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Abstract

Background

The current SARS-CoV-2 pandemic has highlighted a need for easy and safe blood sampling in combination with accurate serological methodology. Venipuncture for testing is usually performed by trained staff at healthcare centres. Long travel distances to healthcare centres in rural regions may introduce a bias of testing towards relatively large communities with closer access. Rural regions are therefore often not represented in population-based data.

Aim

The aim of this retrospective cohort study was to develop and implement a strategy for at-home testing in a rural region of Sweden during spring 2021, and to evaluate its role to provide equal health care for its inhabitants.

Methods

We developed a sensitive method to measure antibodies to the S-protein of SARS-CoV-2 and optimised this assay for clinical use together with a strategy of at-home capillary blood sampling.

Results

We demonstrated that our ELISA gave comparable results after analysis of capillary blood or serum from SARS-CoV-2-experienced individuals. We demonstrated stability of the assay under conditions that reflected temperature and humidity during winter or summer. By assessment of capillary blood samples from 4,122 individuals, we could show both feasibility of the strategy and that implementation shifted the geographical spread of testing in favour of rural areas.

Conclusion

Implementation of at-home sampling enabled citizens living in remote rural areas access to centralised and sensitive laboratory antibody tests. The strategy for testing used here could therefore enable disease control authorities to get rapid access to information concerning immunity to infectious diseases, even across vast geographical distance.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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2023-03-30
2024-04-27
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2023.28.13.2200432
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At-home sampling to meet geographical challenges for serological assessment of SARS-CoV-2 exposure in a rural region of northern Sweden, March to May 2021: a retrospective cohort study
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Julia+Wigren+Bystr%C3%B6m&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Byström Julia Wigren</a>, <a href="/search?value1=Linnea+Vikstr%C3%B6m&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Vikström Linnea</a>, <a href="/search?value1=Ebba+Rosendal&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Rosendal Ebba</a>, <a href="/search?value1=Remigius+Gr%C3%B6ning&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Gröning Remigius</a>, <a href="/search?value1=Yong-Dae+Gwon&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Gwon Yong-Dae</a>, <a href="/search?value1=Emma+Nilsson&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Nilsson Emma</a>, <a href="/search?value1=Atin+Sharma&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Sharma Atin</a>, <a href="/search?value1=Akbar+Espaillat&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Espaillat Akbar</a>, <a href="/search?value1=Leo+Hanke&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hanke Leo</a>, <a href="/search?value1=Gerald+McInerney&option1=author&noRedirect=true" class="nonDisambigAuthorLink">McInerney Gerald</a>, <a href="/search?value1=Andrea+Puhar&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Puhar Andrea</a>, <a href="/search?value1=Felipe+Cava&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Cava Felipe</a>, <a href="/search?value1=Gunilla+B+Karlsson+Hedestam&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Karlsson Hedestam Gunilla B</a>, <a href="/search?value1=Therese+Thunberg&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Thunberg Therese</a>, <a href="/search?value1=Tor+Monsen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Monsen Tor</a>, <a href="/search?value1=Fredrik+Elgh&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Elgh Fredrik</a>, <a href="/search?value1=Magnus+Evander&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Evander Magnus</a>, <a href="/search?value1=Anders+F+Johansson&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Johansson Anders F</a>, <a href="/search?value1=Anna+K+%C3%96verby&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Överby Anna K</a>, <a href="/search?value1=Clas+Ahlm&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ahlm Clas</a>, <a href="/search?value1=Johan+Normark&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Normark Johan</a>, <a href="/search?value1=Mattias+NE+Forsell&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Forsell Mattias NE</a></span>. At-home sampling to meet geographical challenges for serological assessment of SARS-CoV-2 exposure in a rural region of northern Sweden, March to May 2021: a retrospective cohort study. <a href="/content/ecdc">Euro Surveill.</a> 2023;28(13):pii=2200432. <a href="https://doi.org/10.2807/1560-7917.ES.2023.28.13.2200432" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2023.28.13.2200432</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 23 May 2022;&nbsp;&nbsp; <span class="generated">Accepted</span>: 13 Jan 2023 </span> </p>
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