Gundlapalli Adi V, Beekmann Susan E, Jones Jefferson M, Thornburg Natalie J, Clarke Kristie E N, Uyeki Timothy M, Satheshkumar Panayampalli S, Carroll Darin S, Plumb Ian D, Briggs-Hagen Melissa, Santibañez Scott, David-Ferdon Corinne, Polgreen Philip M, McDonald L Clifford
COVID-19 Emergency Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Infectious Diseases Society of America-Emerging Infections Network and Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
Open Forum Infect Dis. 2023 Feb 18;10(3):ofad091. doi: 10.1093/ofid/ofad091. eCollection 2023 Mar.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody tests have had limited recommended clinical application during the coronavirus disease 2019 (COVID-19) pandemic. To inform clinical practice, an understanding is needed of current perspectives of United States-based infectious disease (ID) physicians on the use, interpretation, and need for SARS-CoV-2 antibody tests.
In March 2022, members of the Emerging Infections Network (EIN), a national network of practicing ID physicians, were surveyed on types of SARS-CoV-2 antibody assays ordered, interpretation of test results, and clinical scenarios for which antibody tests were considered.
Of 1867 active EIN members, 747 (40%) responded. Among the 583 who managed or consulted on COVID-19 patients, a majority (434/583 [75%]) had ordered SARS-CoV-2 antibody tests and were comfortable interpreting positive (452/578 [78%]) and negative (405/562 [72%]) results. Antibody tests were used for diagnosing post-COVID-19 conditions (61%), identifying prior SARS-CoV-2 infection (60%), and differentiating prior infection and response to COVID-19 vaccination (37%). Less than a third of respondents had used antibody tests to assess need for additional vaccines or risk stratification. Lack of sufficient evidence for use and nonstandardized assays were among the most common barriers for ordering tests. Respondents indicated that statements from professional societies and government agencies would influence their decision to order SARS-CoV-2 antibody tests for clinical decision making.
Practicing ID physicians are using SARS-CoV-2 antibody tests, and there is an unmet need for clarifying the appropriate use of these tests in clinical practice. Professional societies and US government agencies can support clinicians in the community through the creation of appropriate guidance.
在2019冠状病毒病（COVID-19）大流行期间，严重急性呼吸综合征冠状病毒2（SARS-CoV-2）抗体检测的推荐临床应用有限。为指导临床实践，需要了解美国传染病（ID）医生对SARS-CoV-2抗体检测的使用、解读及需求的当前观点。
2022年3月，对新兴感染网络（EIN）的成员进行了调查，该网络是一个由执业ID医生组成的全国性网络，调查内容包括所订购的SARS-CoV-2抗体检测类型、检测结果解读以及考虑进行抗体检测的临床场景。
在1867名活跃的EIN成员中,747名（40%）做出了回应。在583名管理或会诊COVID-19患者的医生中，大多数（434/583[75%]）订购过SARS-CoV-2抗体检测，并且能够解读阳性（452/578[78%]）和阴性（405/562[72%]）结果。抗体检测用于诊断COVID-19后状况（61%）、识别既往SARS-CoV-2感染（60%）以及区分既往感染和对COVID-19疫苗的反应（37%）。不到三分之一的受访者使用抗体检测来评估额外疫苗的需求或风险分层。检测使用缺乏充分证据和检测方法不标准化是订购检测最常见的障碍。受访者表示，专业协会和政府机构的声明会影响他们为临床决策订购SARS-CoV-2抗体检测的决定。
执业ID医生正在使用SARS-CoV-2抗体检测，在临床实践中明确这些检测的适当使用方面存在未满足的需求。专业协会和美国政府机构可以通过制定适当的指南来支持社区中的临床医生。
