Analysis of adjunctive serological detection to nucleic acid test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection diagnosis

https://doi.org/10.1016/j.intimp.2020.106746Get rights and content

Highlights

  • Adjunct of serological test improves the accuracy in COVID-19 diagnosis after onsets.

  • Demographic characteristics of patients are analyzed based on severity of COVID-19.

  • COVID-19 patients are sorted to three subgroups by severity of illness for analysis.

  • No differences of IgM-IgG concentrations exist among subgroups of COVID-19 patients.

Abstract

Background

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused coronavirus disease 2019 (COVID-19) epidemic in China, December 2019. The clinical features and treatment of COVID-19 patients remain largely elusive. However, accurate detection is required for SARS-CoV-2 infection diagnosis. We aimed to evaluate the antibodies-based test and nucleic acid-based test for SARS-CoV-2-infected patients.

Methods

We retrospectively studied 133 patients diagnosed with SARS-CoV-2 and admitted to Renmin Hospital of Wuhan University, China, from January 23 to March 1, 2020. Demographic data, clinical records, laboratory tests, and outcomes were collected. Data were accessed by SARS-CoV-2 IgM-IgG antibody test and real-time reverse transcriptase PCR (RT-PCR) detection for SARS-CoV-2 nucleic acid in COVID-19 patients.

Results

Of 133 COVID-19 patients, there were 44 moderate cases, 52 severe cases, and 37 critical cases with no differences in gender and age among three subgroups. In RT-PCR detection, the positive rate was 65.9%, 71.2%, and 67.6% in moderate, severe, and critical cases, respectively. Whereas the positive rate of IgM/IgG antibody detection in patients was 79.5%/93.2%, 82.7%/100%, and 73.0%/97.3% in moderate, severe, and critical cases, respectively. Moreover, the IgM and IgG antibodies concentrations were also examined with no differences among three subgroups.

Conclusion

The IgM-IgG antibody test exhibited a useful adjunct to RT-PCR detection, and improved the accuracy in COVID-19 diagnosis regardless of the severity of illness, which provides an effective complement to the false-negative results from a nucleic acid test for SARS-CoV-2 infection diagnosis after onsets.

Keywords

SARS-CoV-2
COVID-19
Severity of illness
IgM-IgG antibody test
Nucleic acid test

Abbreviations

RT-PCR
real-time reverse transcriptase polymerase chain reaction
COVID-19
coronavirus disease 2019
SARS-CoV-2
severe acute respiratory syndrome coronavirus 2
IgM
immunoglobulin M
IgG
immunoglobulin G
CT
Computed Tomography
ICU
intensive care unit
RLU
relative light unit
antibody unit
AU
MERS
Middle East respiratory syndrome coronavirus
d.p.o
days post-disease onset
ddPCR
droplet digital PCR
CRISPR
Clustered regularly interspaced short palindromic repeats
mNGS
metagenomic next-generation sequencing

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1

These authors contributed equally to this work.

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