Back to normal; serological testing for COVID-19 diagnosis unveils missed infections.
Adult
Antibodies, Viral
/ blood
COVID-19
/ diagnosis
COVID-19 Serological Testing
/ methods
Coronavirus Nucleocapsid Proteins
/ immunology
Female
Humans
Immunoglobulin G
/ blood
Immunoglobulin M
/ blood
Male
Middle Aged
Phosphoproteins
/ immunology
SARS-CoV-2
/ immunology
Seroconversion
Spike Glycoprotein, Coronavirus
/ immunology
Young Adult
COVID-19
SARS-CoV-2
diagnosis
immunoglobulin
serologic tests
viral tropism
Journal
Journal of medical virology
ISSN: 1096-9071
Titre abrégé: J Med Virol
Pays: United States
ID NLM: 7705876
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
revised:
03
03
2021
received:
02
01
2021
accepted:
17
03
2021
pubmed:
20
3
2021
medline:
9
6
2021
entrez:
19
3
2021
Statut:
ppublish
Résumé
The gold standard for coronavirus disease (COVID-19) diagnosis has been the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA by nucleic acid amplification testing (NAAT). On the other hand, serological testing for COVID-19 may offer advantages in detecting possibly overlooked infections by NAAT. To evaluate seroconversion of NAAT-negative pneumonia patients, immunoglobulin M (IgM) and IgG targeting the spike protein of SARS-CoV-2 were semiquantified by an immunofluorescence assay. Seroconversion was confirmed by another serological method, targeting the nucleocapsid protein. Eight suspected but unconfirmed COVID-19 pneumonia patients (median age, 39 years; range, 21-55) were included. The median period between symptom onset and NAAT sample collection was 6 days (2-27 days). None of them had tested positive for SARS-CoV-2 by NAAT. In contrast, all eight patients revealed seropositivity with the two serological methods, indicating actual seroconversion against SARS-CoV-2. The median period between onset and blood sampling was 26.5 days (7-51 days). Eight patients with COVID-19 pneumonia, initially tested negative for SARS-CoV-2 by NAAT, were finally confirmed of the diagnosis by serological testing. To cover the whole spectrum of this heterogenous infectious disease, serology testing should be implemented to the multitiered diagnostic algorithm for COVID-19.
Sections du résumé
BACKGROUND
The gold standard for coronavirus disease (COVID-19) diagnosis has been the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA by nucleic acid amplification testing (NAAT). On the other hand, serological testing for COVID-19 may offer advantages in detecting possibly overlooked infections by NAAT.
METHODS
To evaluate seroconversion of NAAT-negative pneumonia patients, immunoglobulin M (IgM) and IgG targeting the spike protein of SARS-CoV-2 were semiquantified by an immunofluorescence assay. Seroconversion was confirmed by another serological method, targeting the nucleocapsid protein.
RESULTS
Eight suspected but unconfirmed COVID-19 pneumonia patients (median age, 39 years; range, 21-55) were included. The median period between symptom onset and NAAT sample collection was 6 days (2-27 days). None of them had tested positive for SARS-CoV-2 by NAAT. In contrast, all eight patients revealed seropositivity with the two serological methods, indicating actual seroconversion against SARS-CoV-2. The median period between onset and blood sampling was 26.5 days (7-51 days).
CONCLUSION
Eight patients with COVID-19 pneumonia, initially tested negative for SARS-CoV-2 by NAAT, were finally confirmed of the diagnosis by serological testing. To cover the whole spectrum of this heterogenous infectious disease, serology testing should be implemented to the multitiered diagnostic algorithm for COVID-19.
Identifiants
pubmed: 33739483
doi: 10.1002/jmv.26949
pmc: PMC8250857
doi:
Substances chimiques
Antibodies, Viral
0
Coronavirus Nucleocapsid Proteins
0
Immunoglobulin G
0
Immunoglobulin M
0
Phosphoproteins
0
Spike Glycoprotein, Coronavirus
0
nucleocapsid phosphoprotein, SARS-CoV-2
0
spike protein, SARS-CoV-2
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
4549-4552Subventions
Organisme : COVID-19 Private Fund
ID : the Shinya Yamanaka laboratory
Organisme : COVID-19 Private Fund
ID : CiRA
Organisme : COVID-19 Private Fund
ID : Kyoto University
Organisme : Japan Agency for Medical Research and Development
ID : JP20he1122001
Organisme : Japan Agency for Medical Research and Development
ID : JP20jk0110021
Organisme : Japan Agency for Medical Research and Development
ID : JP20nk0101627
Organisme : Japan Agency for Medical Research and Development
ID : JP20wm0125003
Informations de copyright
© 2021 Wiley Periodicals LLC.
Références
J Med Virol. 2021 Feb;93(2):692-694
pubmed: 32897566
N Engl J Med. 2020 Aug 6;383(6):e38
pubmed: 32502334
Clin Infect Dis. 2020 Jul 28;71(15):778-785
pubmed: 32198501
Emerg Infect Dis. 2021 Feb;27(2):628-631
pubmed: 33496235
Ann Intern Med. 2020 Aug 18;173(4):262-267
pubmed: 32422057
J Med Virol. 2021 Jul;93(7):4549-4552
pubmed: 33739483
N Engl J Med. 2020 Oct 29;383(18):1782-1784
pubmed: 32871061
N Engl J Med. 2020 Oct 29;383(18):1724-1734
pubmed: 32871063
Clin Infect Dis. 2021 Jun 15;72(12):2225-2240
pubmed: 33104186
BMJ Case Rep. 2020 Aug 11;13(8):
pubmed: 32784236