Colgrove Robert, Bruno-Murtha Lou Ann, Chastain Cody A, Hanson Kimberly E, Lee Francesca, Odom John Audrey R, Humphries Romney
Division of Infectious Diseases, Mount Auburn Hospital, Cambridge, Massachusetts, USA.
Harvard Medical School, Boston, Massachusetts, USA.
Open Forum Infect Dis. 2022 Dec 14;10(1):ofac674. doi: 10.1093/ofid/ofac674. eCollection 2023 Jan.
Diagnosis of acute severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection relies on detection of viral antigens or amplified viral nucleic acids. Serology, although invaluable for epidemiology, is not routinely needed clinically. However, in some settings, serologic data may have direct clinical utility: for example, in evaluation of persistent symptoms in patients without a prior diagnosis of acute infection. In contrast, SARS-CoV-2 serologic testing is sometimes used or requested in situations in which existing data do not support it, such as determination of need for vaccination. In this study, we describe available methods of serologic testing and provide cases supported by clinical vignettes of where such tests can be helpful, as well as examples where they are not. These examples may help clarify clinical decision making in this rapidly evolving area.
新型严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染的诊断依赖于病毒抗原检测或病毒核酸扩增检测。血清学检测虽然对流行病学研究非常重要，但临床上通常并不需要。然而，在某些情况下，血清学数据可能具有直接的临床应用价值：例如，用于评估既往未诊断为急性感染的患者的持续症状。相比之下，在现有数据不支持的情况下，有时会使用或要求进行SARS-CoV-2血清学检测，例如确定是否需要接种疫苗。在本研究中，我们描述了可用的血清学检测方法，并提供了一些临床案例，这些案例展示了此类检测在哪些情况下可能有用，以及在哪些情况下无用。这些案例可能有助于阐明在这个快速发展的领域中的临床决策。
