Is antibody testing recommended for diagnosing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection?

Updated: Jun 16, 2020
  • Author: Medscape Drugs & Diseases; more...
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The Centers for Disease Control and Prevention (CDC) does not currently recommend using only antibody testing for diagnosing acute severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and the US Food and Drug Administrations has not authorized antibody tests for such diagnostic purposes. [3] In certain situations, serologic assays may be used to support clinical assessment of persons who present late in their illnesses when used in conjunction with viral detection tests. In addition, serologic assays may be used if it is suspected that a postinfectious syndrome (eg, Multisystem Inflammatory Syndrome in Children (MIS-C) is caused by SARS-CoV-2 infection.

The relative broad availability of serologic assays for SARS-CoV-2 can play an important role in understanding the transmission dynamic of the virus in the general population and in identifying groups at higher risk for infection. [3] Unlike viral direct detection methods, such as nucleic acid amplification or antigen detection tests that can detect acutely infected persons, antibody tests help determine whether the individual being tested was previously infected—even if that person never showed symptoms.

It is currently not clear whether a positive serologic test indicates immunity against SARS-CoV-2; at this time, serologic tests should not be used to determine if an individual is immune. [3] As additional data are collected to understand the significance of the presence or level of antibodies and their correlation with immunity, serologic tests may have utility in infection control decisions, but for now this evidence is not available.

Antibody tests can help determine the proportion of a population previously infected with SARS-CoV-2. [3] Thus, demographic and geographic patterns of serologic test results can help determine which communities may have experienced a higher infection rate.

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