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Revista de salud publica del Paraguay

On-line version ISSN 2307-3349

Abstract

BEJARANO, Domingo Pérez et al. Diagnostic performance of serological test, antibody response and correlation with clinical characteristics in health workers with COVID-19 from the General Hospital of Luque. Rev. salud publica Parag. [online]. 2021, vol.11, n.1, pp.8-19. ISSN 2307-3349.  https://doi.org/10.18004/rspp.2021.junio.8.

Introduction:

The reverse transcriptase polymerase chain reaction (RT-PCR) test has limitations in its diagnostic performance and requires complex equipment. Antibody detection tests can be used as epidemiological screening, but should be evaluated in a regional context. Knowing the profitability of the test, part of the spectrum of humoral immunity evoked by SARS-CoV-2 could be explored. Health personnel, as a population with high commitment and first impact in the pandemic, constitutes the ideal stage.

Objective:

To evaluate the diagnostic performance of the serological test, antibody response and its correlation with clinical characteristics in health workers with COVID-19 at the General Hospital of Luque.

Methodology:

To evaluate the diagnostic performance of the serological test, antibody response and its correlation with clinical characteristics in health workers with COVID-19 at the General Hospital of Luque between March and October 2020, a descriptive study was carried out in 107 health workers, selected by convenience between March and October 2020, after having completed ≥14 days from the diagnosis. The RT-PCR test was performed on nasal and pharyngeal swab samples. Antibody detection was performed in plasma sample, analyzed by Elecsys Anti-SARS-CoV-2 electrochemiluminescence immunoassay (<1, negative). Data were also collected: demographic, anthropometric, comorbidities, recent history of dengue, BCG vaccination, symptoms of the acute stage, and time between onset of symptoms and swabbing and onset of symptoms and interview. Descriptive and inferential analysis was used and the sensitivity, specificity, predictive values and accuracy of the test were calculated.

Results:

Globally, 56 health care workers had a positive diagnosis of COVID-19, of which seven women (asymptomatic) showed levels <1 to the immunoassay for antibodies. Of the 51 workers with a negative RT-PCR result, 3 showed elevated antibody titers. The sensitivity of the test was 89.3%, the specificity 94.1% and the accuracy 91.6%. No correlation was observed between the global level of antibodies and age (r 0.09; p 0.52) as well as with comorbidities. Finally, workers with persistent symptoms had more noticeable antibody levels than those who resolved the disease (p = 0.049).

Conclusion:

The anti-N antibody detection test for SARS-CoV-2 had a good diagnostic performance, showing some false negatives to RT-PCR, confirming its usefulness for seroprevalence studies. Antibody levels were higher in workers with persistent symptoms.

Keywords : COVID-19; SARS-CoV-2; RT-PCR; serology immunoassays.

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