Yale School of Medicine, New Haven, CT.
Pain Management Centers of America, Paducah, KY and Evansville, IN; LSU Health Science Center, New Orleans, LA.
Pain Physician. 2020 Aug;23(4S):S381-S390.
The interventional pain management community saw the COVID-19 pandemic decimate elective interventional procedures and new patient visits across the United States until the reopening of America and the restarting of interventional procedures and elective surgical procedures began again. Health care providers, along with essential workers and patients, continue to be concerned about functioning in a safe and responsible manner. Consequently, a level of comfort is created by the testing health care workers with long exposure to new patients and patients undergoing interventions in high risk environments. As the United States and the world suffers from an ongoing infodemic, there are substantial amounts of misinformation, and some appropriate information being produced on molecular, antigen and antibody testing. Consequently, this manuscript is undertaken to describe the value and validity of coronavirus antibody testing.
Literature review.
Antibody tests detect antibodies or immunoglobulins that are produced as the human immune response to SARS-CoV-2 infection. A positive result suggests that the individual has potentially been exposed to SARS-CoV-2. When immunoglobulins M (IgM) antibodies are present, they can indicate an active or recent infection, whereas immunoglobulin G (IgG) antibodies show up later in the infection process and can often indicate a past infection, but does not exclude recently infected patients who can still be contagious, especially when IgM antibodies are also concurrently detected. While past knowledge indicates that for viral infections, IgG antibodies usually persist longer than IgM antibodies and provide immunity from re-infection, it is not clearly known if that is true for COVID-19.
A narrative review with paucity of literature.
Antibody tests have been developed to detect IgG only, both IgG and IgM, or total antibodies. At present, multiple antibody tests are available for use in the United States. In a review of 54 available studies through the end of April, mostly from China, the accuracy of pooled results for combination IgG/IgM tests was 91.4% (95% CI, 87.0 - 96.6) for 15 to 21 days post-symptom onset. Thus, antibody tests provide a promise and a peril in the ongoing Covid-19 pandemic.
美国介入性疼痛管理界看到，新冠疫情使美国各地的择期介入性手术和新患者就诊数量锐减，直到美国重新开放，介入性手术和择期手术再次开始。医疗保健提供者与基本工人和患者一起，继续关注以安全和负责任的方式开展工作。因此，对长时间接触新患者和在高风险环境下接受干预的患者的医护人员进行检测，会产生一定程度的放心。随着美国和世界遭受持续信息疫情的影响，存在大量错误信息，也有一些关于分子、抗原和抗体检测的适当信息。因此，本文旨在描述冠状病毒抗体检测的价值和有效性。
文献回顾。
抗体检测用于检测作为人类对 SARS-CoV-2 感染的免疫反应产生的抗体或免疫球蛋白。阳性结果表明，个体可能已接触 SARS-CoV-2。当存在免疫球蛋白 M（IgM）抗体时，它们可以表明正在发生或最近发生感染，而免疫球蛋白 G（IgG）抗体在感染过程后期出现，通常可以表明过去发生过感染，但不能排除最近仍有传染性的感染患者，特别是当同时检测到 IgM 抗体时。虽然过去的知识表明，对于病毒感染，IgG 抗体通常比 IgM 抗体持续时间更长，并提供免受再感染的免疫力，但目前尚不清楚这是否适用于 COVID-19。
文献资料不足的叙述性综述。
已经开发出抗体检测来检测 IgG，以及 IgG 和 IgM，或总抗体。目前，有多种抗体检测在美国可供使用。在对截至 4 月底的 54 项可用研究的综述中，这些研究主要来自中国，针对发病后 15 至 21 天的组合 IgG/IgM 检测的汇总结果准确性为 91.4%（95%CI，87.0-96.6）。因此，抗体检测在持续的新冠疫情中提供了希望和危险。
