Abstract Geographical variation in severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) spread requires seroprevalence studies based on local tests, but robust validation is needed. We summarize an evaluation of antibody tests used in a serological study of SARS‐CoV‐2 in Saint Petersburg, Russia. We validated three different antibody assays: chemiluminescent microparticle immunoassay (CMIA) Abbott Architect SARS‐CoV‐2 immunoglobulin G (IgG), enzyme linked immunosorbent assay (ELISA) CoronaPass total antibodies test, and ELISA SARS‐CoV‐2‐IgG‐EIA‐BEST. Clinical sensitivity was estimated with the SARS‐CoV‐2 polymerase chain reaction (PCR) test as the gold standard using manufacturer recommended cutoff. Specificity was estimated using prepandemic sera samples. The median time between positive PCR test results and antibody tests was 21 weeks. Measures of concordance were calculated against the microneutralization test (MNA).Sensitivity was equal to 91.1% (95% confidence intervbal [CI]: 78.8–97.5), 90% (95% CI: 76.4–96.4), and 63.1% (95% CI [50.2–74.7]) for ELISA Coronapass, ELISA VectorBest, and CMIA Abbott, respectively. Specificity was equal to 100% for all the tests. Comparison of receiver operating characteristics has shown lower AUC for CMIA Abbott. The cutoff SC/O ratio of 0.28 for CMIA Abbott resulted in a sensitivity of 80% at the same level of specificity. Less than 33% of the participants with positive antibody test results had neutralizing antibodies in titers 1:80 and above. Antibody assays results and MNA correlated moderately. This study encourages the use of local antibody tests and sets the reference for seroprevalence correction. Available tests’ sensitivity allows detecting antibodies within the majority of PCR positive individuals. The Abbott assay sensitivity can be improved by incorporating a new cutoff. Manufacturers’ test characteristics may introduce bias into the study results. Highlights 1) This report is the first diagnostic performance study of antibody assays used in the representative population‐based serological study of SARS‐CoV‐2 in St. Petersburg, Russia. 2) The sensitivity for two local assays was equal to 91.1% (95%CI: 78.8‐97.5) and 89.1\% (95%CI: 76.4‐96.4), CMIA Abbott’s sensitivity was equal to 63.1\% (95%CI 50.2‐74.7)), with 100% specificity for all the tests. 3) Moving the S/CO ratio from Abbott assays from manufacturers recommended 1.4 to 0.28 improved sensitivity from 63% to 80%, without loss in specificity. 4) Less than a third of samples positive for binding antibodies were also positive in the virus neutralization test (with 1:80 titer as a threshold) in the population‐based sample.
【저자키워드】 seroepidemiologic study, COVID19, SARSCoV2, SARSCoV2 infection antibody testing, 【초록키워드】 neutralizing antibody, IgG, coronavirus, antibody, Variation, Russia, diagnostic, Local, ELISA, SARS‐CoV‐2, Spread, immunoassay, sensitivity, specificity, PCR, Concordance, Characteristics, Immunoglobulin, CMIA, clinical, sera, virus neutralization test, Antibody test, antibody assay, total antibody, threshold, serological, Microneutralization test, AUC, binding antibody, Abbott, Saint Petersburg, acute respiratory syndrome, 95%CI, 95% CI, median time, gold standard, positive PCR test, measure, participant, Cutoff, Architect, positive, receiver operating characteristics, positive individuals, Microparticle, antibody test result, polymerase chain, robust, shown, calculated, majority, correlated, immunosorbent, MNA, 【제목키워드】 Russia, Spread, antibody assay,