Clinical Value of SARS-CoV2 IgM and IgG Antibodies in Diagnosis of COVID-19 in Suspected Cases

Clinical Value of SARS-CoV2 IgM and IgG Antibodies in Diagnosis of COVID-19 in Suspected Cases

Feng Y

Yangchun Feng Clinical Laboratory Center, The Third Hospital Affiliated to Xinjiang Medical University (Affiliated Cancer Hospital), Urumqi, 830011, People’s Republic of ChinaCorrespondence: Yangchun FengThird Hospital Affiliated to Xinjiang Medical University (Affiliated Cancer Hospital), Urumqi 830011, People’s Republic of ChinaEmail paopao1987123@163.comObjective: To explore the clinical value of SARS-CoV2 IgM and IgG antibodies in the diagnosis of COVID-19 in suspected cases by likelihood ratio.Methods: By reinterpreting data from a previous study, the positive likelihood ratio of IgM and IgG antibodies in COVID-19 pneumonia diagnosis was calculated, and the posterior probability of IgM and IgG antibodies and their tandem detection was calculated finally.Results: The positive likelihood ratios of single IgM and IgG antibodies were 18.50 and 12.65, respectively, and the posterior probabilities were 90.18% and 86.26%, respectively. However, the posterior probability of the two antibody-tandem test was 99.15%, which could give clinicians more quantitative confidence in the diagnosis of COVID-19 in suspected cases. According to the results of this study, combining the advantages and disadvantages of nucleic acid testing and antibody detection, a feasible clinical path was found for clinicians to diagnose COVID-19 pneumonia from suspected cases.Conclusion: For suspected cases, IgM- and IgG-antibody tests should first be done at the same time. If all antibody tests are positive, COVID-19 pneumonia could be confirmed. If not, nucleic acid detection (once or more) should be carried out, and in extreme cases high-throughput viral genome sequencing is required.Keywords: COVID-19, SARS-CoV2, positive likelihood ratio, posterior probability, antibody test, nucleic acid test, clinical pathway

2020

covid-19, SARS-CoV-2, clinical pathway, Antibody test, nucleic acid test, posterior probability, Positive Likelihood Ratio

Biotemas

Universidade Federal de Santa Catarina

Pathology