Comparison of Antibody Class-Specific SARS-CoV-2 Serologies for the Diagnosis of Acute COVID-19.
| Title: | Comparison of Antibody Class-Specific SARS-CoV-2 Serologies for the Diagnosis of Acute COVID-19. |
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| Authors: | Verkerke H; Center for Transfusion Medicine and Cellular Therapies, Emory University School of Medicine, Atlanta, Georgia, USA.; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Joint Program in Transfusion Medicine, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.; Horwath M; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Saeedi B; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Boyer D; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Allen JW; Center for Transfusion Medicine and Cellular Therapies, Emory University School of Medicine, Atlanta, Georgia, USA.; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Joint Program in Transfusion Medicine, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.; Owens J; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Arthur CM; Center for Transfusion Medicine and Cellular Therapies, Emory University School of Medicine, Atlanta, Georgia, USA.; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Nakahara H; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Rha J; Center for Transfusion Medicine and Cellular Therapies, Emory University School of Medicine, Atlanta, Georgia, USA.; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Patel K; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Joint Program in Transfusion Medicine, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.; Wu SC; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Paul A; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Yasin N; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Wang J; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Shin S; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Brown D; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Normile K; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Cole L; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Meyers M; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Lin H; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Woods E; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Isaac J; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Broder K; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Wade J; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Kauffman RC; Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.; Patel R; Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.; Josephson CD; Center for Transfusion Medicine and Cellular Therapies, Emory University School of Medicine, Atlanta, Georgia, USA.; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Reynolds S; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Sherman M; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Wrammert J; Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.; Alter D; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Guarner J; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Roback JD; Center for Transfusion Medicine and Cellular Therapies, Emory University School of Medicine, Atlanta, Georgia, USA.; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Neish A; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA aneish@emory.edu srstowell@bwh.harvard.edu.; Stowell SR; Center for Transfusion Medicine and Cellular Therapies, Emory University School of Medicine, Atlanta, Georgia, USA aneish@emory.edu srstowell@bwh.harvard.edu.; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.; Joint Program in Transfusion Medicine, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. |
| Source: | Journal of clinical microbiology [J Clin Microbiol] 2021 Mar 19; Vol. 59 (4). Date of Electronic Publication: 2021 Mar 19 (Print Publication: 2021). |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: American Society for Microbiology Country of Publication: United States NLM ID: 7505564 Publication Model: Electronic-Print Cited Medium: Internet ISSN: 1098-660X (Electronic) Linking ISSN: 00951137 NLM ISO Abbreviation: J Clin Microbiol Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Washington, American Society for Microbiology. |
| MeSH Terms: | COVID-19* ; SARS-CoV-2*; Antibodies, Viral ; Cross-Sectional Studies ; Humans ; Immunoglobulin M ; Sensitivity and Specificity |
| Abstract: | Accurate diagnosis of acute severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is critical for appropriate management of patients with this disease. We examined the possible complementary role of laboratory-developed class-specific clinical serology in assessing SARS-CoV-2 infection in hospitalized patients. Serological tests for immunoglobulin G (IgG), IgA, and IgM antibodies against the receptor binding domain (RBD) of SARS-CoV-2 were evaluated using samples from real-time reverse transcription-quantitative PCR (qRT-PCR)-confirmed inpatient coronavirus disease 2019 (COVID-19) cases. We analyzed the influence of timing and clinical severity on the diagnostic value of class-specific COVID-19 serology testing. Cross-sectional analysis revealed higher sensitivity and specificity at lower optical density cutoffs for IgA in hospitalized patients than for IgG and IgM serology (IgG area under the curve [AUC] of 0.91 [95% confidence interval {CI}, 0.89 to 0.93] versus IgA AUC of 0.97 [95% CI, 0.96 to 0.98] versus IgM AUC of 0.95 [95% CI, 0.92 to 0.97]). The enhanced performance of IgA serology was apparent in the first 2 weeks after symptom onset and the first week after PCR testing. In patients requiring intubation, all three tests exhibit enhanced sensitivity. Among PCR-negative patients under investigation for SARS-CoV-2 infection, 2 out of 61 showed clear evidence of seroconversion IgG, IgA, and IgM. Suspected false-positive results in the latter population were most frequently observed in IgG and IgM serology tests. Our findings suggest the potential utility of IgA serology in the acute setting and explore the benefits and limitations of class-specific serology as a complementary diagnostic tool to PCR for COVID-19 in the acute setting.; (Copyright © 2021 American Society for Microbiology.) |
| References: | Cell Rep Med. 2020 Jun 23;1(3):100040. (PMID: 32835303); Clin Transl Immunology. 2020 May 06;9(5):e01136. (PMID: 32382418); Nat Commun. 2020 Oct 27;11(1):5411. (PMID: 33110070); J Infect. 2020 Aug;81(2):e91-e92. (PMID: 32417311); PLoS One. 2020 Sep 17;15(9):e0237694. (PMID: 32941461); Nat Med. 2020 Jun;26(6):845-848. (PMID: 32350462); Malays J Pathol. 2020 Apr;42(1):13-21. (PMID: 32342927); Sci Transl Med. 2021 Jan 20;13(577):. (PMID: 33288661); N Engl J Med. 2020 Mar 19;382(12):1177-1179. (PMID: 32074444); BMJ. 2020 Jul 1;370:m2516. (PMID: 32611558); Int Immunopharmacol. 2020 Sep;86:106746. (PMID: 32619956); Clin Infect Dis. 2020 Nov 19;71(16):2066-2072. (PMID: 32357209); J Clin Microbiol. 2020 May 26;58(6):. (PMID: 32245835); Front Immunol. 2013 Jul 12;4:185. (PMID: 23874333); Clin Chem. 2020 Apr 1;66(4):549-555. (PMID: 32031583); J Med Internet Res. 2020 Oct 30;22(10):e19152. (PMID: 33031048); J Clin Microbiol. 2020 Apr 23;58(5):. (PMID: 32102856); Nature. 2020 Mar;579(7798):270-273. (PMID: 32015507); J Clin Virol. 2020 Sep;130:104569. (PMID: 32769023); Cochrane Database Syst Rev. 2020 Jun 25;6:CD013652. (PMID: 32584464); mBio. 2020 Mar 26;11(2):. (PMID: 32217609); Sci Transl Med. 2021 Jan 20;13(577):. (PMID: 33288662); Cell Mol Immunol. 2020 Jul;17(7):773-775. (PMID: 32467617); Science. 2020 Aug 21;369(6506):956-963. (PMID: 32540903); N Engl J Med. 2020 Dec 17;383(25):2451-2460. (PMID: 32412710); Lancet. 2020 Feb 15;395(10223):497-506. (PMID: 31986264); Science. 2020 Mar 27;367(6485):1444-1448. (PMID: 32132184) |
| Grant Information: | R01 HL135575 United States HL NHLBI NIH HHS; T32 GM008169 United States GM NIGMS NIH HHS; T32 HL066987 United States HL NHLBI NIH HHS; T32 HL069769 United States HL NHLBI NIH HHS |
| Contributed Indexing: | Keywords: COVID-19; SARS-CoV-2; antibodies; immunodiagnostics; serology; spike |
| Substance Nomenclature: | 0 (Antibodies, Viral); 0 (Immunoglobulin M) |
| Entry Date(s): | Date Created: 20210120 Date Completed: 20210623 Latest Revision: 20230727 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC8092741 |
| DOI: | 10.1128/JCM.02026-20 |
| PMID: | 33468605 |
| Database: | MEDLINE |
Journal Article