Performance evaluation of serological assays to determine the immunoglobulin status in SARS-CoV-2 infected patients

J Clin Virol. 2020 Oct:131:104589. doi: 10.1016/j.jcv.2020.104589. Epub 2020 Aug 11.

Abstract

Background: Serological assays for the determination of the immune status of patients that have tested positive for infection with SARS-CoV-2 by RT-PCR are required for, e.g., contact tracing and epidemiological studies. However, data concerning the performance parameters of commercially available high-throughput ELISA tests are still not available on a large scale.

Study design: In our study, we have evaluated an in-house developed ELISA for the detection of the immunoglobulin classes A, G and M directed against the full-length spike glycoprotein from SARS-CoV-2. For this analysis, we have included 110 sera from patients presenting with COVID-19 symptoms or blood donors without symptoms collected at the Austrian Red Cross, Blood Transfusion Service for Upper Austria, Linz. In addition, we have selected four commercially available IgG-based ELISAs as well as one IgA/IgG-based ELISA for the detection of SARS-CoV-2 antigens as well as a multiplexed IgG-based micro-ELISA assay developed for rapid Point of Care testing applications.

Conclusions: All assays evaluated in the course of this study demonstrated suitable sensitivity and specificity values for the identification of patients that have experienced a past infection with SARS-CoV-2. However, testing for the presence of additional immunoglobulins (IgA and IgM) as well as using combinations of different viral antigens is highly advised to improve the predictive values of serological assays.

Keywords: COVID-19; ELISA; Evaluation; Immunoglobulin; Point of care; SARS-CoV-2.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antibodies, Viral / blood*
  • Betacoronavirus
  • COVID-19
  • COVID-19 Testing
  • Clinical Laboratory Techniques
  • Coronavirus Infections / diagnosis*
  • Coronavirus Infections / immunology
  • Enzyme-Linked Immunosorbent Assay*
  • Female
  • Humans
  • Immunoglobulin G / blood
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / diagnosis*
  • Pneumonia, Viral / immunology
  • SARS-CoV-2
  • Sensitivity and Specificity
  • Serologic Tests*

Substances

  • Antibodies, Viral
  • Immunoglobulin G