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Dimeric IgA is a specific biomarker of recent SARS-CoV-2 infection

Drummer, H. E.; Van, H.; Klock, E.; Zheng, S.; Wei, Z.; Boo, I.; Center, R. J.; Li, F.; Bhat, P.; Ffrench, R.; Lau, J. S. Y.; McMahon, J.; Laeyendecker, O.; Fernandez, R. E.; Manabe, Y. C.; Klein, S. L.; Quinn, T. C.; Anderson, D. A.

2021-07-01 infectious diseases
10.1101/2021.06.28.21259671 medRxiv
Show abstract

Current tests for SARS-CoV-2 antibodies (IgG, IgM, IgA) cannot differentiate recent and past infections. We describe a point of care, lateral flow assay for SARS-CoV-2 dIgA based on the highly selective binding of dIgA to a chimeric form of secretory component (CSC), that distinguishes dIgA from monomeric IgA. Detection of specific dIgA uses a complex of biotinylated SARS-CoV-2 receptor binding domain and streptavidin-colloidal gold. SARS-CoV-2-specific dIgA was measured both in 112 cross-sectional samples and a longitudinal panel of 362 plasma samples from 45 patients with PCR-confirmed SARS-CoV-2 infection, and 193 discrete pre-COVID-19 or PCR-negative patient samples. The assay demonstrated 100% sensitivity from 11 days post-symptom onset, and a specificity of 98.2%. With an estimated half-life of 6.3 days, dIgA provides a unique biomarker for the detection of recent SARS-CoV-2 infections with potential to enhance diagnosis and management of COVID-19 at point-of-care.

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