A dual antigen ELISA allows the assessment of SARS-CoV-2 antibody seroprevalence in a low transmission setting

  1. Sarah M. Hicks
  2. Kai Pohl
  3. Teresa Neeman
  4. Hayley A. McNamara
  5. Kate M. Parsons
  6. Jin-shu He
  7. Sidra A. Ali
  8. Samina Nazir
  9. Louise C. Rowntree
  10. Thi H. O. Nguyen
  11. Katherine Kedzierska
  12. Denise L. Doolan
  13. Carola G. Vinueas
  14. Matthew C. Cook
  15. Nicholas Coatsworth
  16. Paul S. Myles
  17. Florian Kurth
  18. Leif E. Sander
  19. Graham J. Mann
  20. Russell L. Gruen
  21. Amee J. George
  22. Elizabeth E. Gardiner
  23. Ian A. Cockburn
  24. the SARS-CoV-2 Testing in Elective Surgery Collaborators
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Abstract

Estimates of seroprevalence of SARS-CoV-2 antibodies have been hampered by inadequate assay sensitivity and specificity. Using an ELISA-based approach to that combines data about IgG responses to both the Nucleocapsid and Spike-receptor binding domain antigens, we show that near-optimal sensitivity and specificity can be achieved. We used this assay to assess the frequency of virus-specific antibodies in a cohort of elective surgery patients in Australia and estimated seroprevalence in Australia to be 0.28% (0 to 0.72%). These data confirm the low level of transmission of SARS-CoV-2 in Australia before July 2020 and validate the specificity of our assay.

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