Evaluation of SARS-CoV-2 serology assays reveals a range of test performance

Autor: Brian R. Shy, Sophia A. Bylsma, Jonathan M. Woo, Dante D. Acenas, Jinwoo Lee, Michael R. Wilson, Alan H.B. Wu, Caroline Whitty, Jason G. Cyster, Lakshmi Warrier, Erin Isaza, Vanessa A. York, Michael G Astudillo, Jeffrey D. Whitman, Tori N. Yamamoto, Kara L. Lynch, Antonia E. Gallman, Dianna Ng, Patrick D. Hsu, Tina Zheng, Mark S. Anderson, Eva M. Gillis-Buck, Jochen K. Lennerz, Kelsey C. Zorn, Justine Levan, Wei Gu, Zachary Steinhart, Ian C. Boothby, Tyler E. Miller, Caryn Bern, Richelle C. Charles, A. John Iafrate, Jackie Chan, Jennifer A Smith, David N. Nguyen, Joseph Hiatt, Ryan Apathy, Alexander Marson, Joel D. Ernst, Gregory M. Goldgof, Trisha A. Macrae, Mary E. Moreno, Diane Yang, Joanna Balcerek, Bradley E. Bernstein, Charles Y. Chiu, Chun Jimmie Ye, Andrew G. Levine, Edward T. Ryan, Haig A. Eskandarian, Aashish Manglik, Nevan J. Krogan, Youjin Lee, Mitchell J. Lipke, Wilfredo F. Garcia-Beltran, Than S. Kyaw, Leonel Torres, Stacy Li, Rita P. Loudermilk, Ruby Yu, Kanishka Koshal, Ujjwal Rathore, Sagar P. Bapat, Jeffrey A. Gelfand, Lila A. Farrington, Ana M. Lyons, Perri C. Callaway, Susan L. Stramer, Allison W. Wong, Steve Miller, Cody T. Mowery, David Wu
Rok vydání: 2020
Předmět:
Male
Antibodies
Viral

Applied Microbiology and Biotechnology
Chromatography
Affinity

Serology
0302 clinical medicine
COVID-19 Testing
80 and over
Medicine
Viral
Lung
Aged
80 and over

0303 health sciences
screening and diagnosis
Chromatography
biology
Reverse Transcriptase Polymerase Chain Reaction
Middle Aged
3. Good health
Detection
Real-time polymerase chain reaction
Infectious Diseases
Point-of-Care Testing
Pneumonia & Influenza
Molecular Medicine
Test performance
Female
Antibody
Coronavirus Infections
Infection
Biotechnology
4.2 Evaluation of markers and technologies
Adult
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
Point-of-care testing
Pneumonia
Viral

Biomedical Engineering
Bioengineering
Enzyme-Linked Immunosorbent Assay
Appropriate use
Sensitivity and Specificity
Article
Antibodies
Vaccine Related
03 medical and health sciences
Young Adult
Betacoronavirus
Clinical Research
Biodefense
Humans
Pandemics
030304 developmental biology
Aged
business.industry
Clinical Laboratory Techniques
SARS-CoV-2
Prevention
Serological assay
COVID-19
Pneumonia
4.1 Discovery and preclinical testing of markers and technologies
Good Health and Well Being
Emerging Infectious Diseases
Immunoglobulin M
Affinity
Immunoglobulin G
Immunology
biology.protein
business
030217 neurology & neurosurgery
Zdroj: Nature biotechnology, vol 38, iss 10
medRxiv
article-version (status) pre
article-version (number) 2
Nature Biotechnology
Popis: Background: Serological tests are crucial tools for assessments of SARS-CoV-2 exposure, infection and potential immunity. Their appropriate use and interpretation require accurate assay performance data. Method: We conducted an evaluation of 10 lateral flow assays (LFAs) and two ELISAs to detect anti-SARS-CoV-2 antibodies. The specimen set comprised 128 plasma or serum samples from 79 symptomatic SARS-CoV-2 RT-PCR-positive individuals; 108 pre-COVID-19 negative controls; and 52 recent samples from individuals who underwent respiratory viral testing but were not diagnosed with Coronavirus Disease 2019 (COVID-19). Samples were blinded and LFA results were interpreted by two independent readers, using a standardized intensity scoring system. Results: Among specimens from SARS-CoV-2 RT-PCR-positive individuals, the percent seropositive increased with time interval, peaking at 81.8–100.0% in samples taken >20 days after symptom onset. Test specificity ranged from 84.3–100.0% in pre-COVID-19 specimens. Specificity was higher when weak LFA bands were considered negative, but this decreased sensitivity. IgM detection was more variable than IgG, and detection was highest when IgM and IgG results were combined. Agreement between ELISAs and LFAs ranged from 75.7–94.8%. No consistent cross-reactivity was observed. Conclusion: Our evaluation showed heterogeneous assay performance. Reader training is key to reliable LFA performance, and can be tailored for survey goals. Informed use of serology will require evaluations covering the full spectrum of SARS-CoV-2 infections, from asymptomatic and mild infection to severe disease, and later convalescence. Well-designed studies to elucidate the mechanisms and serological correlates of protective immunity will be crucial to guide rational clinical and public health policies.
Databáze: OpenAIRE