tetano
Editor, Senior Moderator
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[SUP] 1 [/SUP], Rundong Qin[SUP] 2 [/SUP], Jiang Mei[SUP] 2 [/SUP], Zhaowei Yang[SUP] 2 [/SUP], Weiping Wen[SUP] 3 [/SUP], Jing Li[SUP] 4 [/SUP]
Affiliations
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[SUP]+[/SUP]IgG-), (2) IgG-positive but IgM-negative (IgG[SUP]+[/SUP]IgM-), (3) both IgM and IgG-positive (IgM[SUP]+[/SUP]IgG[SUP]+[/SUP]), (4) IgM-positive without IgG information (IgM[SUP]+[/SUP]IgG[SUP]+/-[/SUP]), (5) IgG-positive without IgM information (IgG[SUP]+[/SUP]IgM[SUP]+/-[/SUP]), (6) either IgM or IgG-positive (IgM[SUP]+[/SUP] or IgG[SUP]+[/SUP]), and (7) IgA-positive (IgA[SUP]+[/SUP]).
Results: Sixty-eight studies were included. The pooled sensitivities of IgM[SUP]+[/SUP]IgG-, IgG[SUP]+[/SUP]IgM-, IgM[SUP]+[/SUP]IgG[SUP]+[/SUP], IgM[SUP]+[/SUP]IgG[SUP]+/-[/SUP], IgG[SUP]+[/SUP]IgM[SUP]+/-[/SUP], and IgM[SUP]+[/SUP] or IgG[SUP]+[/SUP] were 6%, 7%, 53%, 68%, 73%, and 79% respectively. The pooled specificity ranged from 98% to 100%. The IgA[SUP]+[/SUP] 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.
. 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[SUP] 1 [/SUP], Rundong Qin[SUP] 2 [/SUP], Jiang Mei[SUP] 2 [/SUP], Zhaowei Yang[SUP] 2 [/SUP], Weiping Wen[SUP] 3 [/SUP], Jing Li[SUP] 4 [/SUP]
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[SUP]+[/SUP]IgG-), (2) IgG-positive but IgM-negative (IgG[SUP]+[/SUP]IgM-), (3) both IgM and IgG-positive (IgM[SUP]+[/SUP]IgG[SUP]+[/SUP]), (4) IgM-positive without IgG information (IgM[SUP]+[/SUP]IgG[SUP]+/-[/SUP]), (5) IgG-positive without IgM information (IgG[SUP]+[/SUP]IgM[SUP]+/-[/SUP]), (6) either IgM or IgG-positive (IgM[SUP]+[/SUP] or IgG[SUP]+[/SUP]), and (7) IgA-positive (IgA[SUP]+[/SUP]).
Results: Sixty-eight studies were included. The pooled sensitivities of IgM[SUP]+[/SUP]IgG-, IgG[SUP]+[/SUP]IgM-, IgM[SUP]+[/SUP]IgG[SUP]+[/SUP], IgM[SUP]+[/SUP]IgG[SUP]+/-[/SUP], IgG[SUP]+[/SUP]IgM[SUP]+/-[/SUP], and IgM[SUP]+[/SUP] or IgG[SUP]+[/SUP] were 6%, 7%, 53%, 68%, 73%, and 79% respectively. The pooled specificity ranged from 98% to 100%. The IgA[SUP]+[/SUP] 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.