Heat inactivation of serum interferes with the immunoanalysis of antibodies to SARS-CoV-2

J Clin Lab Anal. 2020 Sep;34(9):e23411. doi: 10.1002/jcla.23411. Epub 2020 Jun 28.

Abstract

Background: The detection of serum antibodies to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is emerging as a new tool for the coronavirus disease 2019 (COVID-19) diagnosis. Since many coronaviruses are sensitive to heat, heating inactivation of samples at 56°C prior to testing is considered a possible method to reduce the risk of transmission, but the effect of heating on the measurement of SARS-CoV-2 antibodies is still unclear.

Methods: By comparing the levels of SARS-CoV-2 antibodies before and after heat inactivation of serum at 56°C for 30 minutes using a quantitative fluorescence immunochromatographic assay RESULTS: We showed that heat inactivation significantly interferes with the levels of antibodies to SARS-CoV-2. The IgM levels of all the 34 serum samples (100%) from COVID-19 patients decreased by an average level of 53.56%. The IgG levels were decreased in 22 of 34 samples (64.71%) by an average level of 49.54%. Similar changes can also be observed in the non-COVID-19 disease group (n = 9). Of note, 44.12% of the detected IgM levels were dropped below the cutoff value after heating, suggesting heat inactivation can lead to false-negative results of these samples.

Conclusion: Our results indicate that heat inactivation of serum at 56°C for 30 minutes interferes with the immunoanalysis of antibodies to SARS-CoV-2. Heat inactivation prior to immunoanalysis is not recommended, and the possibility of false-negative results should be considered if the sample was pre-inactivated by heating.

Keywords: COVID-19; SARS-CoV-2; antibodies; heat inactivation; immunoanalysis.

MeSH terms

  • Antibodies, Viral / immunology*
  • Betacoronavirus / immunology*
  • COVID-19
  • Coronavirus Infections / blood*
  • Coronavirus Infections / immunology*
  • Coronavirus Infections / virology
  • Hot Temperature*
  • Humans
  • Immunoassay / methods*
  • Immunoglobulin G / blood
  • Immunoglobulin M / blood
  • Pandemics
  • Pneumonia, Viral / blood*
  • Pneumonia, Viral / immunology*
  • Pneumonia, Viral / virology
  • SARS-CoV-2
  • Serum / immunology*

Substances

  • Antibodies, Viral
  • Immunoglobulin G
  • Immunoglobulin M