Antibodies and distortion of insulin and C-peptide results in patients with hypoglycaemia of unknown origin

False negative RT-PCR and false positive antibody tests–Concern and solutions in the diagnosis of COVID-19

Prevalence and predictors of SARS-CoV-2 antibodies among solid organ transplant recipients with confirmed infection.

28-Year-Old Man With Recurrent Vertigo, Syncope, and Progressive Memory Impairment

Antigen‐antibody combination assays for blood donor screening: weighing the advantages and costs

BackgroundResearchers conducting cohort studies may wish to investigate the effect of episodes of COVID-19 illness on participants. A definitive diagnosis of COVID-19 is not always available, so studies have to rely on proxy indicators. This paper seeks to contribute evidence that may assist the use and interpretation of these COVID-indicators.MethodsWe described five potential COVID-indicators: self-reported core symptoms, a symptom algorithm; self-reported suspicion of COVID-19; self-reported external results; and home antibody testing based on a 'lateral flow' antibody (IgG/IgM) test cassette. Included were staff and postgraduate research students at a large London university who volunteered for the study and were living in the UK in June 2020. Excluded were those who did not return a valid antibody test result. We provide descriptive statistics of prevalence and overlap of the five indicators.ResultsCore symptoms were the most common COVID-indicator (770/1882 participants positive, 41%), followed by suspicion of COVID-19 (n = 509/1882, 27%), a positive symptom algorithm (n = 298/1882, 16%), study antibody lateral flow positive (n = 124/1882, 7%) and a positive external test result (n = 39/1882, 2%), thus a 20-fold difference between least and most common. Meeting any one indicator increased the likelihood of all others, with concordance between 65 and 94%. Report of a low suspicion of having had COVID-19 predicted a negative antibody test in 98%, but positive suspicion predicted a positive antibody test in only 20%. Those who reported previous external antibody tests were more likely to have received a positive result from the external test (24%) than the study test (15%).ConclusionsOur results support the use of proxy indicators of past COVID-19, with the caveat that none is perfect. Differences from previous antibody studies, most significantly in lower proportions of participants positive for antibodies, may be partly due to a decline in antibody detection over time. Subsequent to our study, vaccination may have further complicated the interpretation of COVID-indicators, only strengthening the need to critically evaluate what criteria should be used to define COVID-19 cases when designing studies and interpreting study results.

Introduction: Coronavirus Disease (COVID-19) is a highly infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) which has infected many people all over the world. One of the best ways to lessen its spread is through early detection and diagnosis. Various serological tests are now being used as a surveillance tool in the detection of antibodies as a response to SARS-CoV-2. The aim of this study is to evaluate the diagnostic accuracy and performance of the available COVID-19 antibody tests authorized by the Food and Drug Administration (FDA) Philippines that make use of Enzyme-Linked Immunosorbent Assay (ELISA), Chemiluminescence Immunoassay (CLIA) and Lateral Flow Immunoassay (LFIA). Method: Complete published journal articles relevant to the diagnostic accuracy of the three antibody tests were collected using trusted medical journal search engines. The quality of journals was assessed using QUADAS-2 to determine the risk of bias and assess the applicability judgments of diagnostic accuracy studies. Forest plots were used to summarize the performance of LFIA, ELISA and CLIA according to their specificity and sensitivity in detecting various antibodies. Pooled sensitivity and specificity were also done using bivariate random-effects models with its log-likelihood, a corresponding chi-square test statistic, and area under the summary Receiver-Operating Characteristic curve to see the potential heterogeneity in the data and to assess the diagnostic accuracy of the COVID-19 antibody tests. Results: Bivariate random-effects model and areas under the sROC curve were used to evaluate the diagnostic accuracy of COVID-19 antibody tests. The pooled sensitivity in detecting IgG based on CLIA, ELISA, and LFIA were 81.7%, 58.7%, and 74.3% respectively, with an overall of 72.0%. For IgM detection, LFIA has a higher pooled sensitivity of 69.6% than CLIA with 61.0%. Overall, the pooled sensitivity is 68.5%. In IgA detection, only ELISA based test was included with a pooled sensitivity of 84.8%. Lastly, pooled sensitivities for combined antibodies based on ELISA and LFIA were 89.0% and 81.6% respectively, with an overall of 82.5%. On the other hand, all tests excluding ELISA-IgA displayed high pooled specificities with a range of 94.0% to 100.0%. Diagnostic accuracies of the test in detecting IgG, IgM, and combined antibodies were found out to be almost perfect based on the computed area under the sROC with values of 0.973, 0.953, and 0.966, respectively. Conclusion: In this systematic review and meta-analysis, existing evidence on the diagnostic accuracy of antibody tests for COVID-19 were found to be characterized by high risks of bias, consistency in the heterogeneity of sensitivities, and consistency in the homogeneity of high specificities except in IgA detection using ELISA. The bivariate random-effects models showed that there are no significant differences in terms of sensitivity among CLIA, ELISA and LFIA in detecting IgG, IgM, and combined antibodies at a 95% confidence interval. Nonetheless, CLIA, ELISA and LFIA were found to have excellent diagnostic accuracies in the detection of IgG, IgM and combined antibodies as reflected by their AUC values. Doi: 10.28991/SciMedJ-2021-0304-1 Full Text: PDF

A woman with severe lupus nephritis and difficult to control diabetes mellitus

mRNA COVID-19 vaccine safety in patients with previous immediate hypersensitivity to pegaspargase

Do HLA antibodies cause hemolytic transfusion reactions or decreased RBC survival?

The diagnosis of hepatitis C virus (HCV) infection in children born to HCV-infected women is based on serologic assays and HCV RNA measurement by PCR. Interpretation of the results of these tests is hampered by uncertainty about the age distribution of loss of maternal antibody and the sensitivity and specificity of PCR at different ages. On the basis of findings from a recent vertical transmission study, we estimated the posttest probability of a child's being infected or uninfected under several test result scenarios. These estimates may assist clinicians in assessing the likelihood of infection in an individual child and in using the currently available assays cost effectively.

Evaluating the value of anti-SARS-CoV-2 antibody detection and neutralizing responses with euvirus: A population of 10776 close contacts in the epidemic of Fujian

Optimal blood donation screening annotation.

BackgroundThis study attempts to explore the influencing factors and solutions of the colloidal gold method for novel coronavirus (2019-nCoV)-specific IgM/IgG antibody detection, summarize the clinical experience and perfect the examination process, improving the application value of antibody detection in COVID-19 diagnosis.MethodsA total of 13,329 peripheral whole blood/plasma/serum samples were obtained for COVID-19 screening from children who visited the Children's Hospital of the Capital Institute of Pediatrics outpatient clinic from April 22, 2020, to November 30, 2020. The colloidal gold method was adopted for 2019-nCoV-specific IgM/IgG antibody detection. The virus nucleic acid test results, clinical records, and serum protein fingerprint results of antibody-positive patients were collected.ResultsAll samples were examined using the colloidal gold method with two 2019-nCoV-specific IgM/IgG antibody detection kits. Four patients were tested single antibody-positive using both kits. The details were as follows: two cases of IgM ( +) and IgG (-) using plasma and serum separately, two cases of IgM (-) and IgG ( +) using serum and whole blood. The protein fingerprinting results and nucleic acid tests of 2019-nCoV antibodies were negative in the 4 cases. Considering the epidemiological history, clinical manifestations, and test results, these 4 children were ruled out for 2019-nCoV infection.ConclusionsWhen the colloidal gold method was used to detect 2019-nCoV-specific IgM/IgG antibodies, it was important to ascertain the test results as precisely as possible. Specimen type and patient history may interfere with the diagnosis.


 
 Objective: To investigate the degree of association between Reverse Transcription Polymerase Chain Reaction positivity and seroconversion after natural COVID-19 infection in Multan, City of Pakistan.
 Study Design: Cross-sectional study.
 Place and Duration of Study: Combined Military Hospital, Multan Pakistan from Apr 2021 to Sep 2021.
 Methodology: In this study, 219 Healthcare Workers with suspected SARS-CoV-2 infection were screened via Reverse Transcription Polymerase Chain Reaction for viral genome, followed by detection of corresponding antibody response in serum samples within ten weeks of their first exposure against spike protein via Chemiluminescence immunoassay. 
 Results: There was a significant association between positive RT-PCR and detectable corresponding antibodies (p=0.001). However, we found no evidence of an association between age and RT-PCR positivity and between age and detectable antibodies (p=0.874 and 0.842, respectively). Furthermore, results indicated no association between gender and RT-PCR positivity and between gender and detectable antibodies (p=0.536 and 0.285, respectively).
 Conclusions: It is concluded that antibody detection against SARS-CoV-2 virus spike protein is a useful laboratory tool for screening for COVID-19 infection.Keywords: Antibody test, Asymptomatic cases, COVID-19, Healthcare workers, PCR, SARS-CoV-2.
 

See article on page 870–874, in this issue