Profile of Immunoglobulin G and IgM Antibodies Against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)

Qu, Jiuxin; Wu, Chi-Sheng; Li, Xiaoyong; Zhang, Guobin; Jiang, Zhichao; Li, Xiaohe; Zhu, Qing; Liu, Lei

doi:10.1093/cid/ciaa489

Cited by 312 publications

(356 citation statements)

References 9 publications

(10 reference statements)

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“…Supporting this are other studies that report overall low IgM responses to SARS-CoV-2 that are often preceded by IgG. 14,17 These data highlight the benefit of measuring all three anti-SARS-CoV-2 antibody isotypes to maximize sensitivity. In the case of SARS-CoV-2, it is unknown for how long IgM, IgA, or IgG antibodies remain detectable after infection.…”

Section: Discussionmentioning

confidence: 52%

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Clinical sensitivity and interpretation of PCR and serological COVID‐19 diagnostics for patients presenting to the hospital

et al. 2020

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The diagnosis of COVID‐19 requires integration of clinical and laboratory data. Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) diagnostic assays play a central role in diagnosis and have fixed technical performance metrics. Interpretation becomes challenging because the clinical sensitivity changes as the virus clears and the immune response emerges. Our goal was to examine the clinical sensitivity of two most common SARS‐CoV‐2 diagnostic test modalities, polymerase chain reaction (PCR) and serology, over the disease course to provide insight into their clinical interpretation in patients presenting to the hospital. We conducted a single‐center, retrospective study. To derive clinical sensitivity of PCR, we identified 209 PCR‐positive SARS‐CoV‐2 patients with multiple PCR test results (624 total PCR tests) and calculated daily sensitivity from date of symptom onset or first positive test. Clinical sensitivity of PCR decreased with days post symptom onset with >90% clinical sensitivity during the first 5 days after symptom onset, 70%‐71% from Days 9 to 11, and 30% at Day 21. To calculate daily clinical sensitivity by serology, we utilized 157 PCR‐positive patients with a total of 197 specimens tested by enzyme‐linked immunosorbent assay for IgM, IgG, and IgA anti‐SARS‐CoV‐2 antibodies. In contrast to PCR, serological sensitivity increased with days post symptom onset with >50% of patients seropositive by at least one antibody isotype after Day 7, >80% after Day 12, and 100% by Day 21. Taken together, PCR and serology are complimentary modalities that require time‐dependent interpretation. Superimposition of sensitivities over time indicate that serology can function as a reliable diagnostic aid indicating recent or prior infection.

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Section: Discussionmentioning

confidence: 52%

“…Nonetheless, other publications indicate that the time courses are comparable. 14,17,22 Our serological studies measured antibodies to the RBD of SARS-CoV-2. We chose this viral antigen because of its specificity to SARS-CoV-2, and because anti-RBD antibodies are typically neutralizing.…”

Section: Negative Results Do Not Completely Preclude Sars-cov-2mentioning

confidence: 99%

Clinical sensitivity and interpretation of PCR and serological COVID‐19 diagnostics for patients presenting to the hospital

et al. 2020

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“…IgG detection may improve and speed up the diagnosis of COVID-19 in symptomatic patients, particularly in negative SARS-CoV-2 PCR cases. It has been shown that in up to 15% of COVID-19-positive patients IgG antibodies are detectable during the rst week following the onset of symptoms [8], although reaching 100% of the patients required two additional weeks [8,12,13,20]. Here, we examined the performance of serology as an adjuvant for the diagnosis of COVID-19 using commercially available procedures.…”

Section: Discussionmentioning

confidence: 99%

“…This potentially allows to improve the microbiological diagnosis along with RNA detection from nasopharyngeal swabs in active cases and also detect past/cured cases [8]. The serological detection of IgG against SARS-CoV-2, mostly using inhouse procedures, has shown a sensitivity that ranges between 78% and 100% in patients requiring hospital admission [7][8][9][10][11][12][13][14][15]. Abbott´s SARS-CoV-2 IgG assay is a recent commercial chemiluminescence immunoassay (CLIA) platform approved by the FDA that allow detecting IgG in serum samples and has been validated in samples from hospitalized patients with COVID-19 [16].…”

Section: Introductionmentioning

confidence: 99%

Detection of SARS-CoV-2 antibodies is insufficient for the diagnosis of active or prior COVID-19

Escribano

Álvarez‐Uría

Alonso

et al. 2020

Preprint

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We assessed the performance of Abbott's SARS-CoV-2 IgG assay and the PanbioTM COVID-19 IgG/IgM rapid test device for the diagnosis of active and past/cured COVID-19. Three cohorts of patients were chosen. Cohort 1, patients (n=65) who attended the emergency department on March 30, 2020 with clinical suspicion of active COVID-19 (n=56 with proven/probable COVID-19). Cohort 2, hospital workers (n=92) who had either been (n=40) or not (n=52) diagnosed with proven/probable COVID-19 and were asymptomatic at the time of the sampling. Cohort 3, patients (n=38) cared at the hospital before the start of the COVID pandemic. Detection of serum antibodies was done using Abbott´s SARS-CoV-2 IgG assay and the PanbioTM COVID-19 IgG/IgM device. Both methods showed 98% agreement for IgG detection. No antibodies were detected in the 38 samples from hospitalized pre-COVID subjects. The diagnostic performance of IgGs detected by Abbott´s SARS-CoV-2 assay in Cohorts 1/2 was: sensitivity (60.7%/75%) and specificity (100%/84.6%). The diagnostic performance of IgM by PanbioTM COVID-19 in Cohorts 1/2 was: sensitivity (16%/17.5%) and specificity (100%/98.1%). We show that IgG detection alone is insufficient for the diagnosis of active or past COVID-19. IgM detection has a limited diagnostic value.

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“…However, a limitation of antibody tests is that they require a longer window period after infection than RT-PCR. Actually, the median IgM and IgG seroconversion period has been reported to be 10 days or longer after symptom onset [4][5][6] . However, information on the early time courses of serum antibody titers and the sensitivity and speci city of antibody tests after the onset of COVID-19 symptoms could make these tests more useful for the COVID-19.…”

Section: Introductionmentioning

confidence: 99%

Time course of the sensitivity and specificity of serum anti-SARS-CoV-2 IgM and IgG antibodies for the diagnosis of symptomatic COVID-19 in Japan

Nakano

Kurano

Morita

et al. 2020

Preprint

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The accurate and prompt diagnosis of SARS-CoV-2 infection is required for the control and treatment of the coronavirus infection disease 2019 (COVID-19). In this study, we aimed to investigate the time courses of the anti-severe acute corona respiratory syndrome coronavirus 2 (SARS-CoV-2) IgM and IgG titers and to evaluate the sensitivity and specificity of such tests according to the specific day after the onset of COVID-19 among a patient population in Japan. We measured the titers of SARS-CoV-2 IgM and IgG in sera from 100 subjects, including 26 symptomatic COVID-19 patients, using chemiluminescent immunoassay (CLIA) methods utilizing magnetic beads coated with SARS-CoV-2 nucleocapsid protein and spike protein. The results of a ROC analysis suggested the possibility that the cutoff values in Japan might be lower than the manufacturer’s reported cutoff (10 AU/mL): 1 AU/mL for IgM and 5 AU/mL for IgG. The sensitivity of the test before Day 8 after symptom onset was less than 50%; at Days 9-10, however, we obtained a much higher sensitivity of 81.8% for both IgM and IgG. At 15 days or later after symptom onset, the SARS-CoV-2 IgG test had a sensitivity of 100%. These results suggest that if the number of days since disease onset is taken into consideration, these antibody tests could be very useful for the diagnosis of COVID-19 and similar diseases.

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Profile of Immunoglobulin G and IgM Antibodies Against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)

Cited by 312 publications

References 9 publications

Clinical sensitivity and interpretation of PCR and serological COVID‐19 diagnostics for patients presenting to the hospital

Clinical sensitivity and interpretation of PCR and serological COVID‐19 diagnostics for patients presenting to the hospital

Detection of SARS-CoV-2 antibodies is insufficient for the diagnosis of active or prior COVID-19

Time course of the sensitivity and specificity of serum anti-SARS-CoV-2 IgM and IgG antibodies for the diagnosis of symptomatic COVID-19 in Japan

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