FDA CovAb SARS-CoV-2 Ab Test Kit Instructions

June 5, 2024
FDA

CovAb SARS-CoV-2 Ab Test Kit

CovAbTM
SARS-CoV-2 Ab Test
For Emergency Use Authorizat io n (EUA) only For prescriptio n use only
For in vitro diagnostic use only
Version 3.0

INTENDED USE
The CovAbTM SARS-CoV-2 Ab Test is a lateral-flow immunoassay intende d for the qualita ti v e detect i on of total antibod y (incl u d i n g IgG, IgA and IgM) to SARS-C o V -2 in oral fluid (gingi va l crevi cu la r fluid ­ GCF). The CovAbTM SARS- CoV-2 Ab Test is intended for use as an aid in identi fyi ng indivi d ua l s with an adapti ve immune res p o n s e to SARS-CoV-2, indicating recent or prior infection. The CovAbT M SARS-CoV-2 Ab Test should not be used to diagnose or exclude acute SARS-CoV-2 infection. At this time, it is unknown for how long antibodies persist following infection and if the presence of antibod i es confer s protecti ve immuni t y.
Testing of oral fluid specimens is limited to laboratories certified under the Clinical Laboratory Improvement Amendments of 1988 (CLIA), 42 U.S.C. §263a, that meet requirements to perform moderate, high, or waived complexity tests. Testing of oral fluid speci m en s This test is authori ze d for use at the Point of Care (P O C ) , i.e., in patient care settings operati ng under a CLIA Certifi ca t e o f Waiver , Certifi cat e of Compli a n ce , or Certifi cat e of Accre d it a ti o n .
Results are for the detection of total SARS-CoV-2 antibodies. The duratio n of time antibodi e s are present in oral fluid post-i n fe c t i o n is not well characterized. Individuals may have detectable virus present for several weeks follo wi ng serocon v er si o n .
Laborato ri e s within the United States and its territori e s are requ i r e d to report all results to the approp ri at e public health authorit i es .
The sensitivity of CovAbTM SARS-CoV-2 Ab Test early after infection is unknown. Negative results do not preclude acute SARS-Co V-2 infection. If acute infection is suspected, direct testing for SARSCoV-2 is necess ar y .
False-positive results for CovAbTM SARS-CoV-2 Ab Test may occur due to cross-r ea ct i vit y from pre-exi st i ng antibo di e s or other poss i b l e causes. Due to the risk of false positive results, confirmation of positive results should be considered using a second, different SARS-CoV-2 antibody assay.
Sampl es should only be tested from individ u a ls who are 15 days or more post symptom onset.
The CovAbTM SARS-CoV-2 Ab Test is only for use under the Food and Drug Admin is tr a ti o n ‘s Emerge n cy Use Authori za ti o n .
BACKGROUND
Corona vir u s es (CoV ) are a large family of viruses that cause ill n e s s ranging from the common cold to more severe diseases such as Severe Acute Respirat o r y Syndro m e (SARS-CoV )1-5. SARS-C oV -2 is a new strain that has not been previously identified in humans.

Corona vir u s es are zoonoti c, meaning they are transmi tt e d bet w e e n animals and people . Severa l known corona vi r us e s are circula t in g in animals that have not yet infect e d human s .
The 2019 Novel Coronavirus (SARS-CoV-2) is identified as the cause of an outbre ak of respirat or y illness first detect e d in Wu h a n , China. The disease caused by SARS-CoV-2 is known as Coronavirus Disease (COVID-19). Patients infected with SARS-CoV-2 report a mild to severe respiratory illness with symptoms of fever, cough, shortne ss of breath , but can also be asymp t o m at i c. Symp to m a t i c , pre- symptomatic, and asymptomatic SARS-CoV-2 carriers all can be potentia l sources for viral transmission6. There is an urgent ne e d for rapid tests to manage the ongoing pande mi c .
PRINCIPLES OF THE PROCEDURE
The CovAbTM SARS-CoV-2 Ab Test is a lateral-flow chromatographic immunoassay that can detect antibodies specific to the SARSCoV-2 virus in oral fluid speci m e ns .
The test uses a SARS-CoV-2-specific protein (spike protein S1 domain) bound to a detector and a cocktail of anti-human IgA, IgM, and IgG antibod i es for captur e . The test control line emp l o ys Strepta vi d i n bound to a detect or and Biotin couple d Bovine Se r u m Albumin.
Control Line Test Line Sample Well
When a test specimen is dispensed into the sample well of the test cartridge, the specimen migrates by capillary action along the cartridge. The anti-SARS- CoV-2 antibodies, if present in the specimen, will bind to the SARS-CoV-2 colloidal gold conjugate forming an immunocomplex. The immunocomplex will then be captured by the anti-immunoglobulin coated test line, forming a reddish- purple colored test line, indicating a SARS-CoV-2 virus antibod y -p os it i ve test result.
The control line will capture streptavi di n colloidal gold. If the cont r o l line is present , it indicat es that the test cartridg e ran proper l y. If th e control line is absent, it indicat e s an invali d result and the sa m p l e should be re-test e d with a differ e nt test cartrid g e .
Information regarding the immune response to SARS-CoV-2 is limited and still evolvi ng .
At this time, it is unknow n how long antibod i es may persist follo w i n g SARS-CoV-2 infection.

COVID-19 Ab C T

WARNINGS AND PRECAUTIONS
1. For in vitro diagnos ti c use only. For prescr i pt io n use only. For u s e under Emerge n cy Use Authori zat i o n only.
2. Test cartrid g es are single use only. Do not reuse test cartridg e s .
3. This product has not been FDA cleared or approved, but has been authori ze d for emergen c y use by FDA under an EUA for u s e by authori ze d laboratori e s .
4. This product has been authorized only for detecting the presence of total antibodies to SARS-CoV2, not for any other viruses or pathoge ns .
5. The emergency use of this product is only authorized for the duratio n of the declar at i on that circu ms t a n ces exist justif y i n g the authorization of emergency use of in vitro diagnostics for detection and/or diagnosis of COVID-19 under Section 564(b) (1) of the Federal Food, Drug and Cosmetic Act, 21 U.S.C. § 360bbb3(b)(1), unless the declaration is terminated or authori zat io n is revoke d sooner .
6. All human oral fluid speci m en s should be handle d as potenti a l l y infectious material. The Centers for Disease Control and the National Institutes of Health recommend that potentially infect i o us agents be handle d at Biosafe t y Level 2.
7. Read the product insert completely before using this assay. Follow the instru ct i on s careful l y, as not doing so may result i n inaccu ra t e or invali d test results.
8. Use of this test kit with sample types other than those specifically approved for use with this device may result in inaccu ra t e or invali d test results.
9. This test should be performed at 18 to 30°C (64 to 86°F). If test kit stored refrigerated, ensure that the pouch and sample solution are brought to operating temperature before perfor m i ng the test.
10. Specimens from patients with active oral infections and/or bleeding gums were not tested and could provide erroneous results.
11. Do not use expired kit compo n e nt s or tests.
12. Do not open the sealed test cartridg e pouch until you are r e a d y to condu ct the test.
13. The person tested should not eat, drink, or smoke within 30 minute s of collecti n g an oral fluid sample and perfor mi n g t h e test.
14. If desiccan t packet is missing , DO NOT USE. Discard test device

and use a new test device .
15. Do not use any test device if the cartridge pouch has been perforated.
16. Do not mix reagent s from diffe r e nt lot number s of kits.
17. Avoid contamination of collection swab and sample solution with foreign matter .
18. Do not use the colle ct i on swab if the package has been o p e n e d or if the swab is droppe d .
19. Do not touch the collection swab pad with fingers before or after specimen collectio n .
20. Test results should be read at 15 minutes. Reading after 20 minute s may give erroneo us results .
21. Only interpre t the test results where there is adequat e lighting .
22. Wash hands thoroug h l y after perfor m i ng the test.
23. Do not reuse the colle cti o n swab or specim e n colle cti o n tube.
24. Each test device is for single use only.
SAFETY PRECAUTIONS
1. Oral fluid specimens may be infectious. Use universal precau ti o n s when perfor m i ng this assay.
2. Wear protecti v e clothi ng such as laborato r y coats, dispo s a b l e gloves and safety glasses when handli ng patient samples . W a s h hands thoroug h l y befor e and after handlin g speci m e ns and ki t reagents.
3. Dispose of all samples and material s used in the test proce d u r e in a biohazard waste container. Proper handling and disposal method s should be establis h e d accor di n g to local regulati o n s .
4. Use routine laborato r y precau ti o n s . Do not eat, drink, or s m o k e in the area where samples and kit reagent s are handle d . A vo i d any contact between hands, eyes or mouth during sample collecti on and testing.
5. Use freshl y prepare d 10% bleach to decont a m in a t e surface s i n the event of a spill of collecte d specimen .
STORAGE AND STABILITY
The CovAbTM SARS-CoV-2 Antibody Test kit should be stored in unopen e d pouch es at 2 to 30°C (36 to 86°F). Do not freeze . Do n o t open pouch until you are ready to perfor m a test. When stored a s indica te d , test devices are stable until the expiratio n date marked

on the pouch. If stored at 2-8°C, ensure that the test device is brought to 18-30° C (64 to 86°F) befor e opening .
SPECIMEN STORAGE AND STABILITY
If testing cannot be performed immediately after colle ct i on , speci m en should be stored at 2-8°C for up to 24 hours.
REAGENTS AND MATERIALS
REAGENTS AND MATERIALS PROVIDED Instructi o n s for use (this docu me n t ) Each box of fifty (50) tests contain s 50 Single Test kits. Each Single Test kit contain s : A . One (1) test cartridg e sealed in a foil pouch with desicca n t B . One (1) individua ll y wrapped sterile oral fluid collecti on swab C . One (1) tube containing 800 µL sample solution (buffer
contain in g protein stabilizer and antimi cro b ia l agent) 4. One (1) sample transfer pipette
COVID-19 Ab
OTHER REQUIRED, BUT NOT PROVIDED MATERIALS · Timer · Tube rack · CovAbTM Control Kit (Cat. # 2039): 2 x 0.5 mL

Manuf act ur ed by:

Co vAb T M
SARS-Co V-2 Ab Test

Di abet om i cs, Inc. 2S3u4i 5t eN#W1O4v0er l ook Dr i ve

Hi l l sbor o, OR 97006, USA

LN- 6096 Rev. A

Co n ta ins1 Test Cartridg

3036

EXTERNAL CONTROLS
External positive and negative controls are not included with the test kit. External controls are available for purchase separately from Diabeto m i cs , Inc. (Cat. # 2039). To run the external contr o l s , follo w the instru ct io n s provid e d in the CovA b T M Control kit. Exte r n a l control s should be run before testing any sampl es with the CovA b T M SARS-CoV-2 Ab Test.
PREPARATION AND SPECIMEN COLLECTION
Consider any materials of human origin as infectious and handle using standard biosafe t y proce d ur es . PREPAR IN G FOR THE TEST 1. Read and make sure you underst an d these instructi o n s b e fo r e
running the test. 2. Have a watch, clock, or timer available . 3. Wash and dry your hands before starting the test. 4. If the patient wears dentures or false teeth, have them take
them out of their mouth before perfor m i ng the test. 5. The patient should not eat or drink during the 30 minutes
before starting the test. This includes chewing tobacco or chewing gum. 6. If a second oral sample is needed , wait until at least 30 mi n u t e s after collect ing the first sample before collecti ng a new one. COLLECTING THE SPECIMEN
1 Open the sample collection tube and place it in a tube rack.
2 Tear open the package containing the swab and remove the swab by grasping the handle . Do not touch th e cloth end of the swab.
3 Identi fy the upper gum line where th e teeth and gum meet. Insert the swab into the back corner of the upper gu m line in the mouth.

4 Apply modera t e pressur e to slowl y an d gently brush the entire length of the upper gum line with the flat side of th e swab in one direction until reaching the other corner of the mouth .

5 Using the same proced ur e , gently w i p e the swab a second time back across the upper gum line to return to the starting position.
Turn the swab over.
6 Using the other side of the swab’s fl a t head, do the same process with the entire lower gum line. Gently wipe the swab against the entire length of the lower gum line in one direction, then back to the starting position .
7 Immediately and carefully without splashing, insert the swab head into the tube containing the sample solution.

8 Grasp the swab handle firmly and slowly push the swab up and down inside the tube 6 to 8 times. This will mix the liquid in the tube with the liquid in the swab as much as possibl e .

6-8x

9 Squee ze as much liquid from the s w a b as possible by pressing each side of the swab 2 to 3 times against the inside of the tube above the level of the liquid.
10 Remove the swab from the tube and discar d it. The speci m e n is now r e a d y for testing .

TEST PROCEDURE
1 Remove the test cartridge from the foil pouch immediately before it is to be used and place it on a flat surface .
2 Use the transfer pipette to collect the liquid sample. Press the bulb completely and release to fill the pipette up to the line marking .
3 Deliver 5 drops of the liquid sample from the tip end of the transfer pipette into the sample well.
4 Start a timer for 15 minute s and allow the test to run.
5 Read results in 15 minutes. DO NOT INTERPRET RESULTS AFTER 20 MINUTES. Discard the device after interpreting the result.

COVID-19 Ab C T

COVID-19 Ab C T

COVI D- 19 Ab C T

CovAbScr eenT M SA Rb S-C To Ve st-2
D ai b e to m i MC oa n atu niaf sutc re d1 T be sty: C a rtid g e
2 3 4 5 NW O ev rlo o k

C O V ID -1 9 A b C T

15:00 00:00

COVID-19 Ab C T

INTERPRETATIONOF TEST RESULT
POSITIVE TEST RESULT When there is a visibl e color line adjace n t to both the test (T) li n e and the control (C) line, this indicat e s that the sample is positi ve an d SARS-CoV-2 antibodies were detected.
Control Line Test Line Sample Well
NEGATIVE TEST RESULT When only the control line (C) is visible and there is no test (T) li n e , this indicates the samples is negative and SARS-CoV-2 antibodies were not detecte d .
Control Line Test Line Sample Well
INVALID TEST For the test to be valid , there must be a visibl e control line (C). If there is no control line, the result is invalid . The invalid result shou l d not be reported. Repeat the test with a new cartridge. (Wait 30 minutes before resamp li ng ). If repeated invali d results are obser v e d , test with a different antibody test to SARS-CoV-2.
Control Line Test Line Sample Well
Control Line Test Line Sample Well

COVID-19 Ab C T

C

T

COVID-19 Ab

C

T

COVID-19 Ab

PERFORMANCE CHARACTERISTICS
CLINICAL EVALU ATIO N: Laborato ry-b as ed study
The clinical performance of the CovAbTM SARS-CoV-2 Ab Test was evaluated in a prospective study testing 155 oral fluid (GCF) samples collected from SARS- CoV-2 RT-PCR positive and negative indivi d ua l s as indicat e d below . All sample s were random i ze d and al l test operator s were blinde d to the status of each sample .
Positive Percent Agreement: CovAbTM SARS-Co V-2 Ab Test Positive percent agreement (PPA) in SARS-CoV-2-positive samples ­ laborat or y -b as e d study.
Subjects: 73 subjects hospitalized for COVID-19 infection or suspected of COVID-19 and confirmed positive in a SARS-Co V-2 RT-P C R test. The sample collecti o n s ranged from 3 days to 218 da ys from onset of symptoms. Samples were tested with the CovAbTM SARS-C o V -2 Ab Test by lab techni cia n s . Positive percen t agree m e n t (PPA) with SARS-CoV-2 RT-PCR-positive samples presented by days post onset of sympt o m s is summa ri ze d in the table below .

Days from onset of symptoms
0 – 7 days 8 – 14 days 15 days Total

No. of RT-PCR positive subjects tested
12 19
42
73

CovAbTM SARS-CoV-2 Ab test results

No. of total antibodies
positive subjects
5
16
41

Total antibodies PPA
5/12 (41.67%) 16/19 (84.21%) 41/42 (97.62%)

95% CI
15.17% – 72.33% 60.42% – 96.62% 87.43% – 99.94%

Negative Percent Agreement: CovAbTM SARS-CoV-2 Ab Tes t Negative percent agreement (NPA) in SARS-CoV-2 -n ega t i ve samples.
Subjects: 82 subjects who were SARS-CoV-2-negative based on a RT-PCR test were tested with the CovAbTM SARS-CoV-2 Ab Test. Negative percent agreement (NPA) with SARS-CoV-2 negative sample s is summa ri ze d in the table below .

No. of RT-PCR negative
subjects tested
82

CovAbTM SARS-CoV-2 Ab test results

No. of total antibodies negative
subjects
81

Total antibodies NPA

95% CI

81/82 (98.78%) 93.39% – 99.97%

POINT- O F-C A R E USE
A prospective study was conducted using oral fluid specimens (GCF ) colle cte d from subje ct s at a nursing home facilit y in Seat t l e , Washington, USA. A total of 151 subjects who tested positive or negative for SARS-CoV-2 by the molecular test were tested by 6 non-laboratorian operators using the CovAbTM SARS-CoV-2 Ab Test. The oral fluid (GCF) sample collections ranged from 8 days to 160 days from onset of symptoms. Positive percent agreement (PPA) with SARS-CoV-2 RT-PCR-positive samples and negative percent agreeme nt (NPA) are summar i ze d in the tables below .

Days from onset of symptoms

No. of RT-PCR positive subjects tested

0-7 days

0

8-14 days

4

15 days

69

Total

73

NA – Not applicabl e

CovAbTM SARS-CoV-2 Ab test results

No. of total antibodies
positive subjects
NA
4
67

Total antibodies PPA
NA 4/4 (100%) 67/69 (97.10%)

95% CI
NA 39.76% – 100% 89.92% – 99.65%

No. of RT-PCR negative
subjects tested
78

CovAbTM SARS-CoV-2 Ab test results

No. of total antibodies negative
subjects
76

Total antibodies NPA

95% CI

76/78 (97.4%)

91.04% – 99.69%

ROBUSTN ESS of the CovAbTM SARS-Co V- 2 Ab Test:
Studie s were perfor m e d to evaluat e the robust use of this test fo r point of care settings . Varying reading time, amount s of sample (b y evalua ti ng swab handlin g after samples collect io n ), varying am o u n t s of Sampl e Diluent , temper at u re , humidi t y, device inclin at io n , a n d lighting conditi o ns were assesse d . The results indica t e d that tes t i n g at 37°C with 95% relative humidit y (RH) may reduce test line co l o r intensity. Testing at 40°C with 60% RH and 95% RH may produce false negative results. Other results from this testing indica t e th a t the test will perform as expected across environmental and use variati on s that may occur in POC settings .
CROSS-REACTI VI TY
The CovAbTM SARS-CoV-2 Ab Test was evaluated for potential

cross-reactivity in conditions unrelated to SARS- CoV-2 infection. SARS-CoV-2 antibody negative oral fluid (GCF) specimens were spiked with serum sample s contai ni n g antibo di e s to potenti al cr o s s reactants and then tested with the CovAbTM SARS-CoV-2 Ab Test. No false positi ve results were observe d . The results are summa r i z e d
in the table below.

Potential cross-reactant (Positive serum samples)
Influenza A Influenza B Haemophil us influenza Respiratory SyncytialVirus (RSV) Hepatiti s C Virus (HCV) Hepatiti s B Virus (HBV) Human Immunodefi ci ency Virus (HIV) Alpha coronavirus229E Alpha coronavirusNL63 Beta coronavirusOC43 Beta coronavirusHKU1 Rheumatoi d factor (RF)

Number of
samples tested
5 7 8 9 5 5 5 20 17 17 12 5

CovAbTM SARS-CoV-2 Ab test results

Reactive Non-Reactive (Positive) (Negative)

0

5

0

7

0

8

0

9

0

5

0

5

0

5

0

20

0

17

0

17

0

12

0

5

INTERFEREN CE
Because the CovAbTM SARS-CoV-2 Ab Test uses an oral fluid speci m en potentia l interfe r e n ce evalua ti ng exogenou s substa n c e s that may be expecte d to be consu m e d orally was condu ct ed . T h e following potential interferents tested did not show interference with test results .

Matrix tested Gingival crevicular fluid

Potential Interferent Ethanol Nicotine
Whole blood Caffeine Food Soda
Mouthwash Cough syrup

Concentration tested 1% v/v
0.01 mg/mL 0.1-0.8% (v/v)
1 mg/mL Custom Normal consumption Normal use
7%

LIMITATIONS OF THE PROCEDURE
1. Sampl es should only be tested from indivi d ua l s who are 15 d a ys or more post sympto m onset. Negative results do not pre cl u d e acute SARS- CoV-2 infection. If acute infection is suspected , direct testing for SARS- CoV-2 is necessary.
2. Results from antibo d y testing should not be used as to dia g n o s e or exclude SARS-CoV-2 infection.
3. Positive results may be due to past or present infection with non-SARS- CoV-2 coronavirus strains such as coronavirus HKU1, NL63, OC43, or 229E.
4. Not for the screen i ng of donated blood.
5. A positive result may not indicate previous SARS-Co V-2 infect i o n . Consid er other inform a ti o n , includ i ng clinical hi s t o r y and local disease preval e n ce , in assessi ng the need for a s e co n d but differ e nt serolog y test to confi r m an immun e respons e .
6. It is unknown at this time if the presence of antibodies to SARS-CoV-2 confers immunity to infection.
7. The performance of this test has not been established in indivi d ua l s that have recei ve d a COVID -1 9 vacci n e . The clin i c a l signifi ca n ce of a positive or negati ve antibod y result follo w i n g COVID -1 9 vacci na ti o n has not been establis h e d , and the res u l t from this test should not be interpreted as an indication or degree of protect i on from infect i on after vacci na ti o n .
8. The performance of this test was established based on the evalua ti o n of a limited number of clini ca l speci m e ns colle c t e d between June 2020 and October 2020 and between May 2020 and June 2020 for lab-based studies conducted in the United States and in India, respecti v el y . For POC studies samples w e r e collected between June 2020 and August 2020 in the United States. The clinical performance has not been established in all circul at i ng varian ts but is anticip a te d to be refle ct i ve of t h e preval e nt variants in circul a ti o n at the time and locatio n of t h e clinica l evalua ti o n . Perfor m a n ce at the time of testing may va r y depend in g on the variant s circul at in g , includi n g newly emer g i n g strains of SARS- C o V -2 and their prevale n ce , which change o ve r time.
9. Proper sample colle ct i o n is critica l for optimal test perfor m a n c e . The CovAbTM SARS-CoV-2 Ab Test must be used in accordan ce with the instructions in this product insert to obtain accurate results.
10. This test uses a biotin-st re p ta vi d in interacti o n for generat i ng t h e Control Line. Testing sampl es collect e d from subje ct s with hi g h doses of biotin intake may cause invali d or erroneo u s test results .

11. This test has not been validat e d in the presen ce of active or a l infect io n s and/or bleedi ng gums.
12. Testing at 37°C with 95% relative humidity (RH) may reduce test line color intensi t y. Testing at 40°C with 60% RH and 9 5 % RH may reduce test line color intensit y and may produce fa l s e negative results.
13. Reading test results earlier than 15 minutes or later than 20 minutes after the addition of the prepared sample may yield erroneous results.
14. The results obtained with this test should only be interpreted in conju n ct io n with clinica l findin gs , and the results from ot h e r laborato r y tests and evalua ti o n s .
15. The test is limited to qualitat i ve detect io n of antibo di e s spe ci f i c for SARS-CoV-2. The color intensity of the test line does not correla t e to SARS-C o V -2 antibod y levels in the speci me n .
16. A negati ve result does not rule out disease or previou s exp o s u r e and can occur if the quantity of antibodies for SARS-CoV-2 in the speci m e n is below the detect io n limit of the test.
CONDITIONS OF AUTHORIZATION FOR THE LABORATORY
The CovAbTM SARS-CoV-2 Ab Test Letter of Authorization, along with the authorized Fact Sheet for Healthcare Providers, the authorized Fact Sheet for Recipients, and authorized labeling are availab le on the FDA websit e :
https:/ / w w w .fd a .g o v/ m e di c al -d e vi ce s / cor o n a vi r us – di s ea s e -20 1 9 covid -1 9 -e m er g e n cy- us e -a ut h or i zat i o ns -m e di ca l -d e vi ce s/ i n -vi tr o diagnostics-euas
Authorized laboratories using the CovAbTM SARS- CoV-2 Ab Test, Letter of Author i zat io n (“you r produ ct ” in the condit i on s be l o w ) , must adhere to the Conditions of Authorization indicated in the Letter of Authori zat i on as listed below :
1. Authorized laboratories using your product must include with test result reports, all authorized Fact Sheets. Under exigent circumstances, other appropriate methods for disseminating these Fact Sheets may be used, which may includ e mass media .
2. Authorized laboratories must use your product as outlined in the authorized labeling. Deviations from the authorized proced u r es , inclu di ng the authori ze d clinica l specim e n typ e s , authorized control materials, authorized other ancillary reagents and authori ze d material s require d to use your pro d u c t are not permitt e d .

3. Authori ze d laborato ri e s that receive your product must no t i f y the relevan t publi c health authorit i es of their intent to run yo u r product prior to initiatin g testing .
4. Authorized laboratories using CovAbTM SARS- CoV-2 Ab Test must have a process in place for reporting test results to health ca r e provid e rs and relevan t public health authori ti e s a s appropriate.
5. Authorized laboratories must collect information on the performance of your product and report to DMD/OHT7-OIR/ OPEQ/CDRH (via email: CDRH-EUA- Reporting@fda.hhs. gov) and Diabetomics, Inc. (support@diabetomics.com) any suspect e d occur re n c e of false-p o si ti v e or false – negati ve res u l t s and significant deviations from the established performance charact er is t i cs of your product of which they becom e aware .
6. All laboratory personnel using your product must be appropr ia t el y trained in immun o chr o m a to gr a p hi c techn i q u e s and use appropriate laboratory and personal protective equipment when handling this kit, and use this product in accord a n ce with the authorize d labeling . All laborato r y pers o n n e l using the assay must also be trained in and be famil ia r with t h e interpr et at i on of results of the product .
7. Diabetomics, Inc., authorized distributors, and authorized laboratories using your product must ensure that any records associated with this EUA are maintained until otherwise notifie d by FDA. Such record s will be made availab l e to FDA fo r inspection upon request
*The letter of authorization refers to authorized laboratories as the following: “Testing of oral fluid (GCF) specimens is limited to Llaborat or i es certifie d under the Clini ca l Laborator y Impro ve m e n t Amendments of 1988 (CLIA), 42 U.S.C. §263a, that meet the requirements to perform high, moderate or waived complexity tests. Testing of oral fluid (GCF) specimensThis test is authorized for use at the Point of Care (POC ), i.e., in patient care sett i n g s operati ng under a CLIA Certificate of Waiver, Certificate of Compliance, orCertifica te of Accredi ta ti on .”

REFERENCES
1. Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challe ng e s . Int J Antimi cr o b Agents . 2020;55 (3 ):1 05 9 24 .
2. Guo YR, Cao QD, Hong ZS, Tan YY, Chen SD, Jin HJ, et al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak – an update on the status. Mil Med Res. 2020;7 (1 ):1 1 .
3. Li H, Liu SM, Yu XH, Tang SL, Tang CK. Coronavirus disease 2019 (COVI D -19 ) : curren t status and future perspe cti v es . Int J Antimi cr o b Agents . 2020;29 :1 0 59 5 1 .
4. Wu Z and McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases From the Chinese Center for Disease Control and Prevention. JAMA 2020;323(13):2648.
5. Pan A, Liu L, Wang C, Guo H, Hao X, Wang Q, et al. Associ a t i o n of Public Health Interventions With the Epidemiology of the COVID -1 9 Outbrea k in Wuhan , China. JAMA . 2020:61 30 .
6. Lai CC, Liu YH, Wang CY, Wang YH, Hsueh SC, Yen MY, et al. Asymptomatic carrier state, acute respiratory disease, and pneumonia due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2): Facts and myths. J Microbiol Immunol Infect. 2020;pii: S1684-1182;(20):30040-2.

GLOSSARY OF SYMBOLS
Manufacturer Storage tempera t ur e Do not reuse For in vitro diagnost i c use Consul t instructi o ns for use Caution Compo n e nt number Batch code, lot number Date of manufa ct ur e Use by date

CovAb.com
Manufactu red by Diabetom ic s, Inc. 2345 NE Overlook Drive, Suite #140 Hillsboro, OR 97006 Phone: 503-924-5110 | Fax: 503-924-5111

CovAbTM
SARS-CoV-2 Ab Test

1

Patient should not eat or drink 30 minutes prior to testing. Open the kit and identify the components.

Each box of fifty (50) tests contains 50 Single Test Kits. Each Single CovAbTM SARS-CoV-2 Ab Test Kit contains: A. One (1) transfer pipette B. One (1) capped tube with sample solution C. One (1) packaged oral swab D. One (1) foil package with one Test Cartridge and one desiccant

CovAbTM
SARS-CoV-2 Ab Test

Manufactured by: Diabetomics, Inc. 2345 NW Overlook Drive Suite #140 Hillsboro, OR 97006, USA
LN-6096 Rev. A

COVID-19 Ab
C T

Contains 1 Test Cartridge

3036

A BC

D

Required but not provided: Timer, Tube rack

Oral Fluid Test for COVID-19 Antibody

Quick Reference Guide
(Read complete instructions for use)
– For Emergency Use Authorization (EUA) only – For prescription use only – For in vitro diagnostic use only

2

Open the sample collection tube and place it in a tube rack.

3

Remove the oral swab from its packaging.

4

Place the swab head against the upper gum line. Apply moderate pressure and slowly wipe the swab across the gum line from right to left all the way to the back of the mouth and then repeat left to right. Flip the swab and repeat the process on the lower gum.

Do not brush.

5

Carefully, without splashing, insert the swab into the liquid in the tube and gently push

the swab up and down 6-8

times to release and mix the

oral fluid.

6-8x

6

Squeeze as much liquid from the swab as possible by pressing each side of the swab

2-3 times against the inside of

the tube above the level of

liquid. Remove and discard the

swab.

7

Remove the Test Cartridge from its packaging and place it on a level surface. Dispose of the

desiccant. Do not use expired

Test Cartridge.

COVID-19 Ab

C T

8

Use the transfer pipette to collect the liquid sample until the line marking. Press the

bulb completely and release

to fill the pipette.

Manufactured by: Diabetomics, Inc. 2345 NW Overlook Drive Suite #140 Hillsboro, OR 97006, USA
LN-6096 Rev. A

COVID-19 Ab C T

CovAbScreenTM
SARS-CoV-2 Ab Test

Contains 1 Test Cartridge

COVID-19 Ab C T
COVID-19 Ab C T
COVID-19 Ab C T

9

Slowly press the bulb of the pipette to transfer 5 drops of the liquid sample to the sample

port on the cartridge.

10 Start a timer for 15 minutes and allow the test to run. 15:00

11

At 15 minutes, evaluate the lines in the reading window on the Test Cartridge. Do not read after 20 minutes.

00:00

12

Interpretation of Test Results

T

C

COVID-19 Ab

COVID-19 Ab C T

COVID-19 Ab C T

T

C

COVID-19 Ab

If there are two lines, both C and T (even faint lines), the test is positive
for antibodies to COVID-19

If there is only a C line, the test is negative for antibodies to COVID-19

If there is no C line, the test is invalid and the test should be
repeated with a new kit.

Dispose of the kit and materials in biohazard waster container.

See opposite side for CovAbTM Controls kit Quick Reference Guide

Manufactured by: Diabetomics, Inc. 2345 NE Overlook Drive Suite #140 Hillsboro, OR 97006
LN-6105, Rev. E

This product has not been FDAcleared or approved, but has been authorized for emergency use by FDA under an EUA for use by authorized laboratories.

This product has been authorized only for detecting the presence of total antibodies to SARS-CoV-2, not for any other viruses or pathogens.

The emergency use of this product is only authorized for the duration of the declaration that circumstances exist justifying the authorization of emergency use of in vitro diagnostics for detection and/or diagnosis of COVID-19 under Section 564(b)(1) of the Federal Food, Drug and Cosmetic Act, 21 U.S.C. § 360bbb3(b)(1), unless the declaration is terminated or authorization is revoked sooner.
Diabetomics, Inc. 2021 All rights reserved

CovAbTM Control Kit
SARS-CoV-2 Ab Test

Oral Fluid Test for COVID-19 Antibody

Quick Reference Guide
(Read complete instructions for use)
– For Emergency Use Authorization (EUA) only – For prescription use only – For in vitro diagnostic use only

1

Each CovAbTM Control Kit contains: A. One (1) negative control (clear cap)

B. One (1) positive control (red cap)

Required but not provided: Timer, Tube rack

AB

CovAbScreen
SARS-CoV-2 Ab T Manufactured by: Diabetomics, Inc. 2345 NW Overlook Drive Suite #140 Hillsboro, OR 97006, USA LN-6096 Rev. A
CovAbScreen
SARS-CoV-2 Ab T Manufactured by: Diabetomics, Inc. 2345 NW Overlook Drive Suite #140 Hillsboro, OR 97006, USA LN-6096 Rev. A

2

The Control Kit will require the use of one test cartridge for testing the negative control

and another test cartridge for

the positive control.

COVID-19 Ab
C T

COVID-19 Ab
C T

3

Remove negative control tube from the package and mix by gentle inversion. Do

not shake. Do not mix

mechanically. Do not dilute

the controls. Use as is.

4

Remove the Test Cartridge from its packaging and place it on a level surface. Dispose of the

desiccant. Do not use expired

Test Cartridge.

COVID-19 Ab

C T

5

Open the negative control tube and place it in a tube rack.

Manufactured by: Diabetomics, Inc. 2345 NW Overlook Drive Suite #140 Hillsboro, OR 97006, USA
LN-6096 Rev. A

CovAbScreenTM
SARS-CoV-2 Ab Test

COVID-19 Ab C T

Contains 1 Test Cartridge

Controls should be run in the following scenarios:
A new operator uses the kit
A new lot of test kits is used
A new shipment of kits is used
The temperature used during storage of the kit falls outside of 2-30°C
The temperature of the test area falls outside of 15-30°C
To verify a higher than expected frequency of positive or negative results
To investigate the cause of repeated invalid results

6

Use the transfer pipette to collect the liquid sample until the line marking. Press the

bulb completely and release

to fill the pipette.

7

Slowly press the bulb of the pipette to transfer 5 drops of the liquid sample to the sample

port on the cartridge.

8

Start a timer for 15 minutes and allow the

test to run.

15:00

9

At 15 minutes, evaluate the lines in the reading window on the Test

Cartridge. Do not read after 20

minutes. Negative control will

display as shown below.

00:00

COVID-19 Ab C T
COVID-19 Ab C T

COVID-19 Ab C T

10 Repeat steps 4-8 with positive control. At 15 minutes, evaluate the lines in the reading window on the Test Cartridge. Do not read after 20 minutes. Positive control will display as shown below.
00:00

COVID-19 Ab C T

4

8

11

Interpretation of Control Results

COVID-19 Ab C T
COVID-19 Ab C T

Positive control shoud show both C and T lines.

Negative control should show only C line.

If the controls do not provide expected results, stop testing
and contact customer support.

Dispose of the kit and materials in biohazard waster container.

Manufactured by: Diabetomics, Inc. 2345 NE Overlook Drive Suite #140 Hillsboro, OR 97006
LN-6105, Rev. E

This product has not been FDAcleared or approved, but has been authorized for emergency use by FDA under an EUA for use by authorized laboratories.

This product has been authorized only for detecting the presence of total antibodies to SARS-CoV-2, not for any other viruses or pathogens.

The emergency use of this product is only authorized for the duration of the declaration that circumstances exist justifying the authorization of emergency use of in vitro diagnostics for detection and/or diagnosis of COVID-19 under Section 564(b)(1) of the Federal Food, Drug and Cosmetic Act, 21 U.S.C. § 360bbb3(b)(1), unless the declaration is terminated or authorization is revoked sooner.
Diabetomics, Inc. 2021 All rights reserved

CovAbTM Control Kit

Diabeto mi cs , Inc. 2345 NE Overlook Drive Suite #140 Hillsboro, OR 97006 USA

2039, 2x 0.5mL xxxx YYYY- M M -D D

For Emergency Use Authorization (EUA) only | For prescription use only | For in vitro diagnostic use only

INTENDED USE
CovAb T M Control Kit (negati ve and positi ve ) is a stable, ready-to – us e liquid , bi-l e v e l control for use as assaye d quality contro l samples to monito r the perfor m an c e o f the CovAbTM SARS-CoV-2 Ab Test.
CovA bT M Contro l Kit is for In Vitro Diagnosti c use only.
SUMMARY AND PRINCIPLE
Good laborato r y practi ce s require that control sample s with known perfor m a n c e with the CovAbTM SARS-CoV-2 Ab Test be used to effectively monitor that the run is valid in order to minim i ze the risks of reporti ng false results .
REAGENTS
CovAbTM Control Kit is prepared using heat-inactivated human serum (0.05%) to achieve the desired concentration levels. These are serum based, liquidstable controls that contain ProClin 300 as preservative. The Negative Control is a protein based buffer spiked with heat inactivated normal human serum, and the Positive Control is a protein based buffer spiked with heat inactivated SARS-C o V -2 antibod y -p os it i ve serum at a level that consist e n tl y produce s a l o w medium intensity color Test Line when assayed in the CovAbTM SARS- CoV-2 Ab Test. The final concentration of serum in the control materials is less than or equal to 0.05% . CovAb T M Control Kit is a ready to use liquid product manufa ct u r e d accor di n g to standar d qualit y contro l proce d ur e s . The manufa ctu r er guaran t e e s stabilit y and consist e n c y of this product .
WARNINGS AND PRECAUTIONS
For in vitro diagnost i c use only. For prescri p ti o n use only. For use under Emerg e n c y Use Authorization only.
This produ ct has not been FDA cleared or approve d , but has been authori ze d fo r emerge n cy use by FDA under an EUA for use by authori ze d laborat or i es .
This produ ct is for use with a test authori ze d only for detecti n g the presen ce o f total antibod ie s to SARS-C o V2 , not for any other viruse s or pathoge ns .
The emergency use of this product is only authorized for the duration of the declar at io n that circu m s ta n ce s exist justifyi ng the authori za ti o n of emerge n c y u s e of in vitro diagnos ti cs for detecti o n and/or diagnos is of COVID -19 under Se ct i o n 564(b )(1 ) of the Federal Food, Drug and Cosme ti c Act, 21 U.S.C . § 360bbb3 ( b ) ( 1 ) , unless the declar at i on is termina t e d or authori zat i on is revoke d sooner .
CovAbTM Control Kit is intended solely for in vitro diagnostic use for the purpose descri b e d on the instru ct i on s for use. Diabeto m i cs , Inc. shall not be liable for a n y unclai m e d damage s arising from any other usage.
STORAGE AND STABILITY
CovAbTM Control Kit is stored at 2-80C and will remain stable in the unope n e d vi a l until the expiration date.
After opening , the conten ts should be used accor di ng to the instruct i o ns for u s e include d in the Control Kit IFU and immedi at el y returned to 2-8°C.
The CovAbTM Control Kit has an open vial stability of up to 30 days under the proper storage conditions. Leaving the vial uncapped, or prolonging its time at room temper at u re , will void this open vial stabilit y claim . Make sure the con t e n t s of the vial are well mixed before use. To avoid evapo ra ti o n , do not leave the vi a l uncap p e d . Control s should not be used beyon d their expirati o n date.
MATERIALS PROVIDED
1. CovAbTM Control Kit, 2 x 0.5 mL 2. Positive control 0.5mL 3. Negative control 0.5mL
MATERIALS NOT PROVIDED
1. Timer 2. Tube rack

INSTRUCTIONSFOR USE
To run the controls follow the instructions provided below 1. Use a cartridg e for the positive control and another for the negati ve control . 2. Remo ve a vial from the package and mix by gentle invers io n . Do not shake. D o
not mix mechan i cal l y. Do not dilute the control s . 3. Add five drops (~150 µL) of each control (eithe r negative contro l or posi t i v e
control) to the respective test cassette with the transfer pipette and read results at 15 minutes. 4. After use, return the control s to 2-8°C. 5. The vial should remain stored at 2-8°C at all times. If additional testing is necess ar y , the time outside of 2-8°C storage should be minimi ze d .
Controls should be run in the following scenarios A new operato r uses the kit; 1. A new lot of test kits is used; 2. A new shipme nt of kits is used; 3. The temper a tu r e used during storage of the kit falls outside of 2-30°C ; 4. The temper at u r e of the test area falls outside of 15-30° C ; 5. To verify a higher than expecte d freque n cy of positive or negati ve results ; 6. To investig at e the cause of repeate d invali d results

EXPECTED VALUES
The performance for each sample is described in the table below. Refer to instructions for use for details on test interpretation. If controls do not provide expect e d results , stop testing and conta ct custom e r support .

Control REF 3043 Negative REF 3044 Positive

CovAbTM SARS-Co V-2 Ab Test Result Negative Positive

LIMITATIONS OF THE PROCEDURE
1. If the liquid in the vial becom e s frozen , discard and use another vial, as t h e results will not be valid.
2. Dispose of any discarded materials in accordance with the requirements of your local waste manage m e n t authorit i es .

ORDERING INFORMATION

Product number 2039

Product description CovAbTM Control Kit

Product packagin g 2 x 0.5 mL

GLOSSARY OF SYMBOLS

Manufacturer Storage tempera t ur e For in vitro diagnost i c use Consul t instructi o ns for use Caution

Compo n e nt number Batch code, lot number Date of manufa ct ur e Use by date

Distribut e d by Diabeto mi cs , Inc. – U.S. custo m er s only please call (877) 748-935 5 or visit www .co va b . co m

References

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