Diagnostic value of combined nucleic acid and antibody detection in suspected COVID-19 cases

Public Health. 2020 Sep:186:1-5. doi: 10.1016/j.puhe.2020.07.011. Epub 2020 Jul 10.

Abstract

Objectives: Nucleic acid testing is the gold standard method for the diagnosis of coronavirus disease 2019 (COVID-19); however, large numbers of false-negative results have been reported. In this study, nucleic acid detection and antibody detection (IgG and IgM) were combined to improve the testing accuracy of patients with suspected COVID-19.

Study design: The positive rate of nucleic acid detection and antibody detection (IgG and IgM) were compared in suspected COVID-19 patients.

Methods: A total of 71 patients with suspected COVID-19 were selected to participate in this study, which included a retrospective analysis of clinical features, imaging examination, laboratory biochemical examination and nucleic acid detection and specific antibody (IgM and IgG) detection.

Results: The majority of participants with suspected COVID-19 presented with fever (67.61%) and cough (54.93%), and the imaging results showed multiple small patches and ground-glass opacity in both lungs, with less common infiltration and consolidation opacity (23.94%). Routine blood tests were mostly normal (69.01%), although only a few patients had lymphopenia (4.23%) or leucopenia (12.68%). There was no statistical difference in the double-positive rate between nucleic acid detection (46.48%) and specific antibody (IgG and IgM) detection (42.25%) (P = 0.612), both of which were also poorly consistent with each other (kappa = 0.231). The positive rate of combined nucleic acid detection and antibody detection (63.38%) was significantly increased, compared with that of nucleic acid detection (46.48%) and that of specific antibody (IgG and IgM) detection (42.25%), and the differences were statistically significant (P = 0.043 and P = 0.012, respectively).

Conclusions: Nucleic acid detection and specific antibody (IgG and IgM) detection had similar positive rates, and their combination could improve the positive rate of COVID-19 detection, which is of great significance for diagnosis and epidemic control.

Keywords: IgG and IgM antibody detection; Novel coronavirus infection; Nucleic acid detection; Suspected cases.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antibodies, Viral / isolation & purification
  • Betacoronavirus / genetics
  • Betacoronavirus / immunology
  • COVID-19
  • COVID-19 Testing
  • Child
  • Child, Preschool
  • Clinical Laboratory Techniques / methods*
  • Coronavirus Infections / diagnosis*
  • Coronavirus Infections / epidemiology
  • Female
  • Humans
  • Immunoglobulin G / isolation & purification
  • Immunoglobulin M / isolation & purification
  • Male
  • Middle Aged
  • Nucleic Acids / isolation & purification
  • Pandemics
  • Pneumonia, Viral / diagnosis*
  • Pneumonia, Viral / epidemiology
  • Reproducibility of Results
  • Retrospective Studies
  • SARS-CoV-2
  • Young Adult

Substances

  • Antibodies, Viral
  • Immunoglobulin G
  • Immunoglobulin M
  • Nucleic Acids