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Document Type

Original Study

Subject Areas

Biochemistry

Keywords

Severe Acute Respiratory Syndrome Coronavirus 2; Coronavirus Disease 2019; Diagnostic Performance; SARS-COV-2 Nucleocapsid Antigen

Abstract

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2) was identified as the aetiological agent of coronavirus disease 2019 (COVID-19). The SARS-COV-2 genome encodes four structural proteins include spike (S) protein, envelope (E) protein, membrane (M) protein, and nucleocapsid (N) protein. nucleocapsid protein is one of the predominantly expressed structural proteins and has been confirmed as an ideal target for early diagnostic detection in SARS-COV-2 infection. In the current study, the diagnostic performance of Nucleocapsid antigen in severe acute respiratory syndrome Coronavirus 2 infected individuals is evaluated in Egypt. Patients and Methods: All human individuals’ samples (n= 106) were collected from El Sahel teaching hospital, Cairo, Egypt, after informed consent of the patients. Clinical samples (n=86) (nasopharyngeal and blood specimens) were collected from every patient after confirmed infection (range from 0- 55 days from beginning of symptoms) using RT-PCR. In addition, 25 healthy volunteers with no signs of clinical impairment and normal chest radiographs were included as controls. Results: significant differences in liver enzymes, alanine aminotransferase (ALT) (P < 0.0001), aspartate aminotransferase (AST) (P < 0.0001); also, creatinine (P < 0.0001), RBCs (P < 0.001), hemoglobin (P < 0.0001), lactate dehydrogenase (LDH) (P < 0.0001), WBCs (P = 0.029), and ferritin (P=0.01); neutrophils (P < 0.0001), and lymphocytes, HbA1C, D-dimer, C reactive protein (CRP), and lactate dehydrogenase (LDH). LDH was the most effective biomarker in distinguishing COVID from heathy individuals (AUC= 0.98, sensitivity= 97%, specificity= 95%). Followed by lymphocytes (AUC=0.95), D-Dimer (AUC=0.89), and CRP (AUC=0.85), then nucleocapsid antigen (AUC=0.75) with sensitivity= 50% and specificity= 100%, finally ferritin (AUC=0.61). Conclusion and Summary: SARS-COV-2 nucleocapsid antigen showed a comparable diagnostic performance to the severity of COVID-19.

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