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Int J Infect Dis
. 2021 Jan 12;S1201-9712(21)00026-6.
doi: 10.1016/j.ijid.2021.01.016. Online ahead of print.
Clinical applications of detecting IgG, IgM, or IgA antibody for the diagnosis of COVID-19: A meta-analysis and systematic review
Mengyu Chen 1 , Rundong Qin 2 , Jiang Mei 2 , Zhaowei Yang 2 , Weiping Wen 3 , Jing Li 4
Affiliations
- PMID: 33450372
- DOI: 10.1016/j.ijid.2021.01.016
Abstract
Background: Coronavirus disease 2019 is a global pandemic. Serological antibody test is one important diagnostic method increasingly used in the clinic, although its clinical application is still under investigation.
Methods: We conducted a meta-analysis to compare the diagnostic performances of severe acute respiratory syndrome coronavirus 2 specific antibody tests in COVID-19 patients. Test results analyzed included (1) IgM-positive but IgG-negative (IgM+IgG-), (2) IgG-positive but IgM-negative (IgG+IgM-), (3) both IgM and IgG-positive (IgM+IgG+), (4) IgM-positive without IgG information (IgM+IgG+/-), (5) IgG-positive without IgM information (IgG+IgM+/-), (6) either IgM or IgG-positive (IgM+ or IgG+), and (7) IgA-positive (IgA+).
Results: Sixty-eight studies were included. The pooled sensitivities of IgM+IgG-, IgG+IgM-, IgM+IgG+, IgM+IgG+/-, IgG+IgM+/-, and IgM+ or IgG+ were 6%, 7%, 53%, 68%, 73%, and 79% respectively. The pooled specificity ranged from 98% to 100%. The IgA+ had a pooled sensitivity of 78%, but a relatively low specificity of 88%. Tests conducted two weeks after symptom onset provided improved diagnostic accuracy. Chemiluminescence immunoassay and detection of S protein as the antigen could offer a more accurate diagnostic result.
Discussion: Our findings support the supplemental role of serological antibody tests in COVID-19 diagnosis. However, their capacity to diagnose COVID-19 early in the disease course could be limited.
Keywords: COVID-19; SARS-CoV-2; antibody tests; diagnostic accuracy; sensitivity; specificity.