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PLoS One . Performance of anti-SARS-CoV-2 antibody testing in asymptomatic or mild COVID-19 patients: A retrospective study in outbreak on a cruise

tetano

Editor, Senior Moderator
PLoS One


. 2021 Sep 28;16(9):e0257452.
doi: 10.1371/journal.pone.0257452. eCollection 2021.
Performance of anti-SARS-CoV-2 antibody testing in asymptomatic or mild COVID-19 patients: A retrospective study in outbreak on a cruise ship


Norihito Kaku[SUP] 1 2 [/SUP], Fumitaka Nishimura[SUP] 2 [/SUP], Yui Shigeishi[SUP] 2 [/SUP], Rina Tachiki[SUP] 2 [/SUP], Hironori Sakai[SUP] 3 [/SUP], Daisuke Sasaki[SUP] 2 [/SUP], Kenji Ota[SUP] 1 2 [/SUP], Kei Sakamoto[SUP] 1 2 [/SUP], Kosuke Kosai[SUP] 1 2 [/SUP], Hiroo Hasegawa[SUP] 1 2 [/SUP], Koichi Izumikawa[SUP] 4 [/SUP], Koya Ariyoshi[SUP] 5 [/SUP], Hiroshi Mukae[SUP] 6 [/SUP], Jiro Yasuda[SUP] 7 [/SUP], Kouichi Morita[SUP] 8 [/SUP], Shigeru Kohno[SUP] 9 [/SUP], Katsunori Yanagihara[SUP] 1 2 [/SUP]



Affiliations

Abstract

Objectives: A few studies on antibody testing have focused on asymptomatic or mild coronavirus disease 2019 (COVID-19) patients with low initial anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody responses. Anti-SARS-CoV-2 antibody-testing performance was evaluated using blood samples from asymptomatic or mild COVID-19 patients.
Methods: Blood samples were collected from 143 COVID-19 patients during an outbreak on a cruise ship 3 weeks after diagnosis. Simultaneously, a follow-up SARS-CoV-2 genetic test was performed. Samples stored before the COVID-19 pandemic were also used to evaluate the lateral flow immunochromatographic assay (LFA) and electrochemiluminescence immunoassay (ECLIA). Titers of anti-SARS-CoV-2 IgM and IgG antibodies against the nucleocapsid and spike proteins were measured using the enzyme-linked immunosorbent assay to confirm which antibodies were influenced on LFA- and ECLIA- false-negative result in crew-member samples.
Results: Sensitivity, specificity, positive-predictive, and negative-predictive values of LFA-detected IgM antibodies were 0.231, 1.000, 1.000, and 0.613, respectively; those of LFA-detected IgG antibodies were 0.483, 0.989, 0.972, and 0.601, respectively; and those of ECLIA-detected total antibodies were 0.783, 1.000, 1.000, and 0.848, respectively. All antibody titers measured using ELISA were significantly lower in blood samples with negative results than in those with positive results in both LFA and ECLIA. In the patients with negative results from the follow-up genetic testing, IgM-, IgG-, and total-antibody positivity rates were 22.9%, 47.6%, and 72.4%, respectively.
Conclusions: These findings suggest that anti-SARS-CoV-2 antibody testing has lower performance in asymptomatic or mild COVID-19 patients than required in the guidelines.
 
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