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Am J Clin Pathol . SARS-CoV-2 Antibody Responses Do Not Predict COVID-19 Disease Severity

tetano

Editor, Senior Moderator
Am J Clin Pathol


. 2020 Jul 15;aqaa123.
doi: 10.1093/ajcp/aqaa123. Online ahead of print.
SARS-CoV-2 Antibody Responses Do Not Predict COVID-19 Disease Severity


William S Phipps[SUP] 1 [/SUP], Jeffrey A SoRelle[SUP] 1 [/SUP], Quan-Zhen Li[SUP] 2 3 [/SUP], Lenin Mahimainathan[SUP] 1 [/SUP], Ellen Araj[SUP] 1 [/SUP], John Markantonis[SUP] 1 [/SUP], Chantale Lacelle[SUP] 1 [/SUP], Jyoti Balani[SUP] 1 [/SUP], Hiren Parikh[SUP] 1 [/SUP], E Blair Solow[SUP] 2 [/SUP], David R Karp[SUP] 2 [/SUP], Ravi Sarode[SUP] 1 4 [/SUP], Alagarraju Muthukumar[SUP] 1 [/SUP]



Affiliations

Abstract

Objectives: Initial reports indicate adequate performance of some serology-based severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) assays. However, additional studies are required to facilitate interpretation of results, including how antibody levels impact immunity and disease course.
Methods: A total of 967 subjects were tested for IgG antibodies reactive to SARS-CoV-2, including 172 suspected cases of SARS-CoV-2, 656 plasma samples from healthy donors, 49 sera from patients with rheumatic disease, and 90 specimens from individuals positive for polymerase chain reaction (PCR)-based respiratory viral panel. A subgroup of SARS-CoV-2 PCR-positive cases was tested for IgM antibodies by proteome array method.
Results: All specificity and cross-reactivity specimens were negative for SARS-CoV-2 IgG antibodies (0/795, 0%). Positive agreement of IgG with PCR was 83% of samples confirmed to be more than 14 days from symptom onset, with less than 100% sensitivity attributable to a case with severe immunosuppression. Virus-specific IgM was positive in a higher proportion of cases less than 3 days from symptom onset. No association was observed between mild and severe disease course with respect to IgG and IgM levels.
Conclusions: The studied SARS-CoV-2 IgG assay had 100% specificity and no adverse cross-reactivity. Measures of IgG and IgM antibodies did not predict disease severity in our patient population.

Keywords: COVID-19; Coronavirus; Global health; Immunology; Microbiology; SARS-CoV-2.
 
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