Multianalyte serology in home-sampled blood enables an unbiased assessment of the immune response against SARS-CoV-2

Serological testing is essential to curb the consequences of the COVID-19 pandemic. However, most assays are still limited to single analytes and samples collected within healthcare. Thus, we establish a multianalyte and multiplexed approach to reliably profile IgG and IgM levels against several versions of SARS-CoV-2 proteins (S, RBD, N) in home-sampled dried blood spots (DBS). We analyse DBS collected during spring of 2020 from 878 random and undiagnosed individuals from the population in Stockholm, Sweden, and use classification approaches to estimate an accumulated seroprevalence of 12.5% (95% CI: 10.3%-14.7%). This includes 5.4% of the samples being IgG(+)IgM(+) against several SARS-CoV-2 proteins, as well as 2.1% being IgG(-)IgM(+) and 5.0% being IgG(+)IgM(-) for the virus' S protein. Subjects classified as IgG(+) for several SARS-CoV-2 proteins report influenza-like symptoms more frequently than those being IgG(+) for only the S protein (OR=6.1; p<0.001). Among all seropositive cases, 30% are asymptomatic. Our strategy enables an accurate individual-level and multiplexed assessment of antibodies in home-sampled blood, assisting our understanding about the undiagnosed seroprevalence and diversity of the immune response against the coronavirus. Here, Roxhed et al. develop a multiplexed approach to screen IgG and IgM levels against several SARS-CoV-2 proteins in home-sampled dried blood spots and estimate seroprevalence of 12.5% in Stockholm in spring of 2020.

Automated summary

Researchers have developed a multiplexed approach to screen IgG and IgM levels against several SARS-CoV-2 proteins in home-sampled dried blood spots and estimated a seroprevalence of 12.5% in Stockholm in spring of 2020.