Evaluation of SARS-CoV-2 Antibody Response Between Paired Fingerprick (HemaPEN®) and Venepuncture Collected Samples in Children and Adults

Serological surveillance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies is important to monitor population COVID-19 immunity. Dried blood spots (DBS) are a valuable method for serosurveys, particularly in remote settings and in children. We compared the measurement of SARS-CoV-2 spike-specific IgG in paired blood samples collected using standard venepuncture (serum) and the hemaPEN^® microsampling DBS device from children and adults. A total of 83 participants (10 months to 65 years of age), comprising COVID-positive and -negative participants, were recruited. Paired serum and DBS samples were assayed for SARS-CoV-2 receptor-binding domain (RBD) and Spike (S1) antibodies using an established in-house ELISA. RBD and S1 IgG concentrations of paired hemaPEN DBS eluates and serum samples were compared using a non-parametric Wilcoxon matched-pairs signed ranked test. A Pearson's correlation was used for RBD and S1 IgG concentrations and the level of agreement between the hemaPEN DBS eluates and serum samples was assessed by Bland-Altman analysis. A total of N = 41 adults (36 COVID-positive and 5 COVID-negative), and N = 42 children (37 COVID-positive, and 5 COVID-negative) have paired serum and DBS assayed. We found moderate to strong correlations between paired hemaPEN DBS eluates and serum SARS-CoV-2 IgG antibodies for RBD (r = 0.9472, <i>p</i> < 0.0001) and S1 proteins (r = 0.6892, <i>p</i> < 0.0001). Similar results were observed in both adult and paediatric populations. No significant differences in S1-specific IgG levels were observed in hemaPEN DBS samples stored for up to 35 weeks at room temperature. Eluted hemaPEN samples showed high specificity and sensitivity (100% and 89.89%, respectively) compared with serum. The use of the microsampling hemaPEN device for DBS sample collection is a feasible approach for assessing SARS-CoV-2 antibodies for serosurveillance studies, particularly in remote settings and in children.