Interlaboratory Agreement of Anti-Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Serologic Assays in the Expedited College of American Pathologists Proficiency Testing Program

Arch Pathol Lab Med. 2021 May 1;145(5):536-542. doi: 10.5858/arpa.2020-0811-SA.

Abstract

Context.—: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a recently emerged, currently pandemic virus, and the etiologic agent of coronavirus disease 2019 (COVID-19). Clinical testing for antibodies to SARS-CoV-2 has rapidly become widespread, but data regarding the interlaboratory performance of these serologic assays are limited.

Objective.—: To describe the development and initial results of the College of American Pathologists (CAP) SARS-CoV-2 Serology Survey.

Design.—: Members from the CAP Microbiology and Diagnostic Immunology and Flow Cytometry Committees formed a working group to support development of a new proficiency testing survey for anti-SARS-CoV-2 antibody assays. Supplemental questions in the survey assessed the state of SARS-CoV-2 serologic testing among participating laboratories as of July 2020. Results were analyzed for agreement by immunoglobulin (Ig) isotype tested, assay manufacturer, and methodology.

Results.—: A total of 4125 qualitative results were received from 1110 laboratories participating in the first survey. Qualitative agreement for assays measuring anti-SARS-CoV-2 total antibodies or IgG was greater than 90% for all 3 samples in the survey. Qualitative agreement for IgM and IgA for the negative sample was greater than 95%, but lacked consensus for the other 2 samples.

Conclusions.—: These initial data suggest overall excellent agreement and comparable performance for most qualitative anti-SARS-CoV-2 IgG and total antibody assays across all participating clinical laboratories, regardless of specific target antigen or assay methodology.

MeSH terms

  • Antibodies, Viral / blood*
  • COVID-19 / blood
  • COVID-19 / diagnosis*
  • COVID-19 / immunology
  • COVID-19 / virology
  • COVID-19 Serological Testing / methods*
  • COVID-19 Serological Testing / standards*
  • Humans
  • Immunoglobulin G / blood
  • Laboratory Proficiency Testing*
  • Reproducibility of Results
  • SARS-CoV-2 / immunology*
  • United States

Substances

  • Antibodies, Viral
  • Immunoglobulin G