COVID-19 Serology at Population Scale: SARS-CoV-2-Specific Antibody Responses in Saliva
Nora Pisanic, Pranay R. Randad, Kate Kruczynski, Yukari C. Manabe, David L. Thomas, Andrew Pekosz, Sabra L. Klein, Michael J. Betenbaugh, William Clarke, Oliver Laeyendecker, Patrizio Caturegli, H. Benjamin Larman, Barbara Detrick, Jessica K. Fairley, Amy C Sherman, Nadine Rouphael, Srilatha Edupuganti, Douglas A. Granger, Steve W. Granger, Matthew H. Collins, Christopher D. Heaney
Abstract
= 28) were significantly correlated. The salivary anti-N IgG response resulted in the highest sensitivity (100%), exhibiting a positive response in 24/24 reverse transcription-PCR (RT-PCR)-confirmed COVID-19 cases sampled at >14 days post-symptom onset (DPSO), whereas the salivary anti-receptor binding domain (RBD) IgG response yielded 100% specificity. Temporal kinetics of IgG in saliva were consistent with those observed in blood and indicated that most individuals seroconvert at around 10 DPSO. Algorithms employing a combination of the IgG responses to N and S antigens result in high diagnostic accuracy (100%) by as early as 10 DPSO. These results support the use of saliva-based antibody testing as a noninvasive and scalable alternative to blood-based antibody testing.