Diagnostic performance of four SARS-CoV-2 antibody assays in patients with COVID-19 or with bacterial and non-SARS-CoV-2 viral respiratory infections.

Diagnostic performance of four SARS-CoV-2 antibody assays in patients with COVID-19 or with bacterial and non-SARS-CoV-2 viral respiratory infections.
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DOI:
10.1007/s10096-021-04285-4
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发表时间:
2021-09
期刊:
European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology
影响因子:
--
通讯作者:
Held J
Held J
中科院分区:
其他
文献类型:
--
作者:
Huber T;Steininger P;Irrgang P;Korn K;Tenbusch M;Diesch K;Achenbach S;Kremer AE;Werblow M;Vetter M;Bogdan C;Held J

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SARS-CoV-2 抗体测定用于流行病学研究和评估高度脆弱患者的疫苗反应。到目前为止,有关 SARS-CoV-2 抗体检测交叉反应性的数据有限。在这里,我们比较了四种酶联免疫吸附测定(ELISA;Vircell SARS-CoV-2 IgM/IgA 和 IgG、Euroimmun SARS-CoV-2 IgA 和 IgG),用于检测 207 名 COVID-19 患者、178 名具有不同细菌感染血清学证据的患者、107 名确诊病毒性呼吸道疾病患者以及 80 名 COVID-19 之前的对照者中的抗 SARS-CoV-2 抗体。在 COVID-19 患者中,检测在第 3 周(Vircell-IgM/A 和 Euroimmun-IgA:各 78.9%)和第 7 周后(Vircell-IgG:97.9%;Euroimmun-IgG:92.1%)显示出最高灵敏度。致命疾病患者的抗体指数较高。一般来说,IgM/IgA 检测相对 IgG 检测仅具有有限的优势或没有优势。在非 SARS-CoV-2 呼吸道感染患者中,IgG 检测比 IgM/IgA 检测更具特异性,并且细菌感染比病毒感染与更多假阳性结果相关。细菌和病毒感染的特异性分别为 68.0 和 81.3% (Vircell-IgM/IgA)、84.8 和 96.3% (Euroimmun-IgA)、97.8 和 86.0% (Vircell-IgG) 以及 97.8 和 99.1% (Euroimmun-IgG)。肺炎支原体、鹦鹉热衣原体和嗜肺军团菌抗体呈阳性的患者血清在 IgM/IgA 测定中产生特别高的非特异性假阳性结果,这是通过使用表达 SARS-CoV-2 刺突蛋白的 HEK 293 T 细胞进行高度特异性流式细胞术测定得出的结果。抗 SARS-CoV-2 IgM/IgA ELISA 获得的阳性结果需要仔细解释,特别是如果有证据表明既往有细菌性呼吸道感染。在线版本包含可在 10.1007/s10096-021-04285-4 获取的补充材料。
SARS-CoV-2 antibody assays are used for epidemiological studies and for the assessment of vaccine responses in highly vulnerable patients. So far, data on cross-reactivity of SARS-CoV-2 antibody assays is limited. Here, we compared four enzyme-linked immunosorbent assays (ELISAs; Vircell SARS-CoV-2 IgM/IgA and IgG, Euroimmun SARS-CoV-2 IgA and IgG) for detection of anti-SARS-CoV-2 antibodies in 207 patients with COVID-19, 178 patients with serological evidence of different bacterial infections, 107 patients with confirmed viral respiratory disease, and 80 controls from the pre-COVID-19 era. In COVID-19 patients, the assays showed highest sensitivity in week 3 (Vircell-IgM/A and Euroimmun-IgA: 78.9% each) and after week 7 (Vircell-IgG: 97.9%; Euroimmun-IgG: 92.1%). The antibody indices were higher in patients with fatal disease. In general, IgM/IgA assays had only limited or no benefit over IgG assays. In patients with non-SARS-CoV-2 respiratory infections, IgG assays were more specific than IgM/IgA assays, and bacterial infections were associated with more false-positive results than viral infections. The specificities in bacterial and viral infections were 68.0 and 81.3% (Vircell-IgM/IgA), 84.8 and 96.3% (Euroimmun-IgA), 97.8 and 86.0% (Vircell-IgG), and 97.8 and 99.1% (Euroimmun-IgG), respectively. Sera from patients positive for antibodies against Mycoplasma pneumoniae, Chlamydia psittaci, and Legionella pneumophila yielded particularly high rates of unspecific false-positive results in the IgM/IgA assays, which was revealed by applying a highly specific flow-cytometric assay using HEK 293 T cells expressing the SARS-CoV-2 spike protein. Positive results obtained with anti-SARS-CoV-2 IgM/IgA ELISAs require careful interpretation, especially if there is evidence for prior bacterial respiratory infections. The online version contains supplementary material available at 10.1007/s10096-021-04285-4.
DOI: 10.1038/261238a0
发表时间: 1976-01-01
期刊: NATURE
影响因子: 64.8
作者:
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影响因子: 5.6
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