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Meta-analysis of diagnostic performance of serology tests for COVID-19: impact of assay design and post-symptom-onset intervals.
Wang, Hongyu; Ai, Jingwen; Loeffelholz, Michael J; Tang, Yi-Wei; Zhang, Wenhong.
  • Wang H; Department of Infectious Diseases, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.
  • Ai J; Department of Infectious Diseases, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.
  • Loeffelholz MJ; Cepheid China, Danaher Diagnostic Platform, Shanghai, People's Republic of China.
  • Tang YW; Cepheid China, Danaher Diagnostic Platform, Shanghai, People's Republic of China.
  • Zhang W; Department of Infectious Diseases, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.
Emerg Microbes Infect ; 9(1): 2200-2211, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-787003
ABSTRACT
Serology detection is recognized for its sensitivity in convalescent patients with COVID-19, in comparison with nucleic acid amplification tests (NAATs). This article aimed to evaluate the diagnostic accuracy of serologic methods for COVID-19 based on assay design and post-symptom-onset intervals. Two authors independently searched PubMed, Cochrane library, Ovid, EBSCO for case-control, longitudinal and cohort studies that determined the diagnostic accuracy of serology tests in comparison with NAATs in COVID-19 cases and used QUADAS-2 for quality assessment. Pooled accuracy was analysed using INLA method. A total of 27 studies were included in this meta-analysis, with 4 cohort, 16 case-control and 7 longitudinal studies and 4565 participants. Serology tests had the lowest sensitivity at 0-7 days after symptom onset and the highest at >14 days. TAB had a better sensitivity than IgG or IgM only. Using combined nucleocapsid (N) and spike(S) protein had a better sensitivity compared to N or S protein only. Lateral flow immunoassay (LFIA) had a lower sensitivity than enzyme-linked immunoassay (ELISA) and chemiluminescent immunoassay (CLIA). Serology tests will play an important role in the clinical diagnosis for later stage COVID-19 patients. ELISA tests, detecting TAB or targeting combined N and S proteins had a higher diagnostic sensitivity compared to other methods.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Serologic Tests / Coronavirus Infections / Clinical Laboratory Techniques / Betacoronavirus Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Reviews Limits: Humans Language: English Journal: Emerg Microbes Infect Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Serologic Tests / Coronavirus Infections / Clinical Laboratory Techniques / Betacoronavirus Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Reviews Limits: Humans Language: English Journal: Emerg Microbes Infect Year: 2020 Document Type: Article