Comparison of 2 fully automated tests detecting antibodies against nucleocapsid N and spike S1/S2 proteins in COVID-19

Abstract

Automated assays for detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies in coronavirus disease 2019 (COVID-19) diagnostics have recently come available. We compared the performance of the Elecsys® Anti-SARS-CoV-2 and LIAISON® SARS-CoV-2 S1/S2 IgG tests. The seroconversion panel comprised of 120 samples from 13 hospitalized COVID-19 patients. For the sensitivity and specificity testing, samples from COVID-19 outpatients >15 days after positive nucleic acid amplification test (NAAT) result (n = 35) and serum control samples collected before the COVID-19 era (n = 161) were included in the material. Samples for the detection of possible cross-reactions were also tested. Based on our results, the SARS-CoV-2 antibodies can be quite reliably detected 2 weeks after NAAT positivity and 3 weeks after the symptom onset with both tests. However, since some COVID-19 patients were positive only with Elecsys®, the antibodies should be screened against N-antigen (Elecsys®) and reactive samples confirmed with S antigen (LIAISON®), but both results should be reported. In some COVID-19 patients, the serology can remain negative.

Keywords: Antibody; COVID-19; Elecsys; LIAISON; SARS-CoV-2; Serology.

Fig. 1

The SARS-CoV-2 antibody kinetics in COVID-19 patients determined by Elecsys® Anti–SARS-CoV-2 and LIAISON® SARS-CoV-2 S1/S2 IgG tests. The analyses were carried out of 83 samples in the seroconversion panel.

Fig. 2

SARS-CoV-2 antibody seroconversion time in COVID-19 patients determined by Elecsys® Anti–SARS-CoV-2 and LIAISON® SARS-CoV-2 S1/S2 IgG tests. Antibody level of the first positive sample (COI for Elecsys® and AU/mL for LIAISON®) is shown in the bar. The cutoff values for the positive result are ≥1 COI and ≥15 AU/mL.