A young Omani researcher has identified ELISA, the antibody test to be supportive to the PCR test in identifying Covid-19 patients who might have a false negative PCR test on initial presentation as part of the research titled ‘Detection of asymptomatic or mildly symptomatic contacts of confirmed Covid-19 cases in Oman using ELISA test.
The study also tried to address why some patients develop severe illness while others do not have same severity.
The study was carried out by Dr Asma al Balushi, Specialist in Infectious Diseases, as part of her fellowship training programme at the Royal Liverpool University Hospital in collaboration with the research team in Oman. As per the study, an asymptomatic or less symptomatic case can also be a positive case whose symptoms are less evident or hidden and can be a carrier without his/her knowledge.
There have been cases that tested negative when first presented using PCR swab test. But the ELISA antibody test, which was done at two stages “on presentation and at 4 to 6 weeks,” showed that some patients had actually been infected with the virus at that time, Dr Asma al Balushi told the observer.
The team conducted the research by visiting houses of confirmed Covid-19 patients with the support of the Ministry of Health (MoH). It aimed to detect early asymptomatic or mildly symptomatic contacts of Covid-19 cases by using the ELISA test in addition to the accredited PCR test through nasal and throat swabs.
The research team also collected blood samples from mild confirmed cases that did not require hospitalisation and compared them to those with more severe cases admitted to the hospitals. Different inflammatory markers have been studied to know which markers are correlated with disease severity in Covid-19 patients. Genetic testing of the human genome, especially ACE-2 genome, was also performed.
The most important finding of this research project is that ELISA test and PCR testing can be used to detect those affected by Coronavirus without the appearance of any symptoms. Some of these patients had the symptoms appear after 2 or 3 days of testing, and some remained asymptomatic.
“This is very important as it increases awareness of people and enhances early recognition of Covid-19 cases. Therefore, people can be cautious and follow the precautionary measures more strictly and reduce the transmission of the virus.
It is noteworthy that some people did not show a significant immune response; thus, antibody testing by ELISA was negative,” said Dr Al Balushi.
In addition to the above, the research team aimed to identify Covid-19 patients who are at a greater risk of deterioration.
The appearance of different Covid-19 variants, each with different severity, prompts early identification of those patients who might deteriorate more rapidly.
This project helped to recognise patients who might deteriorate earlier by performing special blood tests and inflammatory markers that reflect the immune response to fight the virus.
Knowing these markers and which ones to use to predict patients’ deterioration and disease progression can be used to prevent further deterioration by implementing early interventions while managing these cases. This reduces the load on intensive care units and might even prevent death. These findings have been published as a scientific paper at the “International Journal of Infectious Diseases”.
The Covid-19 Research Programme of the Ministry of Higher Education, Research and Innovation (MoHERI) has witnessed an array of research projects that dives into different aspects regarding the Covid-19 pandemic and studies like this have their value on national and international levels in the present scenario when the country is winning over the pandemic.
“These projects promote and enhance research level in the country to compete with other countries with high research level to provide scientific materials to understand diseases. Moreover, this attracts experienced people from all over the world to collaborate with researchers from our country”, adds Dr Al Balushi.
The research was conducted in collaboration with the Ministry of Higher Education, Research and Innovation (MoHERI), Ministry of Health, Royal Hospital, Sultan Qaboos University Hospital, Royal Liverpool University Hospital in the United Kingdom, the Central Public Health Laboratories and the National Genetic Center in Oman.
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