Virologia

Point-of-care antibody test: A diagnostic tool for the detection of COVID-19 in Indonesia

Severe Acute Respiratory Syndrome (SARS-Cov-2) is a novel viral pathogen that is primarily known to cause Coronavirus disease 2019 (COVID-19). SARS-CoV-2 has emerged in late 2019 in Wuhan, China causing a global pandemic. COVID-19 disease often elevates the risk of arterial or venous thromboembolism and in most cases it causes hypoxemic respiratory failures with features of the acute respiratory distress syndrome.The spread of this virus is ravaging the world therefore; proper COVID-19 diagnosis is an absolute necessity that will lead to follow proper guidelines and protocols in order to cope up with this virus.

Ministry of Health Republic of Indonesia (2020) reported that at the start of the pandemic, there is only one laboratory in Indonesia that is certified and equipped to conduct a real-time reverse transcriptase-polymerase chain reaction (rRT-PCR). As per July 2020, the number of laboratories has expanded to 164 laboratories in accordance with the needs. Real time RT-PCR is nuclear derived method that is used for detecting the presence of specific genetic material in pathogen and is considered as the gold standard for diagnosing COVID-19 disease. Trained operators and standardized laboratories are needed to perform this test and it is not pocket friendly. Many people cannot afford it in remote areas.

According to the COVID-19 National Task Force, out of 34 provinces in Indonesia, only one province DKI Jakarta reached WHO standard of testing 1/1000 people per week. Clinical and Laboratory Standard Institute (CLSI) reported that Wondfo SARS-CoV-2 antibody test (Guangzhou Wondfo Biotech Co., Ltd) detects combined IgM and IgG in blood samples within 15 minutes without a high skill required. Nisa Fauziah et al. (2021) with her research team conducted a research in order to explain the performance of combined IgM and IgG point-of-care antibody test (POC-Ab) (Wondfo®) as compared to real-time reverse transcriptase (rRT-PCR) (Allplex™ 2019-nCoV Assay) in detecting coronavirus disease 2019 (COVID-19).

For this research, COVID-19 patients with positive rRT-PCR consecutively and 20 patients with negative rRT-PCR results were selected randomly from the same group of patients as controls in a tertiary hospital from January to March 2020 in Bandung, Indonesia then comparison of POC-Ab with rRT-PCR results among patients was studied.

The results of this demonstrated that POC-Ab has a high specificity for COVID-19 with no false-positive result in non-COVID-19 sera. Therefore, it can be used to guide diagnostic among symptomatic patients in resource limited settings.Given its low sensitivity, patients with high suspicion of COVID-19 but non-reactive result should be prioritized for rRT-PCR testing.

Keywords:

COVID-19; SARS-CoV-2; POC-Ab; rRT-PCR; Indonesia; high sensitivity.

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