here, an up-conversion phosphor technology-based point-of-care testing (UPT-POCT) and a microneutralization assay were employed to detect total antibodies against the receptor-binding domain of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein and NAb activity in COVID-19 patients' sera, respectively, in order to determine if UPT-POCT could be used as a surrogate method for rapid evaluation of serum NAb activity in COVID-19 patients. In total, 519 serum samples from 213 recovered and 99 polymerase chain reaction re-positive (RP) COVID-19 patients were used in this report. We found that UPT-POCT reporting values correlated highly with NAb titers from 1:4 to 1:1024, with a correlation coefficient r = 0.9654 (P < 0.001), as well as protection rate against RP (r = 0.9886, P < 0.0001). As a significant point for reducing re-positive rate, UPT-POCT values of 4.380, corresponding to NAb titer of 1:64, may be appropriate as an indicator for evaluating high efficiency of protection. This study demonstrates that the quantitative lateral flow based UPT-POCT, could be used to rapidly evaluate NAb titer, which is of importance for assessing vaccine immunization efficacy, herd immunity, and screening patient plasma for high NAbs.

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