Feng Yangchun
Clinical Laboratory Center, The Third Hospital Affiliated to Xinjiang Medical University (Affiliated Cancer Hospital), Urumqi, 830011, People's Republic of China.
J Inflamm Res. 2020 Dec 10;13:1089-1094. doi: 10.2147/JIR.S287733. eCollection 2020.
To explore the clinical value of SARS-CoV2 IgM and IgG antibodies in the diagnosis of COVID-19 in suspected cases by likelihood ratio.
By reinterpreting data from a previous study, the positive likelihood ratio of IgM and IgG antibodies in COVID-19 pneumonia diagnosis was calculated, and the posterior probability of IgM and IgG antibodies and their tandem detection was calculated finally.
The positive likelihood ratios of single IgM and IgG antibodies were 18.50 and 12.65, respectively, and the posterior probabilities were 90.18% and 86.26%, respectively. However, the posterior probability of the two antibody-tandem test was 99.15%, which could give clinicians more quantitative confidence in the diagnosis of COVID-19 in suspected cases. According to the results of this study, combining the advantages and disadvantages of nucleic acid testing and antibody detection, a feasible clinical path was found for clinicians to diagnose COVID-19 pneumonia from suspected cases.
For suspected cases, IgM- and IgG-antibody tests should first be done at the same time. If all antibody tests are positive, COVID-19 pneumonia could be confirmed. If not, nucleic acid detection (once or more) should be carried out, and in extreme cases high-throughput viral genome sequencing is required.
通过似然比探讨严重急性呼吸综合征冠状病毒2（SARS-CoV2）IgM和IgG抗体在疑似病例诊断新型冠状病毒肺炎（COVID-19）中的临床价值。
通过重新分析一项既往研究的数据，计算IgM和IgG抗体在COVID-19肺炎诊断中的阳性似然比，最终计算IgM和IgG抗体及其联合检测的后验概率。
单一IgM和IgG抗体的阳性似然比分别为18.50和12.65，后验概率分别为90.18%和86.26%。然而，两种抗体联合检测的后验概率为99.15%，这可以为临床医生在疑似病例的COVID-19诊断中提供更多定量的信心。根据本研究结果，结合核酸检测和抗体检测的优缺点，为临床医生从疑似病例中诊断COVID-19肺炎找到了一条可行的临床路径。
对于疑似病例，应首先同时进行IgM和IgG抗体检测。如果所有抗体检测均为阳性，则可确诊COVID-19肺炎。如果不是，则应进行核酸检测（一次或多次），在极端情况下需要进行高通量病毒基因组测序。
