School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, QLD 4072, Australia.
Tianjin Key Laboratory for Modern Drug Delivery and High-Efficiency, Collaborative Innovation Center of Chemical Science and Engineering, School of Pharmaceutical Science and Technology, Tianjin University, Tianjin 300072, China.
Biochem Soc Trans. 2020 Dec 18;48(6):2851-2863. doi: 10.1042/BST20200744.
The ongoing COVID-19 pandemic has placed an overwhelming burden on the healthcare system, and caused major disruption to the world economy. COVID-19 is caused by SARS-CoV-2, a novel coronavirus that leads to a variety of symptoms in humans, including cough, fever and respiratory failure. SARS-CoV-2 infection can trigger extensive immune responses, including the production of antibodies. The detection of antibody response by serological testing provides a supplementary diagnostic tool to molecular tests. We hereby present a succinct yet comprehensive review on the antibody response to SARS-CoV-2 infection, as well as molecular mechanisms behind the strengths and limitations of serological antibody tests. The presence of antibodies can be detected in patient sera within days post symptom onset. Serological tests demonstrate superior sensitivity to molecular tests in some periods of time during disease development. Compared with the molecular tests, serological tests can be used for point-of-care testing, providing faster results at a lower cost. Commercially available serological tests show variable sensitivity and specificity, and the molecular basis of these variabilities are analysed. We discuss assays of different complexities that are used to specifically quantitate neutralising antibodies against SARS-CoV-2, which has important implications for vaccine development and herd immunity. Furthermore, we discuss examples of successful applications of serological tests to contact tracing and community-level sero-surveying, which provide invaluable information for pandemic management and assessment.
持续的 COVID-19 大流行给医疗系统带来了巨大的负担，并对世界经济造成了重大干扰。COVID-19 是由 SARS-CoV-2 引起的，这是一种新型冠状病毒，会导致人类出现各种症状，包括咳嗽、发热和呼吸衰竭。SARS-CoV-2 感染会引发广泛的免疫反应，包括产生抗体。血清学检测对抗体反应的检测为分子检测提供了一种补充诊断工具。我们在此简要而全面地回顾了 SARS-CoV-2 感染的抗体反应，以及血清学抗体检测的优势和局限性背后的分子机制。在症状出现后几天内，可在患者血清中检测到抗体。在疾病发展的某些时期，血清学检测比分子检测具有更高的敏感性。与分子检测相比，血清学检测可用于即时检测，以更低的成本提供更快的结果。市售的血清学检测显示出不同的敏感性和特异性，并分析了这些变异性的分子基础。我们讨论了用于特异性定量 SARS-CoV-2 中和抗体的不同复杂程度的检测方法，这对疫苗开发和群体免疫具有重要意义。此外，我们还讨论了血清学检测在接触者追踪和社区级血清调查中的成功应用实例，这些检测为大流行管理和评估提供了宝贵的信息。
