Sensitive detection of SARS-CoV-2-specific-antibodies in dried blood spot samples

Morley, G. L.; Taylor, S.; Jossi, S.; Perez-Toledo, M.; Faustini, S. E.; Marcial-Juarez, E.; Shields, A. M.; Goodall, M.; Allen, J. D.; Watanabe, Y.; Newby, M. L.; Crispin, M.; Drayson, M. T.; Cunningham, A. F.; Richter, A. G.; O'Shea, M. K.

Abstract Importance: Population-wide serological testing is an essential component in understanding the COVID-19 pandemic. The logistical challenges of undertaking widespread serological testing could be eased through use of a reliable dried blood spot (DBS) sampling method. Objective: To validate the use of dried blood spot sampling for the detection of SARS-CoV-2-specific antibodies. Design, setting and participants: Eighty-seven matched DBS and serum samples were obtained from eighty individuals, including thirty-one who were previously PCR-positive for SARS-CoV-2. DBS eluates and sera were used in an ELISA to detect antibodies to the viral spike protein. Results: Specific anti-SARS-Cov-2 spike glycoprotein antibodies were detectable in both serum and DBS eluate and there was a significant correlation between the antibody levels detected in matched samples (r = 0.96, p<0.0001). Using serum as the gold standard in the assay, matched DBS samples achieved a Cohens kappa coefficient of 0.975 (near-perfect agreement), a sensitivity of 98.1% and specificity of 100%, for detecting anti-spike glycoprotein antibodies. Conclusions and relevance: Eluates from DBS samples are a reliable and reproducible source of antibodies to be used for the detection of SARS-CoV-2-specific antibodies. The use of DBS sampling could complement the use of venepuncture in the immunosurveillance of COVID-19 in both low and high income settings.