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Huber, Timo; Steininger, Philipp; Irrgang, Pascal; Korn, Klaus; Tenbusch, Matthias; Diesch, Katharina; Achenbach, Susanne; Kremer, Andreas E.; Werblow, Marissa; Vetter, Marcel; Bogdan, Christian; Held, Jürgen

Diagnostic performance of four SARS-CoV-2 antibody assays in patients with COVID-19 or with bacterial and non-SARS-CoV-2 viral respiratory infections

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  • Medientyp: E-Artikel
  • Titel: Diagnostic performance of four SARS-CoV-2 antibody assays in patients with COVID-19 or with bacterial and non-SARS-CoV-2 viral respiratory infections
  • Beteiligte: Huber, Timo; Steininger, Philipp; Irrgang, Pascal; Korn, Klaus; Tenbusch, Matthias; Diesch, Katharina; Achenbach, Susanne; Kremer, Andreas E.; Werblow, Marissa; Vetter, Marcel; Bogdan, Christian; Held, Jürgen
  • Erschienen: Springer Science and Business Media LLC, 2021
  • Erschienen in: European Journal of Clinical Microbiology & Infectious Diseases
  • Sprache: Englisch
  • DOI: 10.1007/s10096-021-04285-4
  • ISSN: 0934-9723; 1435-4373
  • Schlagwörter: Infectious Diseases ; Microbiology (medical) ; General Medicine
  • Entstehung:
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  • Beschreibung: <jats:title>Abstract</jats:title><jats:p>SARS-CoV-2 antibody assays are used for epidemiological studies and for the assessment of vaccine responses in highly vulnerable patients. So far, data on cross-reactivity of SARS-CoV-2 antibody assays is limited. Here, we compared four enzyme-linked immunosorbent assays (ELISAs; Vircell SARS-CoV-2 IgM/IgA and IgG, Euroimmun SARS-CoV-2 IgA and IgG) for detection of anti-SARS-CoV-2 antibodies in 207 patients with COVID-19, 178 patients with serological evidence of different bacterial infections, 107 patients with confirmed viral respiratory disease, and 80 controls from the pre-COVID-19 era. In COVID-19 patients, the assays showed highest sensitivity in week 3 (Vircell-IgM/A and Euroimmun-IgA: 78.9% each) and after week 7 (Vircell-IgG: 97.9%; Euroimmun-IgG: 92.1%). The antibody indices were higher in patients with fatal disease. In general, IgM/IgA assays had only limited or no benefit over IgG assays. In patients with non-SARS-CoV-2 respiratory infections, IgG assays were more specific than IgM/IgA assays, and bacterial infections were associated with more false-positive results than viral infections. The specificities in bacterial and viral infections were 68.0 and 81.3% (Vircell-IgM/IgA), 84.8 and 96.3% (Euroimmun-IgA), 97.8 and 86.0% (Vircell-IgG), and 97.8 and 99.1% (Euroimmun-IgG), respectively. Sera from patients positive for antibodies against <jats:italic>Mycoplasma pneumoniae</jats:italic>, <jats:italic>Chlamydia psittaci</jats:italic>, and <jats:italic>Legionella pneumophila</jats:italic> yielded particularly high rates of unspecific false-positive results in the IgM/IgA assays, which was revealed by applying a highly specific flow-cytometric assay using HEK 293 T cells expressing the SARS-CoV-2 spike protein. Positive results obtained with anti-SARS-CoV-2 IgM/IgA ELISAs require careful interpretation, especially if there is evidence for prior bacterial respiratory infections.</jats:p>