Evidence map›Paper›PMID 34605900›Full record

ArticleClinical chemistry2021

SARS-CoV-2 Nucleocapsid Plasma Antigen for Diagnosis and Monitoring of COVID-19.

Hannah Wang, Catherine A Hogan, Michelle Verghese, Daniel Solis, Mamdouh Sibai, ChunHong Huang, Katharina Röltgen, Bryan A Stevens, Fumiko Yamamoto, Malaya K Sahoo and 3 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical chemistry, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed
2.8field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 47 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. Article
  5. Review
  6. Article
  7. Article
  8. Review
  9. Article
  10. Review
  11. Article
  12. Review
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 1 institution in 1 country.

Hannah WangDepartment of Pathology, Stanford University School of Medicine, Stanford, CA, USA.ORCID 0000-0002-3712-9188
Catherine A HoganDepartment of Pathology, Stanford University School of Medicine, Stanford, CA, USA.
Michelle VergheseDepartment of Pathology, Stanford University School of Medicine, Stanford, CA, USA.
Daniel SolisDepartment of Pathology, Stanford University School of Medicine, Stanford, CA, USA.
Mamdouh SibaiDepartment of Pathology, Stanford University School of Medicine, Stanford, CA, USA.
ChunHong HuangDepartment of Pathology, Stanford University School of Medicine, Stanford, CA, USA.
Katharina RöltgenDepartment of Pathology, Stanford University School of Medicine, Stanford, CA, USA.
Bryan A StevensDepartment of Pathology, Stanford University School of Medicine, Stanford, CA, USA.
Fumiko YamamotoDepartment of Pathology, Stanford University School of Medicine, Stanford, CA, USA.
Malaya K SahooDepartment of Pathology, Stanford University School of Medicine, Stanford, CA, USA.
James ZehnderDepartment of Pathology, Stanford University School of Medicine, Stanford, CA, USA.
Scott D BoydDepartment of Pathology, Stanford University School of Medicine, Stanford, CA, USA.
Benjamin A PinskyDepartment of Pathology, Stanford University School of Medicine, Stanford, CA, USA.ORCID 0000-0001-8751-4810
Stanford University · US

Funding

Stanford Center for Clinical & Translational Education and Research (Spectrum)UL1TR003142 · NCATS · STANFORD UNIVERSITY · PI O'HARA, RUTH M · 2019 to 2023
$45.0M
Spectrum Stanford Center for clinical and Translational Research and EducationUL1TR001085 · NCATS · STANFORD UNIVERSITY · PI CULLEN, MARK RICHARD, GREENBERG, HARRY BERNARD · 2013 to 2017
$37.1M
Project 3: T CellsU54CA260517 · NCI · STANFORD UNIVERSITY · PI DAVIS, MARK MORRIS · 2020 to 2024
$10.4M
Effects of aging on primary and secondary vaccine responses in a 15-year longitudinal cohortR01AI130398 · NIAID · STANFORD UNIVERSITY · PI BOYD, SCOTT DEXTER · 2017 to 2021
$4.0M
Storage and recall of human B cell memory of influenza over tissues and timeR01AI127877 · NIAID · STANFORD UNIVERSITY · PI BOYD, SCOTT DEXTER · 2017 to 2021
$2.0M
NCATS NIH HHS UL1 TR001085NCATS NIH HHS UL1 TR003142NCI NIH HHS U54 CA260517NIAID NIH HHS R01 AI127877NIAID NIH HHS R01 AI130398NIH HHS 1U54CA260517NIH HHS UL1 TR001085
6 · The paper itself

Abstract

backgroundDetection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleocapsid antigen in blood has been described, but the diagnostic and prognostic role of antigenemia is not well understood. This study aimed to determine the frequency, duration, and concentration of nucleocapsid antigen in plasma and its association with coronavirus disease 2019 (COVID-19) severity.

methodsWe utilized an ultrasensitive electrochemiluminescence immunoassay targeting SARS-CoV-2 nucleocapsid antigen to evaluate 777 plasma samples from 104 individuals with COVID-19. We compared plasma antigen to respiratory nucleic acid amplification testing (NAAT) in 74 individuals with COVID-19 from samples collected ±1 day of diagnostic respiratory NAAT and in 52 SARS-CoV-2-negative individuals. We used Kruskal-Wallis tests, multivariable logistic regression, and mixed-effects modeling to evaluate whether plasma antigen concentration was associated with disease severity.

resultsPlasma antigen had 91.9% (95% CI 83.2%-97.0%) clinical sensitivity and 94.2% (84.1%-98.8%) clinical specificity. Antigen-negative plasma samples belonged to patients with later respiratory cycle thresholds (Ct) when compared with antigen-positive plasma samples. Median plasma antigen concentration (log10 fg/mL) was 5.4 (interquartile range 3.9-6.0) in outpatients, 6.0 (5.4-6.5) in inpatients, and 6.6 (6.1-7.2) in intensive care unit (ICU) patients. In models adjusted for age, sex, diabetes, and hypertension, plasma antigen concentration at diagnosis was associated with ICU admission [odds ratio 2.8 (95% CI 1.2-6.2), P=.01] but not with non-ICU hospitalization. Rate of antigen decrease was not associated with disease severity.

conclusionsSARS-CoV-2 plasma nucleocapsid antigen exhibited comparable diagnostic performance to upper respiratory NAAT, especially among those with late respiratory Ct. In addition to currently available tools, antigenemia may facilitate patient triage to optimize intensive care utilization.

Indexed as

COVID-19Antigens, ViralCoronavirus Nucleocapsid ProteinsCOVID-19 TestingElectrochemical TechniquesHospitalizationHumansImmunoassayLuminescent MeasurementsNucleocapsidPhosphoproteinsSARS-CoV-2Sensitivity and SpecificityAntigens, ViralCoronavirus Nucleocapsid Proteinsnucleocapsid phosphoprotein, SARS-CoV-2Phosphoproteins

Identifiers

PMID34605900
PMCPMC8522398
OpenAlexW3202826924

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.