SARS-CoV-2 rapid antibody test results and subsequent risk of hospitalisation and death in 361,801 people

Matthew Whitaker, Bethan Davies, Christina Atchison, Wendy Barclay, Deborah Ashby, Ara Darzi, Steven Riley, Graham Cooke, Christl A. Donnelly, Marc Chadeau-Hyam, Paul Elliott () and Helen Ward
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Matthew Whitaker: Imperial College London
Bethan Davies: Imperial College London
Christina Atchison: Imperial College London
Wendy Barclay: National Institute for Health Research Imperial Biomedical Research Centre
Deborah Ashby: Imperial College London
Ara Darzi: Imperial College Healthcare NHS Trust
Steven Riley: Imperial College London
Graham Cooke: Imperial College Healthcare NHS Trust
Christl A. Donnelly: Imperial College London
Marc Chadeau-Hyam: Imperial College London
Paul Elliott: Imperial College London
Helen Ward: Imperial College London

Nature Communications, 2023, vol. 14, issue 1, 1-8

Abstract: Abstract The value of SARS-CoV-2 lateral flow immunoassay (LFIA) tests for estimating individual disease risk is unclear. The REACT-2 study in England, UK, obtained self-administered SARS-CoV-2 LFIA test results from 361,801 adults in January-May 2021. Here, we link to routine data on subsequent hospitalisation (to September 2021), and death (to December 2021). Among those who had received one or more vaccines, a negative LFIA is associated with increased risk of hospitalisation with COVID-19 (HR: 2.73 [95% confidence interval: 1.15,6.48]), death (all-cause) (HR: 1.59, 95% CI:1.07, 2.37), and death with COVID-19 as underlying cause (20.6 [1.83,232]). For people designated at high risk from COVID-19, who had received one or more vaccines, there is an additional risk of all-cause mortality of 1.9 per 1000 for those testing antibody negative compared to positive. However, the LFIA does not provide substantial predictive information over and above that which is available from detailed sociodemographic and health-related variables. Nonetheless, this simple test provides a marker which could be a valuable addition to understanding population and individual-level risk.

Date: 2023
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DOI: 10.1038/s41467-023-40643-w

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