Karl Boehme, Ph.D., pipetting serum samples at his laminar flow biosafety cabinet.

The University of Arkansas for Medical Sciences (UAMS) has developed and begun using high-accuracy antibody testing to determine the magnitude of COVID-19 infection in Arkansas and inform the decisions of policymakers.

As part of the research program, UAMS will collect blood samples from nearly 7,500 Arkansas adults and children through October. By early August, a robotic-assisted immunoassay machine will enable processing of 2,500 samples per day for workplace, school and other community settings. UAMS researchers are now processing only up to 180 samples per day by hand.

The effort is supported by $3.3 million in federal coronavirus aid that was then allocated by the Arkansas Coronavirus Aid, Relief and Economic Security Act Steering Committee created by Gov. Asa Hutchinson.

Unlike diagnostic tests, COVID-19 antibody testing looks back into the immune system’s history. A positive antibody test means the person was exposed to the virus and developed antibodies against the virus. It will give state leaders a good idea how many Arkansans have been infected with the virus since it first came to the state, even if they did not become ill or have symptoms.

“It will be critical for policymakers to estimate how many Arkansans have been previously infected as they consider reopening schools, allowing mass gatherings, and keeping workplaces safe,” said UAMS Chancellor Cam Patterson, M.D., MBA.

“As much as we may want to, we know we can’t test everyone with the antibody test right now, but we can design a program that will give us an estimate of how many Arkansans have had COVID-19,” said Laura James, M.D., director of the UAMS Translational Research Institute.

Seroprevalence is the proportion of people in a population whose blood serum tests positive for a particular disease. There are two study components: a laboratory component and a statewide epidemiology component.

The lab component was initiated in early March by Josh Kennedy, M.D., associate professor, College of Medicine, Department of Pediatrics, along with Karl Boehme, Ph.D., and Craig Forrest, Ph.D., both associate professors in the College of Medicine, Department of Microbiology and Immunology.

Boehme and Forrest developed and validated the high-accuracy antibody test using components provided by Florian Krammer, Ph.D., a microbiology colleague at the Icahn School of Medicine at Mount Sinai in New York, and blood samples that Kennedy acquired.

“This vital research would not have been possible without their collaboration and original laboratory science,” said James, also associate vice chancellor for Clinical and Translational Research.

The researchers’ achievement inspired leaders across UAMS and Arkansas Children’s Hospital to come together in support of the statewide project.

The epidemiology component of the study, led by the UAMS College of Public Health, will utilize the contact tracing call center to enroll study participants and college health histories and blood samples from individuals who represent the entire state. It will provide the first results about the prevalence of asymptomatic Arkansans.

The epidemiology component is being led by College of Public Health Dean Mark Williams, Ph.D., and Benjamin Amick, Ph.D., associate dean for research. Key College of Public Health team members are epidemiologists Wendy Nembhard, Ph.D., Victor Cardenas, M.D., Ph.D., and Lori Fischbach, Ph.D., and biostatistician James Selig, Ph.D.

Providing accurate estimates is vitally important in helping policymakers plan for implementing protective and treatment measures in Arkansas,” Williams said. “Without this information, public health officials are just guessing, and there is a chance they will guess wrong.”

The UAMS antibody test requires a small amount of blood, although more than a pin prick. Its validity testing shows it is not fooled by antibodies for other coronaviruses.

Boehme said the antibody testing will serve as a springboard for researchers to answer deeper questions about COVID-19 in other studies, such as:

-- How many antibodies are present when tested?

-- How robust is the immune response?

-- How much antibody is required to provide immunity?

-- How long does immunity last?

“For other coronaviruses, the antibody response may wane after a year or two,” Boehme said. “The duration of immunity has implications for a vaccine; will the vaccine be effective for life or will it be a yearly vaccine like with the flu?”

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