How to interpret and use COVID-19 serology and immunology tests
Although molecular tests are considered the reference standard for coronavirus disease 2019 (COVID-19) diagnostics, serological and immunological tests may be useful in specific settings. This review summarizes the underlying principles and performance of COVID-19 serological and immunological testi...
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Veröffentlicht in: | Clinical microbiology and infection 2021-07, Vol.27 (7), p.981-986 |
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description | Although molecular tests are considered the reference standard for coronavirus disease 2019 (COVID-19) diagnostics, serological and immunological tests may be useful in specific settings.
This review summarizes the underlying principles and performance of COVID-19 serological and immunological testing.
Selected peer-reviewed publications on COVID-19 related serology and immunology published between December 2019 and March 2021.
Serological tests are highly specific but heterogeneous in their sensitivity for the diagnosis of COVID-19. For certain indications, including delayed disease presentations, serological tests can have added value. The presence of antibodies against SARS-CoV-2 may indicate a recent or past COVID-19 infection. Lateral flow immunoassay (LFIA) antibody tests have the advantages of being easy and fast to perform, but many have a low sensitivity in acute settings. Enzyme-linked immunosorbent assay (ELISA) and chemiluminescence immunoassays (CLIAs) have higher sensitivities. Besides humoral immunity, cellular immunity is also essential for successful host defences against viruses. Enzyme-linked immunospot (ELISpot) assays can be used to measure T-cell responses against SARS-CoV-2. The presence of cross-reactive SARS-CoV-2-specific T cells in never exposed patients suggests the possibility of cellular immunity induced by other circulating coronaviruses. T-cell responses against SARS-CoV-2 have also been detected in recovered COVID-19 patients with no detectable antibodies.
Serological and immunological tests are primarily applied for population-based seroprevalence studies to evaluate the effectiveness of COVID-19 control measures and increase our understanding of the immunology behind COVID-19. Combining molecular diagnostics with serological tests may optimize the detection of COVID-19. As not all infected patients will develop antibodies against SARS-CoV-2, assessment of cellular immunity may provide complementary information on whether a patient has been previously infected with COVID-19. More studies are needed to understand the correlations of these serological and immunological parameters with protective immunity, taking into account the different circulating virus variants. |
doi_str_mv | 10.1016/j.cmi.2021.05.001 |
format | Article |
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This review summarizes the underlying principles and performance of COVID-19 serological and immunological testing.
Selected peer-reviewed publications on COVID-19 related serology and immunology published between December 2019 and March 2021.
Serological tests are highly specific but heterogeneous in their sensitivity for the diagnosis of COVID-19. For certain indications, including delayed disease presentations, serological tests can have added value. The presence of antibodies against SARS-CoV-2 may indicate a recent or past COVID-19 infection. Lateral flow immunoassay (LFIA) antibody tests have the advantages of being easy and fast to perform, but many have a low sensitivity in acute settings. Enzyme-linked immunosorbent assay (ELISA) and chemiluminescence immunoassays (CLIAs) have higher sensitivities. Besides humoral immunity, cellular immunity is also essential for successful host defences against viruses. Enzyme-linked immunospot (ELISpot) assays can be used to measure T-cell responses against SARS-CoV-2. The presence of cross-reactive SARS-CoV-2-specific T cells in never exposed patients suggests the possibility of cellular immunity induced by other circulating coronaviruses. T-cell responses against SARS-CoV-2 have also been detected in recovered COVID-19 patients with no detectable antibodies.
Serological and immunological tests are primarily applied for population-based seroprevalence studies to evaluate the effectiveness of COVID-19 control measures and increase our understanding of the immunology behind COVID-19. Combining molecular diagnostics with serological tests may optimize the detection of COVID-19. As not all infected patients will develop antibodies against SARS-CoV-2, assessment of cellular immunity may provide complementary information on whether a patient has been previously infected with COVID-19. More studies are needed to understand the correlations of these serological and immunological parameters with protective immunity, taking into account the different circulating virus variants.</description><identifier>ISSN: 1198-743X</identifier><identifier>EISSN: 1469-0691</identifier><identifier>DOI: 10.1016/j.cmi.2021.05.001</identifier><identifier>PMID: 33975005</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Antibodies ; Antibodies, Viral - blood ; COVID-19 ; COVID-19 - diagnosis ; COVID-19 - immunology ; COVID-19 Serological Testing ; Humans ; Immunity ; Immunity, Cellular ; Immunity, Humoral ; Immunoassay ; Narrative Review ; SARS-CoV-2 ; SARS-CoV-2 - immunology ; SARS-CoV-2 - isolation & purification ; Sensitivity and Specificity ; Serology ; T cell</subject><ispartof>Clinical microbiology and infection, 2021-07, Vol.27 (7), p.981-986</ispartof><rights>2021 European Society of Clinical Microbiology and Infectious Diseases</rights><rights>Copyright © 2021 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.</rights><rights>2021 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved. 2021 European Society of Clinical Microbiology and Infectious Diseases</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c451t-f001166b51343b868db0291aba8be113a836797379348510d91472d054ff0ead3</citedby><cites>FETCH-LOGICAL-c451t-f001166b51343b868db0291aba8be113a836797379348510d91472d054ff0ead3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33975005$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ong, David S.Y.</creatorcontrib><creatorcontrib>Fragkou, Paraskevi C.</creatorcontrib><creatorcontrib>Schweitzer, Valentijn A.</creatorcontrib><creatorcontrib>Chemaly, Roy F.</creatorcontrib><creatorcontrib>Moschopoulos, Charalampos D.</creatorcontrib><creatorcontrib>Skevaki, Chrysanthi</creatorcontrib><creatorcontrib>the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Respiratory Viruses (ESGREV)</creatorcontrib><creatorcontrib>European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Respiratory Viruses (ESGREV)</creatorcontrib><title>How to interpret and use COVID-19 serology and immunology tests</title><title>Clinical microbiology and infection</title><addtitle>Clin Microbiol Infect</addtitle><description>Although molecular tests are considered the reference standard for coronavirus disease 2019 (COVID-19) diagnostics, serological and immunological tests may be useful in specific settings.
This review summarizes the underlying principles and performance of COVID-19 serological and immunological testing.
Selected peer-reviewed publications on COVID-19 related serology and immunology published between December 2019 and March 2021.
Serological tests are highly specific but heterogeneous in their sensitivity for the diagnosis of COVID-19. For certain indications, including delayed disease presentations, serological tests can have added value. The presence of antibodies against SARS-CoV-2 may indicate a recent or past COVID-19 infection. Lateral flow immunoassay (LFIA) antibody tests have the advantages of being easy and fast to perform, but many have a low sensitivity in acute settings. Enzyme-linked immunosorbent assay (ELISA) and chemiluminescence immunoassays (CLIAs) have higher sensitivities. Besides humoral immunity, cellular immunity is also essential for successful host defences against viruses. Enzyme-linked immunospot (ELISpot) assays can be used to measure T-cell responses against SARS-CoV-2. The presence of cross-reactive SARS-CoV-2-specific T cells in never exposed patients suggests the possibility of cellular immunity induced by other circulating coronaviruses. T-cell responses against SARS-CoV-2 have also been detected in recovered COVID-19 patients with no detectable antibodies.
Serological and immunological tests are primarily applied for population-based seroprevalence studies to evaluate the effectiveness of COVID-19 control measures and increase our understanding of the immunology behind COVID-19. Combining molecular diagnostics with serological tests may optimize the detection of COVID-19. As not all infected patients will develop antibodies against SARS-CoV-2, assessment of cellular immunity may provide complementary information on whether a patient has been previously infected with COVID-19. More studies are needed to understand the correlations of these serological and immunological parameters with protective immunity, taking into account the different circulating virus variants.</description><subject>Antibodies</subject><subject>Antibodies, Viral - blood</subject><subject>COVID-19</subject><subject>COVID-19 - diagnosis</subject><subject>COVID-19 - immunology</subject><subject>COVID-19 Serological Testing</subject><subject>Humans</subject><subject>Immunity</subject><subject>Immunity, Cellular</subject><subject>Immunity, Humoral</subject><subject>Immunoassay</subject><subject>Narrative Review</subject><subject>SARS-CoV-2</subject><subject>SARS-CoV-2 - immunology</subject><subject>SARS-CoV-2 - isolation & purification</subject><subject>Sensitivity and Specificity</subject><subject>Serology</subject><subject>T cell</subject><issn>1198-743X</issn><issn>1469-0691</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEFP3DAQhS3UqlDoD-BS5dhL0hk7dmIhUVVbWpCQuEDVm-UkE-pVEm_thIp_j5elCC49jUfz5s3zx9gxQoGA6vO6aEdXcOBYgCwAcI8dYKl0Dkrjm_RGXedVKX7ts_cxrgGAC1G-Y_tC6EoCyAP25dz_zWafuWmmsAk0Z3bqsiVStrr6efEtR51FCn7wt_ePEzeOy7RrZ4pzPGJveztE-vBUD9nN97Pr1Xl-efXjYvX1Mm9LiXPep3CoVCNRlKKpVd01wDXaxtYNIQpbC1XpSlRalLVE6DSWFe9Aln0PZDtxyE53vpulGalraZqDHcwmuNGGe-OtM68nk_ttbv2dqRGU5DwZfHoyCP7PkqKb0cWWhsFO5JdouORqexNkkuJO2gYfY6D--QyC2YI3a5PAmy14A9Kkv6Wdjy_zPW_8I50EJzsBJUp3joKJraOppc4FamfTefcf-wfUyJIr</recordid><startdate>20210701</startdate><enddate>20210701</enddate><creator>Ong, David S.Y.</creator><creator>Fragkou, Paraskevi C.</creator><creator>Schweitzer, Valentijn A.</creator><creator>Chemaly, Roy F.</creator><creator>Moschopoulos, Charalampos D.</creator><creator>Skevaki, Chrysanthi</creator><general>Elsevier Ltd</general><general>European Society of Clinical Microbiology and Infectious Diseases. 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This review summarizes the underlying principles and performance of COVID-19 serological and immunological testing.
Selected peer-reviewed publications on COVID-19 related serology and immunology published between December 2019 and March 2021.
Serological tests are highly specific but heterogeneous in their sensitivity for the diagnosis of COVID-19. For certain indications, including delayed disease presentations, serological tests can have added value. The presence of antibodies against SARS-CoV-2 may indicate a recent or past COVID-19 infection. Lateral flow immunoassay (LFIA) antibody tests have the advantages of being easy and fast to perform, but many have a low sensitivity in acute settings. Enzyme-linked immunosorbent assay (ELISA) and chemiluminescence immunoassays (CLIAs) have higher sensitivities. Besides humoral immunity, cellular immunity is also essential for successful host defences against viruses. Enzyme-linked immunospot (ELISpot) assays can be used to measure T-cell responses against SARS-CoV-2. The presence of cross-reactive SARS-CoV-2-specific T cells in never exposed patients suggests the possibility of cellular immunity induced by other circulating coronaviruses. T-cell responses against SARS-CoV-2 have also been detected in recovered COVID-19 patients with no detectable antibodies.
Serological and immunological tests are primarily applied for population-based seroprevalence studies to evaluate the effectiveness of COVID-19 control measures and increase our understanding of the immunology behind COVID-19. Combining molecular diagnostics with serological tests may optimize the detection of COVID-19. As not all infected patients will develop antibodies against SARS-CoV-2, assessment of cellular immunity may provide complementary information on whether a patient has been previously infected with COVID-19. More studies are needed to understand the correlations of these serological and immunological parameters with protective immunity, taking into account the different circulating virus variants.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>33975005</pmid><doi>10.1016/j.cmi.2021.05.001</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Antibodies Antibodies, Viral - blood COVID-19 COVID-19 - diagnosis COVID-19 - immunology COVID-19 Serological Testing Humans Immunity Immunity, Cellular Immunity, Humoral Immunoassay Narrative Review SARS-CoV-2 SARS-CoV-2 - immunology SARS-CoV-2 - isolation & purification Sensitivity and Specificity Serology T cell |
title | How to interpret and use COVID-19 serology and immunology tests |
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