Comparison of four commercial SARS-CoV-2 IgG immuno-assays in RT-PCR negative patients with suspect CT findings
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Comparison of four commercial SARS‑CoV‑2 IgG immuno‑assays in RT‑PCR negative patients with suspect CT findings Jens T. Van Praet1,2 · Ann‑Sofie Coene3 · Kris Van De Moortele4 · Patrick Descheemaeker5 · Marijke Reynders5 Received: 17 June 2020 / Accepted: 2 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract A subset of patients with Covid-19 presents with negative RT-PCR screening but suspect CT findings. Using four commercially available anti-SARS-CoV-2 IgG immuno-assays, we found this subset constituted 9.2% of all consecutively admitted outpatients with Covid-19 in our hospital. Clinical specificity for Covid-19 of some N protein-based immuno-assays was suboptimal, as positive results were observed in control patients with recent common human coronavirus, influenza B and adenovirus infections. Keywords ELISA · Covid-19 · SARS-CoV-2 · Serology
Introduction Coronavirus disease 19 (Covid-19) is a viral illness caused by the recently emerged novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In contrast to the common human coronaviruses (NL63, 229E, OC43 and HKU1), which are associated with mild respiratory syndromes, SARS-CoV-2 may cause a severe lower respiratory tract infection. The first available diagnostic test for Covid-19, moved upfront by the WHO, was RT-PCR with virus-specific primers and probes on upper respiratory tract samples. Two or Electronic supplementary material The online version of this article (https://doi.org/10.1007/s15010-020-01523-3) contains supplementary material, which is available to authorized users. * Jens T. Van Praet [email protected] 1
Department of Nephrology and Infectious Diseases, AZ SintJan Brugge-Oostende AV, Ruddershove 10, 8000 Brugge, Belgium
2
Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
3
Faculty of Medicine, KU Leuven, Leuven, Belgium
4
Department of Radiology, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
5
Department of Laboratory Medicine, Medical Microbiology, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
more genetic targets should be included to obtain optimal specificity, certainly in regions where the prevalence is low. Its sensitivity dependents on the disease course, as viral loads are decreasing fast in the naso- and oropharynx after 5–7 days of illness [1]. RT-PCR testing of deeper respiratory samples might be useful in the second stage of the disease. However, bronchoalveolar lavage (BAL) procedures are avoided because of the risk of aerosol generation, putting the operator at risk for nosocomial transmission. CT thorax has proven to be an additional diagnostic tool, with high sensitivity during the second phase of the disease (day 7–14). Although typical radiologic features have been described, certain overlap is present with other respiratory pathogens or drug-related lung disease [2]. More recently, anti-IgM, anti-IgA and anti-IgG SARS-CoV-2 responses against the Nucleocapsid (N) and Spike (S) viral structural prot
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