Di-san junyi daxue xuebao (Aug 2020)
Application value of SARS-CoV-2 IgG and IgM antibodies in diagnosis and treatment of new coronavirus pneumonia
Abstract
Objective To explore the application value of chemiluminescence detection of SARS-CoV-2 IgM/IgG antibodies in the adjuvant diagnosis and treatment of coronavirus disease 2019 (COVID-19). Methods A total of 208 COVID-19-confirmed patients admitted in the Acute Pneumonia Section of Chongqing Three Gorges Central Hospital from January 23 to March 3, 2020 were recruited and served as the confirmed group, and another 208 cases, including 158 non-COVID-19 patients from other departments and 50 health volunteers as blood donors were subjected as the control group. Chemiluminescence assay was used for detection of the antibodies. Results The results showed that the clinical sensitivity, specificity, positive predictive value, and negative predictive value for SARS-CoV-2 IgG antibody were 85.7%, 99.0%, 98.8%, and 87.6%, respectively. While the above values for SARS-CoV-2 IgM antibody were 66.5%, 98.0%, 97.1%, and 75.0%, respectively. And these values were 89.6%, 96.8%, 97.3%, and 87.9%, respectively, when the 2 antibodies combined together. There was no statistical difference in the detection rate of SARS-CoV-2 IgG and IgM antibodies. The average detection time from the date of onset was 10.8 (10.8±4.1) d in the severe group, statistically earlier than that in the mild group [13.3 (13.3±6.4) d, P=0.017]. The median detection time of the IgG negative group was 7.0 (5.0~12.0) d after onset, earlier than 13.5 (10.0~17.0) d of the IgG positive group, with statistical difference (P=0.000 1); while, the median time of the IgM negative group was 11.0 (6.0~16.0) d after onset, earlier than 14.0 (10.0~17.0) d in the IgG positive group (P=0.016). Conclusion Chemiluminescence assay for detection of SARS-CoV-2 IgM and IgG antibodies has good specificity and sensitivity, and can help diagnose COVID-19, by making up the shortcomings of viral nucleic acid test. The detection time is the main factor affecting the results of antibody test, and early detection of SARS-CoV-2 IgM/IgG antibodies may indicate a more serious illness.
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