Evaluation of a Rapid Immunochromatographic Middle East Respiratory Syndrome Coronavirus Antigen Detection Assay

Abstract Middle East respiratory syndrome coronavirus (MERS-CoV) infection in humans has a high mortality of >30%. Dromedaries are the reservoir of MERS-CoV and the main source of human infections. However, MERS-CoV infections in dromedaries are usually subclinical. Rapid diagnosis of MERS-CoV infection in these animals is important in preventing camel-to-human transmission of the virus. The possible cross-reactivity of a previously reported rapid nucleocapsid protein-based antigen detection assay for MERS-CoV was examined with different CoVs, including Tylonycteris bat CoV HKU4, dromedary camel CoV UAE-HKU23, human CoV-229E, human CoV-OC43, severe acute respiratory syndrome CoV-2 and rabbit CoV HKU14, where none of them showed false-positive results. The assay was further validated using quantitative real-time RT-PCR confirmed MERS-CoV-positive and -negative dromedary nasal samples collected in Dubai, the United Arab Emirates, which showed that the rapid antigen detection assay has a specificity of 100% and sensitivity of 91.7%.