Evaluation of four commercial, fully automated SARS-CoV-2 antibody tests suggests a revision of the Siemens SARS-CoV-2 IgG assay

Author:

Irsara ChristianORCID,Egger Alexander E.,Prokop Wolfgang,Nairz Manfred,Loacker Lorin,Sahanic Sabina,Sonnweber Thomas,Mayer Wolfgang,Schennach Harald,Loeffler-Ragg Judith,Bellmann-Weiler Rosa,Tancevski Ivan,Weiss Günter,Anliker Markus,Griesmacher Andrea,Hoermann Gregor

Abstract

AbstractObjectivesSerological tests detect antibodies against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in the ongoing coronavirus disease-19 (COVID-19) pandemic. Independent external clinical validation of performance characteristics is of paramount importance.MethodsFour fully automated assays, Roche Elecsys Anti-SARS-CoV-2, Abbott SARS-CoV-2 IgG, Siemens SARS-CoV-2 total (COV2T) and SARS-CoV-2 IgG (COV2G) were evaluated using 350 pre-pandemic samples and 700 samples from 245 COVID-19 patients (158 hospitalized, 87 outpatients).ResultsAll tests showed very high diagnostic specificity. Sensitivities in samples collected at least 14 days after disease onset were slightly lower than manufacturers’ claims for Roche (93.04%), Abbott (90.83%), and Siemens COV2T (90.26%), and distinctly lower for Siemens COV2G (78.76%). Concordantly negative results were enriched for immunocompromised patients. ROC curve analyses suggest a lowering of the cut-off index for the Siemens COV2G assay. Finally, the combination of two anti-SARS-CoV-2 antibody assays is feasible when considering borderline reactive results.ConclusionsThorough on-site evaluation of commercially available serologic tests for detection of antibodies against SARS-CoV-2 remains imperative for laboratories. The potentially impaired sensitivity of the Siemens COV2G necessitates a switch to the company’s newly filed SARS-CoV-2 IgG assay (sCOVG) for follow-up studies. A combination of tests could be considered in clinical practice.

Publisher

Cold Spring Harbor Laboratory

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