Department of Laboratory Medicine, GZA hospitals, Antwerpen, Belgium.
Department of Internal Medicine, GZA hospitals, Antwerpen, Belgium.
Diagn Microbiol Infect Dis. 2022 May;103(1):115653. doi: 10.1016/j.diagmicrobio.2022.115653. Epub 2022 Jan 31.
Differentiating COVID-19 from other causes of viral pneumonia, like herpes simplex (HSV), can be complicated by shared clinical and laboratory features. Viral pneumonia is mostly diagnosed based on molecular or serological techniques. Serological immunoassay interferences, often attributed to concurrent appearance of heterologous (viral) immunoglobulins, is well-known, but has not been studied in COVID-19 patients. Following false positive HSV immunoglobulin M (IgM) results in our index patient, 25 other COVID-19 patients were tested for HSV-1/2 IgM with the chemiluminescent Liaison assay and Euroimmun enzyme-linked immunosorbent assay. Forty-five percent of COVID-19 patients tested positive for HSV IgM with Liaison. No HSV indices were positive with Euroimmun enzyme-linked immunosorbent assay, suggesting immunoassay interference. Significant correlation between HSV IgM and SARS-CoV-2 IgM/IgG positivity was found. Adding 0.5% polyvinylpyrrolidone, inhibiting non-specific solid-phase adsorption, abolished interference in 22% of false positive cases, suggesting interference caused by solid-phase reactive IgM. Hence, serologic immunoassay results should be interpreted with caution in COVID-19 patients.
将 COVID-19 与其他病毒性肺炎的病因（如单纯疱疹病毒 [HSV]）区分开来可能会因临床和实验室特征的相似性而变得复杂。病毒性肺炎主要基于分子或血清学技术进行诊断。血清学免疫测定干扰通常归因于异源（病毒）免疫球蛋白的同时出现，这是众所周知的，但尚未在 COVID-19 患者中进行研究。在我们的索引患者出现假阳性 HSV 免疫球蛋白 M（IgM）结果后，我们使用化学发光联免疫测定法和 Euroimmun 酶联免疫吸附试验对 25 名其他 COVID-19 患者进行了 HSV-1/2 IgM 检测。45%的 COVID-19 患者用联免疫法检测到 HSV IgM 阳性。Euroimmun 酶联免疫吸附试验没有检测到任何 HSV 指数阳性，提示免疫测定干扰。发现 HSV IgM 与 SARS-CoV-2 IgM/IgG 阳性之间存在显著相关性。添加 0.5%聚乙烯吡咯烷酮，抑制非特异性固相吸附，可消除 22%假阳性病例的干扰，提示固相反应性 IgM 引起的干扰。因此，在 COVID-19 患者中应谨慎解释血清学免疫测定结果。
