Meta-analysis of diagnostic performance of serology tests for COVID-19: impact of assay design and post-symptom-onset intervals

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. T...

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Published inEmerging microbes & infections Vol. 9; no. 1; pp. 2200 - 2211
Main Authors Wang, Hongyu, Ai, Jingwen, Loeffelholz, Michael J., Tang, Yi-Wei, Zhang, Wenhong
Format Journal Article
LanguageEnglish
Published United States Taylor & Francis 01.01.2020
Taylor & Francis Ltd
Taylor & Francis Group
Subjects
Accuracy
Antibodies, Viral - blood
Antibodies, Viral - immunology
Antigens, Viral - immunology
Betacoronavirus - immunology
Clinical Laboratory Techniques - methods
Clinical Laboratory Techniques - standards
Coronavirus Infections - diagnosis
Coronavirus Infections - immunology
Coronavirus Infections - virology
Coronaviruses
COVID-19
COVID-19 Testing
Humans
Immunoassay
Immunoassay - methods
Immunoassay - standards
immunoassays
Immunoglobulin G - blood
Immunoglobulin G - immunology
Immunoglobulin M - blood
Immunoglobulin M - immunology
Meta-analysis
metanalysis
Pandemics
Pneumonia, Viral - diagnosis
Pneumonia, Viral - immunology
Pneumonia, Viral - virology
Publication Bias
SARS-CoV-2
Sensitivity and Specificity
Serologic Tests - methods
Serologic Tests - standards
Serology
Symptom Assessment
COVID-19
immunoassays
SARS-CoV-2
metanalysis
serology
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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.
AbstractList 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.
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.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.
Author Loeffelholz, Michael J.
Tang, Yi-Wei
Zhang, Wenhong
Wang, Hongyu
Ai, Jingwen
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/32962560$$D View this record in MEDLINE/PubMed
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Issue 1
Keywords COVID-19
immunoassays
SARS-CoV-2
metanalysis
serology
Language English
License open-access: http://creativecommons.org/licenses/by/4.0/: This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Supplemental data for this article can be accessed at https://doi.org/10.1080/22221751.2020.1826362
Hongyu Wang, Jingwen Ai contributed equally to this manuscript.
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Snippet Serology detection is recognized for its sensitivity in convalescent patients with COVID-19, in comparison with nucleic acid amplification tests (NAATs). This...
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SubjectTerms Accuracy
Antibodies, Viral - blood
Antibodies, Viral - immunology
Antigens, Viral - immunology
Betacoronavirus - immunology
Clinical Laboratory Techniques - methods
Clinical Laboratory Techniques - standards
Coronavirus Infections - diagnosis
Coronavirus Infections - immunology
Coronavirus Infections - virology
Coronaviruses
COVID-19
COVID-19 Testing
Humans
Immunoassay
Immunoassay - methods
Immunoassay - standards
immunoassays
Immunoglobulin G - blood
Immunoglobulin G - immunology
Immunoglobulin M - blood
Immunoglobulin M - immunology
Meta-analysis
metanalysis
Pandemics
Pneumonia, Viral - diagnosis
Pneumonia, Viral - immunology
Pneumonia, Viral - virology
Publication Bias
SARS-CoV-2
Sensitivity and Specificity
Serologic Tests - methods
Serologic Tests - standards
Serology
Symptom Assessment
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Title Meta-analysis of diagnostic performance of serology tests for COVID-19: impact of assay design and post-symptom-onset intervals
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