Acta Scientific Microbiology (ASMI) (ISSN: 2581-3226)

Review Article Volume 3 Issue 9

Serology: A Precise Tool in Diagnosis and Epidemiology of COVID-19

Bramhadev Pattnaik1, Mahendra P Yadav2, Sharanagouda Patil3* and Pinaki Panigrahi4

1One Health Center for Surveillance and Disease Dynamics, AIPH University, Bhubaneswar, Odisha and Former Director, ICAR-Directorate of Foot and Mouth Disease, Mukteswar, India
2Former Vice-Chancellor, SVP University of Agriculture and Technology, Meerut, India
3ICAR-National Institute of Veterinary Epidemiology and Disease Informatics (NIVEDI), Bengaluru, India
4Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Georgetown University Medical Center, Washington, D.C. USA

*Corresponding Author: Sharanagouda Patil, ICAR-National Institute of Veterinary Epidemiology and Disease Informatics (NIVEDI), Bengaluru, India.

Received: June 01, 2020; Published: August 26, 2020

×

Abstract

The coronavirus infectious disease-2019 (COVID-19), caused by a β-Coronavirus, named SARS-CoV-2, has become a global pandemic since its origin in Wuhan, China during the last week of December 2019, affecting 212 countries and territories in the World involving all the five continents. Prompt and precise diagnosis of the disease is central to its control and eradication. Real- time polymerase chain reaction (real-time PCR) using dual labelled TaqMan probe and targeting two genomic areas, usually RdRp and envelope (E) regions, of the virus is being extensively used for the diagnosis of SARS-CoV-2 in respiratory clinical specimens. As stage of the infection cannot be ascertained during collection of respiratory specimens for nucleic acid test (NAT; RT-PCR), this may lead to false negatives (error of omission) as virus load in the respiratory exudates and saliva gradually decreases with the increase in time post infection. Virus excretion would be maximum during clinical sickness that follows incubation period of usually up to ~14 days and clinical samples collected during this period are suitable for PCR diagnosis than those collected after clinical sickness. In addition, there are other variables, like quality of swabs and virus transport medium, PCR protocol and reagents, enzyme inhibitors, and proficiency of the manpower engaged in executing diagnostic techniques may affect the quality of the test result. There are three grades of clinical sickness in COVID-19, viz. asymptomatic, mild symptomatic and highly symptomatic. Available data indicate that about 50% of the people exposed to SARS-CoV-2 infection may become asymptomatic, as was observed in case of the COVID-19 affected Japan cruise ship ‘Diamond Princess’ with 3,711 people on board. In case of asymptomatic and mild symptomatic cases, due to low virus load in the clinical specimens collected, the negative result in NAT/PCR need to be cross checked using a suitable antibody assay. It is known that virus load in the body and the quantum of virus excreted in body fluids gradually decreases with the remission from sickness, whereas quantum of specific antibody against the virus increases with time till plateau. Anti-virus antibody remains in the host for longer duration and can be detected even after clearance of the infection from the body. Therefore, NAT must be complemented by antibody test to enhance quality of diagnosis and mitigate errors of omission. Further, unlike NAT/PCR, serology/antibody test is a powerful tool in tracking virus transmission, estimating actual number of cases, and epidemiological mapping of the disease in a population. Further, availability of a precise antibody test system/assay would be handy for post-pandemic surveillance of COVID-19. The current review includes the results of COVID-19 diagnosis and kinetics of antibody response reported by different authors/groups of scientists that vouch for quick development of a ‘COVID-19 antibody assay’ system for use in epidemiological studies of the disease.

Keywords: Antibody Test; COVID-19; Epidemiology; PCR; SARS-CoV-2; Serology

×

References

  1. Guan W J., et al. "Clinical characteristics of 2019 novel coronavirus infection in China". The New England Journal of Medicine 382 (2020): 1708-1720.
  2. Xiao K., et al. "Isolation of SARS-CoV-2-related coronavirus from Malayan pangolins". Nature (2020).
  3. Wang Y., et al. "Asymptomatic Cases with SARS-CoV-2 Infection". Journal of Medical Virology (2020).
  4. Majumder M A M and Kenneth D. "Early transmissibility assessment of a novel coronavirus in Wuhan, China". SSRN (2020).
  5. Wu J T., et al. "Nowcasting and forecasting the potential domes- tic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling study". Lancet 395.10225 (2020a): 689-697. 
  6. Chen W H., et al. "Potential for developing a SARS-C0V receptor-binding domain (RBD) recombinant protein as a heterologous human vaccine against coronavirus infectious disease (COVID)- 19". Human Vaccines and Immunotherapeutics 16.6 (2020): 1239-1242.
  7. Walls A C., et al. "Unexpected receptor functional mimicry elucidates activation of coronavirus fusion". Cell 176 (2019): 1026-1039.
  8. Hirano T and Murakami M. "COVID-19: A new virus, but a familiar receptor and cytokinereleasesyndrome". Immunity 52 (2020): 731-733.
  9. Sahu KK., et al. “COVID-19: update on epidemiology, disease spread and management”. Monaldi Archives for Chest Disease 90.1292 (2020): 197-205.
  10. Liu R., et al. "Positive rate of RT-PCR detection of SARS-CoV-2 infection in 4880 cases from one hospital in Wuhan, China, from Jan to Feb 2020". Clinica Chimica Acta 505 (2020): 172-175.
  11. Wenting Tan., et al. "Viral Kinetics and Antibody Responses in Patients with COVID-19". medRxiv (2020).
  12. Long Q X., et al. "Antibody responses to SARS-CoV-2 in COVID-19 patients: the perspective application of serological tests in clinical practice". medRxiv (2020a).
  13. Long Q X., et al. "Antibody responses to SARS-CoV-2 in patients with COVID-19". Nature Medicine (2020b).
  14. Kelvin Kai-Wang To., et al. "Temporal profiles of viral load in posterior oropharyngeal saliva samples and serum antibody responses during infection by SARS-CoV-2: an observational cohort study". The Lancet Infectious diseases 20.5 (2020a): 565-574.
  15. Xie J., et al. "Characteristics of Patients with Coronavirus Disease (COVID-19) Confirmed using an IgM-IgG Antibody Test". Journal of Medical Virology (2020).
  16. Liu K., et al. "Clinical features of COVID-19 in elderly patients: A comparison with young and middle-aged patients". Journal of Infection 80.6 (2020): e14-e18.
  17. Cassaniti I., et al. “Performance of VivaDiag COVID-19 IgM/IgG Rapid Test is inadequate for diagnosis of COVID-19 in acute patients referring to emergency room department”. Journal of Medical Virology (2020).
  18. Xiang F., et al. "Antibody detection and dynamic characteristics in patients with COVID-19". Clinical Infectious Diseases (2020): ciaa461.
  19. Meyer B., et al. "Serological assays for emerging coronaviruses: Challenges and pitfalls". Virus Research 194 (2014): 175-183.
  20. FDA, USA (2020).
  21. Wang C., et al. "A Human Monoclonal Antibody Blocking SARS-CoV-2 Infection". Nature Communication 11.1 (2020): 2251.
  22. Huang A T., et al. "A systematic review of antibody mediated immunity to coronaviruses: antibody kinetics, correlates of protection, and association of antibody responses with severity of disease". medRxiv (2020).
  23. Anderson DE., et al. “Lack of cross-neutralization by SARS patient sera towards SARS-CoV-2". Emerging Microbes and Infections (2020).
  24. Kelvin Kai-Wang To., et al. "Consistent Detection of 2019 Novel Coronavirus in Saliva". Clinical Infectious Diseases 71.15 (2020b): 841-843.
  25. Zeng F., et al. "A comparison study of SARS-CoV-2 IgG antibody between male and female COVID-19 patients: a possible reason underlying different outcome between sex". Journal of Medical Virology (2020).
  26. Stowell S and Guarner J. “Role of serology in the COVID-19 pandemic”. Clinical Infectious Diseases (2020).
  27. Zhao R., et al. "Early detection of SARS-CoV-2 antibodies in COVID-19 patients as a serologic marker of infection". Clinical Infectious Diseases (2020).
  28. Pulia M S., et al. "Multi-Tiered Screening and Diagnosis Strategy for COVID-19: A Model for Sustainable Testing Capacity in Response to Pandemic". Annuals of Medicine 14 (2020): 1-8.
  29. Perera R A., et al. "Serological Assays for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), March 2020". Euro Surveillance 25.16 (2020): 2000421.
  30. Wong J Y., et al. "Case fatality risk of influenza A (H1N1pdm09): a systematic review". Epidemiology 24.6 (2013): 830-841.
  31. Wu J T., et al. "Inferring influenza infection attack rate from seroprevalence data". PLoS Pathogens 10.4 (2014): e1004054.
  32. Theel E S., et al. "The Role of antibody Testing for SARS-Co: Is There One?”. Journal of Clinical Microbiology (2020).
  33. Guo L., et al. "Profiling Early Humoral Response to Diagnose Novel Coronavirus Disease (COVID-19)". Clinical Infectious Diseases (2020). 
  34. Zhao J., et al. "Antibody responses to SARS-CoV-2 in patients of novel coronavirus disease 2019". Clinical Infectious Diseases (2020).
  35. Schlomchik M., et al. "The distribution and functions of immunoglobulin isotypes”. In: Immunobiology: The Immune System in Health and Disease, 5th ed. Garland Publishing, New York, NY.
  36. Casadevall A and Pirofski L A. "The convalescent sera option for containing COVID-19". Journal of Clinical Investigation 130 (2020): 1545-1548.
  37. Amanat F., et al. “A serological assay to detect SARS-CoV-2 seroconversion in humans”. medRxiv (2020).
  38. Tang F., et al. “Lack of peripheral memory B cell responses in recovered patients with severe acute respiratory syndrome: a six-year follow-up study”. Journal of Immunology 186 (2011): 7264-7268.
  39. Rokni M., et al. "Immune responses and pathogenesis of SARS-CoV-2 342 during an outbreak in Iran: Comparison with SARS and MERS". Reviews in Medical Virology 30.3 (2020): e2107.
  40. Kimball A., et al. "Asymptomatic and Presymptomatic SARS-CoV-2 Infections in Residents of a Long-Term Care Skilled Nursing Facility - King County, Washington, March 2020". Morbidity and Mortality Weekly Report (MMWR) 69 (2020): 377-381. 
  41. Mizumoto K., et al. "Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, 361 Yokohama, Japan, 2020". Euro Surveillance 25.10 (2020): 2000180.
  42. Zhou X., et al. "Follow-up of asymptomatic patients with SARS-CoV-2 infection". Clinical Microbiology Infection 26.7 (2020): 957-959. 
  43. Xue X., et al. "Effect of heat inactivation of blood samples on the efficacy of three detection methods of SARS-CoV-2 antibodies". Nan Fang Yi Ke Da Xue Xue Bao 40.3 (2020): 316-320. 
  44. Zou L., et al. "SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients". The New England Journal of Medicine 382 (2020): 1177-1179.
  45. Jiang X., et al. "Asymptomatic SARS-CoV-2 infected case with viral detection positive in stool but negative in nasopharyngeal samples lasts for 42 days". Journal of Medical Virology (2020).
  46. Protocols (2020) http://en.nhc.gov.cn/2020-03/29/c_78468.htm.
  47. Ronni T., et al. "Control of IFN-inducible MxA gene expression in human cells". Journal of Immunology 150.5 (1993): 1715-1726.
  48. Ronni T., et al. "Regulation of IFN-alpha/beta, MxA, 2', 5'-oligoadenylate synthetase, and HLA gene expression in influenza A-infected human lung epithelial cells". Journal of Immunology 158.5 (1997): 2363-2374.
  49. Tynell J., et al. "Middle East respiratory syndrome coronavirus shows poor replication but significant induction of antiviral responses in human monocyte-derived macrophages and dendritic cells". Journal of General Virology 97.2 (2016): 344-355.
  50. Staeheli P and Sutcliffe J G. “Identification of a second interferon-regulated murine Mx gene”. Molecular and Cellular Biology 8 (1988): 4524-4528.
  51. Simon A., et al. “Interferon-regulated Mx genes are not responsive to interleukin-1, tumor necrosis factor, and other cytokines”. Journal of Virology 2 (1991): 968-971.
×

Citation

Citation: Bramhadev Pattnaik., et al. “Serology: A Precise Tool in Diagnosis and Epidemiology of COVID-19". Acta Scientific Microbiology 3.9 (2020): 83-91.



Indexed In






News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is December 15, 2020.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of “Best Article of the Issue”.
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.
  • Contact US