Comparison of dried blood spots and venous blood for the detection of SARS-CoV-2 antibodies in a population of nursing home residents

Meyers, E.; Heytens, S.; Formukong, A.; Vercruysse, H.; De Sutter, A.; Geens, T.; Hofkens, K.; Janssens, H.; Nys, E.; Padalko, E.; Deschepper, E.; Cools, P.

In the current SARS-CoV-2 pandemic, testing for SARS-CoV-2 specific antibodies is paramount to monitor immune responses in post-authorization vaccination and sero-epidemiology studies. However, large scale and iterative serological testing by venipuncture in older persons can be challenging. Capillary blood sampled using a finger prick and collected on protein saver cards, i.e. dried blood spots (DBS), has already proven to be a promising alternative. However, elderly persons have a reduced cutaneous microvasculature, which may affect DBS-based antibody testing. Therefore, we aimed to evaluate the performance of DBS for the detection of SARS-CoV-2 antibodies in nursing homes residents. We collected venous blood and paired Whatman and EUROIMMUN DBS from nursing home residents, and from staff as a reference population. Venous blood samples were analyzed for the presence of SARS-CoV-2 IgG antibodies using the Abbot chemiluminescent microparticle immunoassay (CMIA). DBS were analyzed by the EUROIMMUN enzyme-linked immuno sorbent assay (ELISA) for SARS-CoV-2 IgG antibodies. We performed a statistical assessment to optimize the ELISA cut-off value for the DBS using the Youden's J index. A total of 273 paired DBS-serum samples were analyzed, of which 129 were positive as assessed by the reference test. The sensitivities and specificities of DBS ranged from 95% to 97.1% and from 97.1% to 98.8%, respectively, depending on population (residents or staff) or DBS card type. These results demonstrate that DBS sampling is a valid alternative to venepuncture for the detection of SARS-CoV-2 antibodies in the elderly.