Antibody Tests for Identification of Current and Past Infection with SARS-CoV-2
2020
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus and resulting COVID-19 pandemic present important diagnostic challenges. Several diagnostic strategies are available to identify current infection, rule out infection, identify people in need of care escalation, or to test for past infection and immune response. Serology tests to detect the presence of antibodies to SARS-CoV-2 aim to identify previous SARS-CoV-2 infection and may help to confirm the presence of current infection.
The objective of this review is to assess the diagnostic accuracy of antibody tests to determine if a person presenting in the community or in primary or secondary care is infected by SARS-CoV-2 or has previously had SARS-CoV-2, and the accuracy of antibody tests for use in seroprevalence surveys.
Pooled results for IgG, IgM, IgA, total antibodies and IgG/IgM all showed low sensitivity during the first week since onset of symptoms (all less than 30.1%), rising in the second week and reaching their highest values in the third week. The combination of IgG/IgM had a sensitivity of 30.1% for 1 to 7 days, 72.2% for 8 to 14 days, 91.4% for 15 to 21 days. Estimates of accuracy beyond three weeks are based on smaller sample sizes and fewer studies. Summary specificities exceeded 98% for all target antibodies.
Antibody Tests for Identification of Current and Past Infection with SARS-CoV-2
Source:
Deeks J, Dinnes J, Takwoingi Y et al. Antibody Tests for Identification of Current and Past Infection With SARS-CoV-2. Cochrane Database of Systematic Reviews 2020; (6). https://doi.org/10.1002/14651858.CD013652