Simultaneous Quantitative SARS-CoV-2 Antigen and Host Antibody Detection and Pre-Screening Strategy at the Point of Care

Kritika Srinivasan Rajsri, Michael P. McRae, Nicolaos J. Christodoulides, Isaac Dapkins, Glennon W. Simmons, Hanover Matz, Helen Dooley, David Fenyö, John T. McDevitt

Research output: Contribution to journalArticlepeer-review


As COVID-19 pandemic public health measures are easing globally, the emergence of new SARS-CoV-2 strains continue to present high risk for vulnerable populations. The antibody-mediated protection acquired from vaccination and/or infection is seen to wane over time and the immunocompromised populations can no longer expect benefit from monoclonal antibody prophylaxis. Hence, there is a need to monitor new variants and its effect on vaccine performance. In this context, surveillance of new SARS-CoV-2 infections and serology testing are gaining consensus for use as screening methods, especially for at-risk groups. Here, we described an improved COVID-19 screening strategy, comprising predictive algorithms and concurrent, rapid, accurate, and quantitative SARS-CoV-2 antigen and host antibody testing strategy, at point of care (POC). We conducted a retrospective analysis of 2553 pre- and asymptomatic patients who were tested for SARS-CoV-2 by RT-PCR. The pre-screening model had an AUC (CI) of 0.76 (0.73–0.78). Despite being the default method for screening, body temperature had lower AUC (0.52 [0.49–0.55]) compared to case incidence rate (0.65 [0.62–0.68]). POC assays for SARS-CoV-2 nucleocapsid protein (NP) and spike (S) receptor binding domain (RBD) IgG antibody showed promising preliminary results, demonstrating a convenient, rapid (<20 min), quantitative, and sensitive (ng/mL) antigen/antibody assay. This integrated pre-screening model and simultaneous antigen/antibody approach may significantly improve accuracy of COVID-19 infection and host immunity screening, helping address unmet needs for monitoring vaccine effectiveness and severe disease surveillance.

Original languageEnglish (US)
Article number670
Issue number6
StatePublished - Jun 2023


  • artificial intelligence
  • clinical decision making
  • COVID-19
  • lab-on-a-chip
  • nucleocapsid antigen
  • SARS-CoV-2 immunity
  • spike RBD IgG

ASJC Scopus subject areas

  • Bioengineering


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