{"id":{"repo_id":"cape-town","oai_identifier":"oai:open.uct.ac.za:11427/37603"},"canonical_url":"https://search.dev.ndltd.org/etd/cape-town/oai:open.uct.ac.za:11427/37603","repository":{"repo_id":"cape-town","name":"University of Cape Town","base_url":"https://open.uct.ac.za/oai/request"},"display":{"title":"Evaluation of two SARS-CoV-2 immunoassays","abstract":"Aim: The purpose of this study is to verify the performance of the Roche Elecsys ® antinucleocapsid (qualitative) and anti-spike (quantitative) SARS-CoV-2 immunoassays to determine whether the performance of the assays is acceptable for diagnostic use in the Groote Schuur Hospital virology/chemistry laboratory, as well as other National Health Laboratory Service (NHLS) laboratories in South Africa. Methods: We performed a verification study using de-identified remnant serum or plasma samples. Standard verification experiments including sensitivity, specificity and precision were performed. Pre-pandemic samples were used to assess specificity. Samples with a linked positive SARS-CoV-2 polymerase chain reaction (PCR) result on a respiratory sample >10 days before the serum/plasma collection date were used to assess sensitivity. Additionally, postvaccine humoral response and other parameters was assessed in a cohort of laboratory staff. Results: For the anti-nucleocapsid antibody assay, specificity was 99.7% based on 316 samples and sensitivity 91.3% based on 404 samples. For the anti-spike antibody assay, the specificity based on 194 samples was 100%, and the sensitivity based on 384 samples was 93.8%. Both assays demonstrated acceptable precision. Furthermore, the anti-spike antibody assay sensitivity was >92% during the first three waves in South Africa, dominated by different SARS-CoV-2 variants. Post-vaccine seroconversion in 115 staff with no evidence of prior natural infection was 99% and hybrid immunity produced higher anti-spike antibody titres compared to vaccine-only participants. Conclusion: Both immunoassays met our acceptance criteria. Both assays can be used for seroprevalence studies. The anti-nucleocapsid immunoassay assay is valuable in confirming past natural infection in patients with previous asymptomatic infection, previous symptomatic infection where no PCR was done or PCR-negative patients who present to hospital with COVID-19 during the second week of illness or later. Most importantly, the antispike immunoassay can be used as a reliable, cheap, and easily accessible surrogate marker of post-vaccine humoral immune response and we recommend using this to confirm and monitor humoral immune response in patients with risk factors for non-seroconversion following vaccination and increased risk for morbidity and mortality following infection with SARS-CoV-2.","abstract_html":"Aim: The purpose of this study is to verify the performance of the Roche Elecsys ® antinucleocapsid (qualitative) and anti-spike (quantitative) SARS-CoV-2 immunoassays to determine whether the performance of the assays is acceptable for diagnostic use in the Groote Schuur Hospital virology/chemistry laboratory, as well as other National Health Laboratory Service (NHLS) laboratories in South Africa. Methods: We performed a verification study using de-identified remnant serum or plasma samples. Standard verification experiments including sensitivity, specificity and precision were performed. Pre-pandemic samples were used to assess specificity. Samples with a linked positive SARS-CoV-2 polymerase chain reaction (PCR) result on a respiratory sample >10 days before the serum/plasma collection date were used to assess sensitivity. Additionally, postvaccine humoral response and other parameters was assessed in a cohort of laboratory staff. Results: For the anti-nucleocapsid antibody assay, specificity was 99.7% based on 316 samples and sensitivity 91.3% based on 404 samples. For the anti-spike antibody assay, the specificity based on 194 samples was 100%, and the sensitivity based on 384 samples was 93.8%. Both assays demonstrated acceptable precision. Furthermore, the anti-spike antibody assay sensitivity was >92% during the first three waves in South Africa, dominated by different SARS-CoV-2 variants. Post-vaccine seroconversion in 115 staff with no evidence of prior natural infection was 99% and hybrid immunity produced higher anti-spike antibody titres compared to vaccine-only participants. Conclusion: Both immunoassays met our acceptance criteria. Both assays can be used for seroprevalence studies. The anti-nucleocapsid immunoassay assay is valuable in confirming past natural infection in patients with previous asymptomatic infection, previous symptomatic infection where no PCR was done or PCR-negative patients who present to hospital with COVID-19 during the second week of illness or later. Most importantly, the antispike immunoassay can be used as a reliable, cheap, and easily accessible surrogate marker of post-vaccine humoral immune response and we recommend using this to confirm and monitor humoral immune response in patients with risk factors for non-seroconversion following vaccination and increased risk for morbidity and mortality following infection with SARS-CoV-2.","abstract_has_math":false,"creators":["Naidoo, Michelle"],"institution":"Department of Clinical Laboratory Sciences","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":["Hardie, Diana"],"committee_chairs":[],"committee_members":[],"year":2022,"date_issued":"2022","date_published":"2022","updated_at":"2026-07-22T22:22:38Z","subjects":["laboratory sciences"],"languages":[],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"http://hdl.handle.net/11427/37603","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Hardie, Diana"]},{"key":"dc:creator","label":"Author","values":["Naidoo, Michelle"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2023-03-31T07:34:23Z"]},{"key":"dc:date.available","label":"Dc Date Available","values":["2023-03-31T07:34:23Z"]},{"key":"dc:date.issued","label":"Date","values":["2022"]},{"key":"dc:publisher.department","label":"Dc Publisher Department","values":["Department of Clinical Laboratory Sciences"]},{"key":"dc:type","label":"Dc Type","values":["Master Thesis"]},{"key":"dc:type.qualificationlevel","label":"Dc Type Qualificationlevel","values":["Masters","MMed"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["laboratory sciences"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.uri","label":"Identifier URI","values":["http://hdl.handle.net/11427/37603"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Aim: The purpose of this study is to verify the performance of the Roche Elecsys ® antinucleocapsid (qualitative) and anti-spike (quantitative) SARS-CoV-2 immunoassays to determine whether the performance of the assays is acceptable for diagnostic use in the Groote Schuur Hospital virology/chemistry laboratory, as well as other National Health Laboratory Service (NHLS) laboratories in South Africa. Methods: We performed a verification study using de-identified remnant serum or plasma samples. Standard verification experiments including sensitivity, specificity and precision were performed. Pre-pandemic samples were used to assess specificity. Samples with a linked positive SARS-CoV-2 polymerase chain reaction (PCR) result on a respiratory sample >10 days before the serum/plasma collection date were used to assess sensitivity. Additionally, postvaccine humoral response and other parameters was assessed in a cohort of laboratory staff. Results: For the anti-nucleocapsid antibody assay, specificity was 99.7% based on 316 samples and sensitivity 91.3% based on 404 samples. For the anti-spike antibody assay, the specificity based on 194 samples was 100%, and the sensitivity based on 384 samples was 93.8%. Both assays demonstrated acceptable precision. Furthermore, the anti-spike antibody assay sensitivity was >92% during the first three waves in South Africa, dominated by different SARS-CoV-2 variants. Post-vaccine seroconversion in 115 staff with no evidence of prior natural infection was 99% and hybrid immunity produced higher anti-spike antibody titres compared to vaccine-only participants. Conclusion: Both immunoassays met our acceptance criteria. Both assays can be used for seroprevalence studies. The anti-nucleocapsid immunoassay assay is valuable in confirming past natural infection in patients with previous asymptomatic infection, previous symptomatic infection where no PCR was done or PCR-negative patients who present to hospital with COVID-19 during the second week of illness or later. Most importantly, the antispike immunoassay can be used as a reliable, cheap, and easily accessible surrogate marker of post-vaccine humoral immune response and we recommend using this to confirm and monitor humoral immune response in patients with risk factors for non-seroconversion following vaccination and increased risk for morbidity and mortality following infection with SARS-CoV-2."]},{"key":"dc:title","label":"Title","values":["Evaluation of two SARS-CoV-2 immunoassays"]}]}],"canonical_facts":{"dc:contributor.advisor":["Hardie, Diana"],"dc:creator":["Naidoo, Michelle"],"dc:date.accessioned":["2023-03-31T07:34:23Z"],"dc:date.available":["2023-03-31T07:34:23Z"],"dc:date.issued":["2022"],"dc:description.abstract":["Aim: The purpose of this study is to verify the performance of the Roche Elecsys ® antinucleocapsid (qualitative) and anti-spike (quantitative) SARS-CoV-2 immunoassays to determine whether the performance of the assays is acceptable for diagnostic use in the Groote Schuur Hospital virology/chemistry laboratory, as well as other National Health Laboratory Service (NHLS) laboratories in South Africa. Methods: We performed a verification study using de-identified remnant serum or plasma samples. Standard verification experiments including sensitivity, specificity and precision were performed. Pre-pandemic samples were used to assess specificity. Samples with a linked positive SARS-CoV-2 polymerase chain reaction (PCR) result on a respiratory sample >10 days before the serum/plasma collection date were used to assess sensitivity. Additionally, postvaccine humoral response and other parameters was assessed in a cohort of laboratory staff. Results: For the anti-nucleocapsid antibody assay, specificity was 99.7% based on 316 samples and sensitivity 91.3% based on 404 samples. For the anti-spike antibody assay, the specificity based on 194 samples was 100%, and the sensitivity based on 384 samples was 93.8%. Both assays demonstrated acceptable precision. Furthermore, the anti-spike antibody assay sensitivity was >92% during the first three waves in South Africa, dominated by different SARS-CoV-2 variants. Post-vaccine seroconversion in 115 staff with no evidence of prior natural infection was 99% and hybrid immunity produced higher anti-spike antibody titres compared to vaccine-only participants. Conclusion: Both immunoassays met our acceptance criteria. Both assays can be used for seroprevalence studies. The anti-nucleocapsid immunoassay assay is valuable in confirming past natural infection in patients with previous asymptomatic infection, previous symptomatic infection where no PCR was done or PCR-negative patients who present to hospital with COVID-19 during the second week of illness or later. Most importantly, the antispike immunoassay can be used as a reliable, cheap, and easily accessible surrogate marker of post-vaccine humoral immune response and we recommend using this to confirm and monitor humoral immune response in patients with risk factors for non-seroconversion following vaccination and increased risk for morbidity and mortality following infection with SARS-CoV-2."],"dc:identifier.uri":["http://hdl.handle.net/11427/37603"],"dc:publisher.department":["Department of Clinical Laboratory Sciences"],"dc:subject":["laboratory sciences"],"dc:title":["Evaluation of two SARS-CoV-2 immunoassays"],"dc:type":["Master Thesis"],"dc:type.qualificationlevel":["Masters","MMed"]},"updated_at":"2026-07-22T22:22:38Z"}