{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T06:49:23Z","timestamp":1791528563768,"version":"4.3.4"},"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2021,12,7]],"date-time":"2021-12-07T00:00:00Z","timestamp":1638835200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institute of Health Research","doi-asserted-by":"crossref","award":["OV1-170355"],"award-info":[{"award-number":["OV1-170355"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"crossref"}]},{"name":"COVID-19 Immunity Task Force"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>The true severity of infection due to COVID-19 is under-represented because it is based on only those who are tested. Although nucleic acid amplifications tests (NAAT) are the gold standard for COVID-19 diagnostic testing, serological assays provide better population-level SARS-CoV-2 prevalence estimates. Implementing large sero-surveys present several logistical challenges within Canada due its unique geography including rural and remote communities. Dried blood spot (DBS) sampling is a practical solution but comparative performance data on SARS-CoV-2 serological tests using DBS is currently lacking. Here we present test performance data from a well-characterized SARS-CoV-2 DBS panel sent to laboratories across Canada representing 10 commercial and 2 in-house developed tests for SARS-CoV-2 antibodies. Three commercial assays identified all positive and negative DBS correctly corresponding to a sensitivity, specificity, positive predictive value, and negative predictive value of 100% (95% CI = 72.2, 100). Two in-house assays also performed equally well. In contrast, several commercial assays could not achieve a sensitivity greater than 40% or a negative predictive value greater than 60%. Our findings represent the foundation for future validation studies on DBS specimens that will play a central role in strengthening Canada\u2019s public health policy in response to COVID-19.<\/jats:p>","DOI":"10.1371\/journal.pone.0261003","type":"journal-article","created":{"date-parts":[[2021,12,7]],"date-time":"2021-12-07T13:37:25Z","timestamp":1638884245000},"page":"e0261003","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":36,"title":["Dried blood spot specimens for SARS-CoV-2 antibody testing: A multi-site, multi-assay comparison"],"prefix":"10.1371","volume":"16","author":[{"given":"Fran\u00e7ois","family":"Cholette","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Mesa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Harris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Ellis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karla","family":"Cachero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Lacap","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yannick","family":"Galipeau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4652-3029","authenticated-orcid":true,"given":"Marc-Andr\u00e9","family":"Langlois","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Claude","family":"Gingras","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cedric P.","family":"Yansouni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4232-871X","authenticated-orcid":true,"given":"Jesse","family":"Papenburg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4867-2063","authenticated-orcid":true,"given":"Matthew P.","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pranesh","family":"Chakraborty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek R.","family":"Stein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Van Caeseele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Bartlett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mel","family":"Krajden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Goldfarb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison","family":"McGeer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Osiowy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Hankins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce","family":"Mazer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Drebot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the COVID-19 Immunity Task Force (CITF) working group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,12,7]]},"reference":[{"issue":"7798","key":"pone.0261003.ref001","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1038\/s41586-020-2008-3","article-title":"A new coronavirus associated with human respiratory disease in China","volume":"579","author":"F Wu","year":"2020","journal-title":"Nature"},{"key":"pone.0261003.ref002","unstructured":"Centre for Systems and Science Engineering at John Hopkins University. COVID-19 dashboard [cited 2021 January 19]. Available from: https:\/\/coronavirus.jhu.edu\/map.html."},{"issue":"3","key":"pone.0261003.ref003","first-page":"23","article-title":"Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR","volume":"25","author":"VM Corman","year":"2020","journal-title":"Euro Surveillance"},{"issue":"1","key":"pone.0261003.ref004","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1186\/s12916-020-01810-8","article-title":"At what times during infection is SARS-CoV-2 detectable and no longer detectable using RT-PCR-based tests? A systematic review of individual participant data","volume":"18","author":"S Mallett","year":"2020","journal-title":"BMC Medicine"},{"issue":"11","key":"pone.0261003.ref005","doi-asserted-by":"crossref","first-page":"e0241959","DOI":"10.1371\/journal.pone.0241959","article-title":"Recommendations for sample pooling on the Cepheid GeneXpert(R) system using the Cepheid Xpert(R) Xpress SARS-CoV-2 assay","volume":"15","author":"MG Becker","year":"2020","journal-title":"PLoS ONE"},{"key":"pone.0261003.ref006","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1038\/s41746-020-0300-0","article-title":"Estimating the efficacy of symptom-based screening for COVID-19","volume":"3","author":"A Callahan","year":"2020","journal-title":"NPJ Digital Medicine"},{"issue":"34","key":"pone.0261003.ref007","doi-asserted-by":"crossref","first-page":"E973","DOI":"10.1503\/cmaj.201588","article-title":"SARS-CoV-2 (COVID-19) serology: implications for clinical practice, laboratory medicine and public health","volume":"192","author":"Canadian Public Health Laboratory N","year":"2020","journal-title":"CMAJ"},{"issue":"19","key":"pone.0261003.ref008","doi-asserted-by":"crossref","first-page":"e142362","DOI":"10.1172\/jci.insight.142362","article-title":"A simple protein-based surrogate neutralization assay for SARS-CoV-2","volume":"5","author":"KT Abe","year":"2020","journal-title":"JCI Insight"},{"issue":"10230","key":"pone.0261003.ref009","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.1016\/S0140-6736(20)30788-1","article-title":"Developing antibody tests for SARS-CoV-2","volume":"395","author":"A. Petherick","year":"2020","journal-title":"The Lancet"},{"issue":"1","key":"pone.0261003.ref010","doi-asserted-by":"crossref","first-page":"32","DOI":"10.5858\/arpa.2020-0499-SA","article-title":"Comparative clinical evaluation of the Roche Elecsys and Abbott severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serology assays for coronavirus disease 2019 (COVID-19).","volume":"145","author":"SS Tan","year":"2021","journal-title":"Archives of Pathology & Laboratory Medicine"},{"issue":"10","key":"pone.0261003.ref011","doi-asserted-by":"crossref","first-page":"1174","DOI":"10.1038\/s41587-020-0659-0","article-title":"Evaluation of SARS-CoV-2 serology assays reveals a range of test performance","volume":"38","author":"JD Whitman","year":"2020","journal-title":"Nat Biotechnol"},{"issue":"5","key":"pone.0261003.ref012","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1093\/ajcp\/aqaa140","article-title":"Humoral Immune Response to SARS-CoV-2","volume":"154","author":"PH Herroelen","year":"2020","journal-title":"Am J Clin Pathol"},{"issue":"12","key":"pone.0261003.ref013","doi-asserted-by":"crossref","first-page":"1390","DOI":"10.1016\/S1473-3099(20)30634-4","article-title":"Performance characteristics of five immunoassays for SARS-CoV-2: a head-to-head benchmark comparison","volume":"20","author":"M Ainsworth","year":"2020","journal-title":"The Lancet Infectious Diseases"},{"issue":"10234","key":"pone.0261003.ref014","doi-asserted-by":"crossref","first-page":"e79","DOI":"10.1016\/S0140-6736(20)30923-5","article-title":"Medical students for health-care staff shortages during the COVID-19 pandemic","volume":"395","author":"S Rasmussen","year":"2020","journal-title":"The Lancet"},{"issue":"8","key":"pone.0261003.ref015","doi-asserted-by":"crossref","DOI":"10.1128\/JCM.00630-20","article-title":"Evaluation of the QIAstat-Dx Respiratory SARS-CoV-2 Panel, the first rapid multiplex PCR commercial assay for SARS-CoV-2 detection","volume":"58","author":"B Visseaux","year":"2020","journal-title":"J Clin Microbiol"},{"issue":"5","key":"pone.0261003.ref016","doi-asserted-by":"crossref","first-page":"100062","DOI":"10.1016\/j.xcrm.2020.100062","article-title":"Point of care nucleic acid testing for SARS-CoV-2 in hospitalized patients: a clinical validation trial and implementation study","volume":"1","author":"DA Collier","year":"2020","journal-title":"Cell Rep Med"},{"key":"pone.0261003.ref017","doi-asserted-by":"crossref","first-page":"104426","DOI":"10.1016\/j.jcv.2020.104426","article-title":"Multi-center evaluation of cepheid Xpert(R) Xpress SARS-CoV-2 point-of-care test during the SARS-CoV-2 pandemic","volume":"128","author":"F Wolters","year":"2020","journal-title":"J Clin Virol"},{"issue":"1","key":"pone.0261003.ref018","doi-asserted-by":"crossref","DOI":"10.1128\/JCM.02338-20","article-title":"Clinical evaluation of BD Veritor SARS-CoV-2 point-of-care test performance compared to PCR-based testing and versus the Sofia 2 SARS antigen point-of-care test","volume":"59","author":"S Young","year":"2020","journal-title":"J Clin Microbiol"},{"issue":"1","key":"pone.0261003.ref019","doi-asserted-by":"crossref","first-page":"20188","DOI":"10.1038\/s41598-020-76913-6","article-title":"A serological assay to detect SARS-CoV-2 antibodies in at-home collected finger-prick dried blood spots","volume":"10","author":"DG Karp","year":"2020","journal-title":"Sci Rep"},{"key":"pone.0261003.ref020","unstructured":"COVID-19 Immunity Task Force. New study to determine how many Canadians have been infected with SARS-CoV-2 2020 [cited 2021 14 March 2021]. Available from: https:\/\/www.covid19immunitytaskforce.ca\/new-study-to-determine-how-many-canadians-have-been-infected-with-sars-cov-2\/."},{"issue":"12","key":"pone.0261003.ref021","doi-asserted-by":"crossref","first-page":"2970","DOI":"10.3201\/eid2612.203309","article-title":"Sensitive detection of SARS-CoV-2-specific antibodies in dried blood spot samples","volume":"26","author":"GL Morley","year":"2020","journal-title":"Emerg Infect Dis"},{"key":"pone.0261003.ref022","first-page":"CD013652","article-title":"Antibody tests for identification of current and past infection with SARS-CoV-2.","volume":"6","author":"JJ Deeks","year":"2020","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"pone.0261003.ref023","article-title":"SARS-CoV-2 infection induces sustained humoral immune responses in convalescent patients following symptomatic COVID-19","author":"J Wu","year":"2020","journal-title":"medRxiv"},{"key":"pone.0261003.ref024","article-title":"Evaluation of antibody testing for SARS-CoV-2 using ELISA and lateral flow immunoassays","author":"ER Adams","year":"2020","journal-title":"medRxiv"},{"key":"pone.0261003.ref025","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.cca.2020.05.050","article-title":"Diagnostic performances and thresholds: The key to harmonization in serological SARS-CoV-2 assays?","volume":"509","author":"M Plebani","year":"2020","journal-title":"Clin Chim Acta"},{"issue":"6","key":"pone.0261003.ref026","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1208\/s12248-020-00510-8","article-title":"Are lessons learned in setting cut points for detection of anti-drug antibodies also useful in serology assays for robust detection of SARS-CoV-2 reactive antibodies?","volume":"22","author":"RR Bowsher","year":"2020","journal-title":"AAPS J"},{"issue":"1","key":"pone.0261003.ref027","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1038\/s41591-020-01202-8","article-title":"Immune determinants of COVID-19 disease presentation and severity","volume":"27","author":"P. Brodin","year":"2021","journal-title":"Nat Med"},{"issue":"1","key":"pone.0261003.ref028","doi-asserted-by":"crossref","first-page":"7754","DOI":"10.1038\/s41598-021-86008-5","article-title":"Self-sampling of capillary blood for SARS-CoV-2 serology","volume":"11","author":"L Brown","year":"2021","journal-title":"Sci Rep."},{"issue":"1","key":"pone.0261003.ref029","doi-asserted-by":"crossref","first-page":"9475","DOI":"10.1038\/s41598-021-88850-z","article-title":"COVID-19 serological survey using micro blood sampling","volume":"11","author":"MM Matthews","year":"2021","journal-title":"Sci Rep"},{"issue":"19","key":"pone.0261003.ref030","article-title":"A simple protein-based surrogate neutralization assay for SARS-CoV-2","volume":"5","author":"KT Abe","year":"2020","journal-title":"JCI Insight."},{"issue":"7","key":"pone.0261003.ref031","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1038\/s41591-020-0913-5","article-title":"A serological assay to detect SARS-CoV-2 seroconversion in humans","volume":"26","author":"F Amanat","year":"2020","journal-title":"Nat Med"},{"issue":"1","key":"pone.0261003.ref032","doi-asserted-by":"crossref","first-page":"159","DOI":"10.2307\/2529310","article-title":"The measurement of observer agreement for categorical data","volume":"33","author":"JR Landis","year":"1977","journal-title":"Biometrics"},{"issue":"2","key":"pone.0261003.ref033","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1214\/ss\/1009213286","article-title":"Interval estimation for a binomial proportion","volume":"16","author":"LD Brown","year":"2001","journal-title":"Statistical Science"},{"issue":"4","key":"pone.0261003.ref034","first-page":"203","article-title":"Measures of diagnostic accuracy: basic definitions.","volume":"19","author":"A-M Simundic","year":"2009","journal-title":"EJIFCC"},{"issue":"2","key":"pone.0261003.ref035","doi-asserted-by":"crossref","DOI":"10.3390\/microorganisms9020245","article-title":"Diagnostic efficiency of three fully automated serology assays and their correlation with a novel surrogate virus neutralization test in symptomatic and asymptomatic SARS-CoV-2 individuals","volume":"9","author":"S Younes","year":"2021","journal-title":"Microorganisms"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0261003","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,7]],"date-time":"2021-12-07T13:38:17Z","timestamp":1638884297000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0261003"}},"subtitle":[],"editor":[{"given":"Gheyath K.","family":"Nasrallah","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,12,7]]},"references-count":35,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2021,12,7]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0261003","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-366992\/v1","asserted-by":"object"}]},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,7]]}}}