tetano
Editor, Senior Moderator
J Med Virol
. 2021 Mar 19.
doi: 10.1002/jmv.26949. Online ahead of print.
Back to Normal; Serological Testing for COVID-19 Diagnosis Unveils Missed Infections
Tomoya Tsuchida[SUP] 1 [/SUP], Yuko Nitahara[SUP] 2 [/SUP], Shotaro Suzuki[SUP] 1 [/SUP], Yuko Komase[SUP] 3 [/SUP], Katherine Candray[SUP] 2 [/SUP], Yasutoshi Kido[SUP] 2 [/SUP], Yu Nakagama[SUP] 2 [/SUP], Yukitaka Yamasaki[SUP] 4 [/SUP], Mitsuru Imamura[SUP] 1 [/SUP], Kimito Kawahata[SUP] 1 [/SUP], Hiroyuki Kunishima[SUP] 4 [/SUP], Shigeki Fujitani[SUP] 5 [/SUP], Masamichi Mineshita[SUP] 1 [/SUP], Takahide Matsuda[SUP] 1 [/SUP]
Affiliations
Abstract
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, IgM and IgG targeting the spike protein of SARS-CoV-2 were semi-quantified 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; 21-55) were included. The median period between symptom onset and NAAT sample collection was 6 days (2-27d). 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 (7-51d).
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 multi-tiered diagnostic algorithm for COVID-19. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; Immunoglobulin; SARS-CoV-2; Viral Tropism; diagnosis; serologic tests.
. 2021 Mar 19.
doi: 10.1002/jmv.26949. Online ahead of print.
Back to Normal; Serological Testing for COVID-19 Diagnosis Unveils Missed Infections
Tomoya Tsuchida[SUP] 1 [/SUP], Yuko Nitahara[SUP] 2 [/SUP], Shotaro Suzuki[SUP] 1 [/SUP], Yuko Komase[SUP] 3 [/SUP], Katherine Candray[SUP] 2 [/SUP], Yasutoshi Kido[SUP] 2 [/SUP], Yu Nakagama[SUP] 2 [/SUP], Yukitaka Yamasaki[SUP] 4 [/SUP], Mitsuru Imamura[SUP] 1 [/SUP], Kimito Kawahata[SUP] 1 [/SUP], Hiroyuki Kunishima[SUP] 4 [/SUP], Shigeki Fujitani[SUP] 5 [/SUP], Masamichi Mineshita[SUP] 1 [/SUP], Takahide Matsuda[SUP] 1 [/SUP]
Affiliations
- PMID: 33739483
- DOI: 10.1002/jmv.26949
Abstract
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, IgM and IgG targeting the spike protein of SARS-CoV-2 were semi-quantified 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; 21-55) were included. The median period between symptom onset and NAAT sample collection was 6 days (2-27d). 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 (7-51d).
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 multi-tiered diagnostic algorithm for COVID-19. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; Immunoglobulin; SARS-CoV-2; Viral Tropism; diagnosis; serologic tests.