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. 2020 Oct 13;154(5):610-619.
doi: 10.1093/ajcp/aqaa140.

Humoral Immune Response to SARS-CoV-2

Pauline H Herroelen  1 , Geert A Martens  1   2   3 , Dieter De Smet  1 , Koen Swaerts  1 , An-Sofie Decavele  1
Affiliations

Humoral Immune Response to SARS-CoV-2

Pauline H Herroelen et al. Am J Clin Pathol. .

Abstract

Objectives: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serology tests are clinically useful to document prior SARS-CoV-2 infections. Data are urgently needed to select assays with optimal sensitivity at acceptable specificity for antibody detection.

Methods: A comparative evaluation was performed of 7 commercial SARS-CoV-2 serology assays on 171 sera from 135 subjects with polymerase chain reaction-confirmed SARS-CoV-2 infection (71 hospitalized patients and 64 paucisymptomatic individuals). Kinetics of IgA/IgM/IgG seroconversion to viral N and S protein epitopes were studied from 0 to 54 days after onset of symptoms. Cross-reactivity was verified on 57 prepandemic samples.

Results: Wantai SARS-COV-2 Ab ELISA and Orient Gene COVID-19 IgG/IgM Rapid Test showed superior overall sensitivity for detection of SARS-CoV-2 antibodies. Elecsys Anti-SARS-CoV-2 assay and EUROIMMUN Anti-SARS-CoV-2 combined IgG/IgA showed acceptable sensitivity (>95%) vs the consensus result of all assays from 10 days post onset of symptoms. Wantai SARS-COV-2 Ab ELISA, Elecsys Anti-SARS-CoV-2 assay, and Innovita 2019-nCoV Ab rapid test showed least cross-reactivity, resulting in an optimal analytical specificity greater than 98%.

Conclusions: Wantai SARS-COV-2 Ab ELISA and Elecsys Anti-SARS-CoV-2 assays are suitable for sensitive and specific detection of SARS-CoV-2 antibodies from 10 days after onset of symptoms.

Keywords: Antibody; COVID-19; Coronavirus; Paucisymptomatic; SARS-CoV-2; Serology.

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Figures

Figure 1
Figure 1
Kinetics of seroconversion in critically ill COVID-19 patients. The upper left panel shows the average kinetics of seroconversion in 13 intensive care unit patients. The other panels show the kinetics in 8 individual patients for whom 3 or more data points were available. Graphs represent for each of the indicated serology tests the normalized signal over time, fitted to a scale from –1 to +1 with 0 (black line) representing the assays’ cutoff, as described in the Statistical Analysis section.
See this image and copyright information in PMC

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