Abstract
We aimed to assess the specificity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody detection assays among people with tissue-borne parasitic infections. We tested three SARS-CoV-2 antibody-detection assays (cPass SARS-CoV-2 neutralization antibody detection kit [cPass], Abbott SARS-CoV-2 IgG assay [Abbott Architect], and Standard Q COVID-19 IgM/IgG combo rapid diagnostic test [SD RDT IgM/SD RDT IgG]) among 559 pre-COVID-19 seropositive sera for several parasitic infections. The specificity of assays was 95 to 98% overall. However, lower specificity was observed among sera from patients with protozoan infections of the reticuloendothelial system, such as human African trypanosomiasis (Abbott Architect; 88% [95% CI, 75 to 95]) and visceral leishmaniasis (SD RDT IgG; 80% [95% CI, 30 to 99]), and from patients with recent malaria in areas of Senegal where malaria is holoendemic (ranging from 91% for Abbott Architect and SD RDT IgM to 98 to 99% for cPass and SD RDT IgG). For specimens from patients with evidence of past or present helminth infection overall, test specificity estimates were all ≥96%. Sera collected from patients clinically suspected of parasitic infections that tested negative for these infections yielded a specificity of 98 to 100%. The majority (>85%) of false-positive results were positive by only one assay. The specificity of SARS-CoV-2 serological assays among sera from patients with tissue-borne parasitic infections was below the threshold required for decisions about individual patient care. Specificity is markedly increased by the use of confirmatory testing with a second assay. Finally, the SD RDT IgG proved similarly specific to laboratory-based assays and provides an option in low-resource settings when detection of anti-SARS-CoV-2 IgG is indicated.
Keywords: COVID-19; SARS-CoV-2; Schistosoma; Strongyloides; Trichinella; antibody test; diagnostic accuracy; filaria; helminth infections; kinetoplastid infections; malaria; neglected tropical diseases; parasitic infections; protozoan infections; serology.
【저자키워드】 COVID-19, SARS-CoV-2, Serology., malaria, Diagnostic accuracy, Antibody test, neglected tropical diseases, Schistosoma, Strongyloides, Trichinella, filaria, helminth infections, kinetoplastid infections, parasitic infections, protozoan infections, 【초록키워드】 IgG, IgM, coronavirus, serology, antibody, diagnostic test, Infection, diagnostic, severe acute respiratory syndrome Coronavirus, malaria, specificity, Diagnostic accuracy, infections, Antibody detection, Serological assay, RDT, Rapid diagnostic test, anti-SARS-CoV-2 IgG, serological assays, IgM/IgG, sera, Patient, Antibody test, respiratory, estimate, threshold, seropositive, Neutralization antibody, SARS-CoV-2 neutralization, Schistosoma, Trichinella, filaria, protozoan infections, Evidence, Abbott, False-positive results, evidence of, visceral leishmaniasis, Patient care, acute respiratory syndrome, African trypanosomiasis, 95% CI, acute respiratory syndrome coronavirus, acute respiratory syndrome coronavirus 2, past, specimen, option, false, Architect, positive, trypanosomiasis, Standard Q, Abbott SARS-CoV-2 IgG, tropical, holoendemic, reticuloendothelial system, tested, collected, indicated, required, provide, clinically suspected, majority, false-positive result, protozoan infection, 【제목키워드】 detection, helminth,