Automated enzyme-linked immunosorbent assay for point-of-care COVID-19 testing

Abstract

The COVID-19 pandemic pushed the demand for readily available monitoring tools, leading to the development of electrochemical point-of-care devices. This work presents an electrochemical capillary-driven immunoassay (eCaDI) device based on polyethylene terephthalate (PET) and adhesive films featuring a screen-printed carbon electrode (SPCE) for the detection of SARS-CoV-2 nucleocapsid (N) protein in clinical samples. The SPCE was modified with protein A and capture antibodies (Ab1) to ensure biomolecule immobilization and enhance sensitivity to detect N protein. The eCaDI automates an enzyme-linked immunosorbent assay (ELISA) through sequential reagent delivery, allowing for one-step sample addition. This process involves capturing the N protein by Ab1, followed by the automated delivery of HRP-labelled antibody and 3,3’,5,5’-tetramethylbenzidine (TMB) followed by electrochemical detection through TMB reduction. The SPCEs are sensitive and selective for SARS-CoV-2 N protein and stable for four weeks. Inactivated virus was used to determine a limit of detection (LOD) of 627 PFU/mL. The results obtained through immunoassay on eCADI were consistent with those of the RT-PCR method, showing a coefficient of determination (R2) of 0.816 for 27 nasal swab samples from SARS-CoV-2 infected individuals. The developed eCADI is an alternative to conventional ELISA, given the device's low cost (less than $1), low consumption of samples and reagents, low waste generation, and short analysis time (5 min). Moreover, the immunoassay has shown potential for diagnosing COVID-19 in decentralized areas.