Department of Hematology and Medical Oncology and University of Miami Miller School of Medicine and Jackson Health System, Miami, FL.
Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine and Jackson Health System, Miami, FL.
Am J Clin Pathol. 2020 Aug 5;154(3):293-304. doi: 10.1093/ajcp/aqaa112.
To examine and summarize the current literature on serologic methods for the detection of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
A literature review was performed using searches in databases including PubMed, medRxiv, and bioRxiv. Thirty-two peer-reviewed papers and 23 preprints were examined.
The studies included lateral flow immunoassay, enzyme-linked immunosorbent assay, chemiluminescence immunoassay, and neutralizing antibody assays. The use of all major SARS-CoV-2 antigens was demonstrated to have diagnostic value. Assays measuring total antibody reactivity had the highest sensitivity. In addition, all the methods provided opportunities to characterize the humoral immune response by isotype. The combined use of IgM and IgG detection resulted in a higher sensitivity than that observed when detecting either isotype alone. Although IgA was rarely studied, it was also demonstrated to be a sensitive marker of infection, and levels correlated with disease severity and neutralizing activity.
The use of serologic testing, in conjunction with reverse transcription polymerase chain reaction testing, was demonstrated to significantly increase the sensitivity of detection of patients infected with SARS-CoV-2. There was conflicting evidence regarding whether antibody titers correlated with clinical severity. However, preliminary investigations indicated some immunoassays may be a surrogate for the prediction of neutralizing antibody titers and the selection of recovered patients for convalescent serum donation.
检查和总结目前关于严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 抗体检测的血清学方法的文献。
通过在 PubMed、medRxiv 和 bioRxiv 等数据库中进行检索，进行文献回顾。检查了 32 篇同行评议论文和 23 篇预印本。
这些研究包括侧向流动免疫测定、酶联免疫吸附测定、化学发光免疫测定和中和抗体测定。证明使用所有主要的 SARS-CoV-2 抗原都具有诊断价值。检测总抗体反应性的测定具有最高的灵敏度。此外，所有方法都提供了通过同种型来描述体液免疫反应的机会。IgM 和 IgG 检测的联合使用比单独检测任何一种同种型的灵敏度都要高。虽然很少研究 IgA，但它也被证明是感染的敏感标志物，其水平与疾病严重程度和中和活性相关。
血清学检测与逆转录聚合酶链反应检测联合使用，显著提高了检测 SARS-CoV-2 感染患者的灵敏度。抗体滴度与临床严重程度是否相关存在相互矛盾的证据。然而，初步研究表明，一些免疫测定可能是预测中和抗体滴度和选择恢复期患者进行恢复期血清捐献的替代指标。
