Serology tests play an important role in the clinical diagnosis for later stage COVID-19 patients

Objectives:
What is the diagnostic accuracy of serologic methods for COVID-19 based on assay design and post-symptom?

Study design:
This review article included 4 cohort, 16 case-control and 7 longitudinal studies with a total of 4,565 participants.

Results and conclusions:   
The investigators found the pooled sensitivity of IgG, IgM and TAB in RNA-positive COVID-19 cases was 0.76 [95% CI = 0.65 to 0.86], 0.69 [95% CI = 0.59 to 0.78] and 0.78 [95% CI = 0.70 to 0.85], respectively.

The investigators found the specificity of IgG, IgM and TAB was 0.98 [95% CI = 0.96 to 0.99], 0.95 [95%CI = 0.91 to 0.98] and 0.97 [95% CI = 0.93 to 0.99], respectively.

The investigators found serology tests had the lowest sensitivity (less than 40%) at 0-7 days after symptom onset and the highest at >14 days.

The investigators found TAB had a better sensitivity than IgG or IgM only.

The investigators found using combined nucleocapsid (N) and spike(S) protein had a better sensitivity compared to N or S protein only.

The investigators found lateral flow immunoassay (LFIA) had a lower sensitivity than enzyme-linked immunoassay (ELISA) and chemiluminescent immunoassay (CLIA).

The investigators concluded serology tests will play an important role in the clinical diagnosis for later stage COVID-19 patients. In clinical practice, COVID-19 serological tests could contribute to the understanding of the immunological state of the population. ELISA tests, detecting TAB or targeting combined N and S proteins have a higher diagnostic sensitivity compared to other methods.

Original title:
Meta-analysis of diagnostic performance of serology tests for COVID-19: impact of assay design and post-symptom-onset intervals by Wang H, Jingwen Ai J, [...], Zhang W.

Link:
https://www.tandfonline.com/doi/full/10.1080/22221751.2020.1826362

Additional information of El Mondo:
Find more information/studies on coronavirus right here.

Serological tests are diagnostic methods that are used to identify antibodies and antigens in a patient's sample.