A rapid simple point-of-care assay for the detection of SARS-CoV-2 neutralizing antibodies

BackgroundNeutralizing antibodies (NAbs) prevent pathogens from infecting host cells. Detection of SARS-CoV-2 NAbs is critical to evaluate herd immunity and monitor vaccine efficacy against SARS-CoV-2, the virus that causes COVID-19. All currently available NAb tests are lab-based and time-intensive.MethodWe develop a 10 min cellulose pull-down test to detect NAbs against SARS-CoV-2 from human plasma. The test evaluates the ability of antibodies to disrupt ACE2 receptor-RBD complex formation. The simple, portable, and rapid testing process relies on two key technologies: (i) the vertical-flow paper-based assay format and (ii) the rapid interaction of cellulose binding domain to cellulose paper.ResultsHere we show the construction of a cellulose-based vertical-flow test. The developed test gives above 80% sensitivity and specificity and up to 93% accuracy as compared to two current lab-based methods using COVID-19 convalescent plasma.ConclusionsA rapid 10 min cellulose based test has been developed for detection of NAb against SARS-CoV-2. The test demonstrates comparable performance to the lab-based tests and can be used at Point-of-Care. Importantly, the approach used for this test can be easily extended to test RBD variants or to evaluate NAbs against other pathogens. Plain language summaryIn response to infections, the human body produces proteins called antibodies. Neutralizing antibodies (NAbs) are one type of such proteins that are capable of inactivating the target, such as the SARS-CoV-2 virus that causes COVID-19. Monitoring levels of NAb allows us to understand levels of protective immunity. However, current methods to measure NAb are laboratory-based and are not necessarily suitable for large scale NAb monitoring in a large population. We develop a rapid test to detect SARS-CoV-2 NAb in 10 min that can be operated outside a laboratory. Our test provides results that are comparable to lab-based tests, which require between 1 h and up to 2 days to get a result. Our test may be useful for large-scale monitoring of immunity, for example in populations that do not have routine access to a lab. Kongsuphol et al. develop a paper-based, vertical flow assay to detect SARS-CoV-2 neutralizing antibodies. The point-of-care assay has comparable performance to lab-based tests and provides results in 10 min.