Longitudinal Monitoring of SARS-CoV-2 IgM and IgG Seropositivity to Detect COVID-19

J Appl Lab Med. 2020 Sep 1;5(5):908-920. doi: 10.1093/jalm/jfaa079.

Abstract

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a novel beta-coronavirus that has recently emerged as the cause of the 2019 coronavirus pandemic (COVID-19). Polymerase chain reaction (PCR) based tests are optimal and recommended for the diagnosis of an acute SARS-CoV-2 infection. Serology tests for viral antibodies provide an important tool to diagnose previous exposure to the virus. Here we evaluate the analytical performance parameters of the Diazyme SARS-CoV-2 IgM/IgG serology assays and describe the kinetics of IgM and IgG seroconversion observed in patients with PCR-confirmed COVID-19 who were admitted to our hospital.

Methods: We validated the performance of the Diazyme assay in 235 presumed SARS-CoV-2 negative subjects to determine specificity. Subsequently, we evaluated the SARS-CoV-2 IgM and IgG seroconversion of 54 PCR-confirmed COVID-19 patients and determined sensitivity of the assay at three different timeframes.

Result: Sensitivity and specificity for detecting seropositivity at ≥15 days following a positive SARS-CoV-2 PCR result, was 100.0% and 98.7% when assaying for the panel of IgM and IgG. The median time to seropositivity observed for a reactive IgM and IgG result from the date of a positive PCR was 5 days (IQR: 2.75-9 days) and 4 days (IQR: 2.75-6.75 days), respectively.

Conclusions: Our data demonstrate that the Diazyme IgM/IgG assays are suited for the purpose of detecting SARS-CoV-2 IgG and IgM in patients with suspected SARS-CoV-2 infections. For the first time, we report longitudinal data showing the evolution of seroconversion for both IgG and IgM in a cohort of acutely ill patients in the United States. We also demonstrate a low false positive rate in patients who were presumed to be disease free.

Keywords: COVID-19; SARS-CoV-2; antibody; diagnosis; serology.

MeSH terms

  • Antibodies, Viral / blood
  • Antibodies, Viral / isolation & purification
  • Betacoronavirus* / immunology
  • Betacoronavirus* / isolation & purification
  • COVID-19
  • COVID-19 Testing
  • Clinical Laboratory Techniques / methods
  • Coronavirus Infections* / diagnosis
  • Coronavirus Infections* / immunology
  • Coronavirus Infections* / virology
  • Female
  • Humans
  • Immunoglobulin G* / blood
  • Immunoglobulin G* / isolation & purification
  • Immunoglobulin M* / blood
  • Immunoglobulin M* / isolation & purification
  • Male
  • Middle Aged
  • Monitoring, Immunologic / methods
  • Pandemics*
  • Pneumonia, Viral* / diagnosis
  • Pneumonia, Viral* / immunology
  • Pneumonia, Viral* / virology
  • SARS-CoV-2
  • Sensitivity and Specificity
  • Seroconversion*

Substances

  • Antibodies, Viral
  • Immunoglobulin G
  • Immunoglobulin M