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. 2021 Feb;38(2):539-541.
doi: 10.1007/s10815-020-02024-w. Epub 2021 Jan 7.

Letter to editor

Scott M Nelson  1   2   3 , Antonio La Marca  4
Affiliations

Letter to editor

Scott M Nelson et al. J Assist Reprod Genet. 2021 Feb.
No abstract available

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Figures

Fig. 1
Fig. 1
Interpreting COVID-19 antibody tests. The implications of pre-test probabilities of 5% and 50% on the interpretation of COVID-19 antibody test if 1000 people were tested. The Cochrane review identified a mean sensitivity of 91.4% and mean specificity of 98.7% and these are here used for illustrative purposes. For the 5% pre-test probability, e.g. a patient with no symptoms but answers yes to a triage question, should the test have a lower sensitivity, particularly if the peak incidence and therefore likely time of infection is > 35 days ago, this would proportionally increase the false-negative and false-positive rate substantially. For example, for 57% specificity, the false-negative rate is 2.1% and the false-positive rate would be 21%. In contrast, if the pre-test probability is 50%, e.g. patient has atypical symptoms for several weeks, a positive test is compelling due to the low false-positive result, but the false-negative rate is still high at 8%. Antibody tests have high specificity, but sensitivity is variable and depends on the time since symptom onset
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References

    1. Magli MC, Racowsky C. Letter to editor. J Assist Reprod Genet. 2020;37(11):2653–2655. doi: 10.1007/s10815-020-01968-3. - DOI - PMC - PubMed
    1. La Marca A, Nelson SM. SARS-CoV-2 testing in infertile patients: different recommendations in Europe and America. J Assist Reprod Genet. 2020;37(8):1823–1828. doi: 10.1007/s10815-020-01887-3. - DOI - PMC - PubMed
    1. Watson J, Richter A, Deeks J. Testing for SARS-CoV-2 antibodies. BMJ. 2020;370:m3325. doi: 10.1136/bmj.m3325. - DOI - PubMed
    1. Nelson SM, Ehnert S, Gromski PS, Child T, Trew G. SARS-Cov-2 viral and serological screening of staff in 31 European fertility units. Human Reproduction Open. 2020;hoaa056. 10.1093/hropen/hoaa056. - PMC - PubMed
    1. La Marca A, Capuzzo M, Paglia T, Roli L, Trenti T, Nelson SM. Testing for SARS-CoV-2 (COVID-19): a systematic review and clinical guide to molecular and serological in-vitro diagnostic assays. Reprod BioMed Online. 2020;41(3):483–499. - PMC - PubMed

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