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The following is a summary of “Infectious diseases society of america guidelines on the diagnosis of COVID-19: serologic testing,” published in the March 2024 issue of Infectious Diseases by Hayden et al.
Serologic testing for COVID-19 entails assessing the presence of antibodies in a person’s bloodstream, which indicates the body’s adaptive immune response to COVID-19.
Researchers conducted a prospective study to create evidence-based guidelines and fill gaps in research about the effectiveness of anti-SARS-CoV-2 antibody tests in diagnosis, vaccination choices, monoclonal antibody usage, and determining serologic immunity correlates in immunocompromised individuals.
They established a diverse group of experts to recognize and rank clinical questions about SARS-CoV-2 serologic tests. The committee utilized the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology to assess the certainty of evidence and create recommendations for testing.
The results include the panel’s recommendation to avoid serologic testing in the initial 2 weeks of symptom onset and not to use it to provide evidence of COVID-19 in symptomatic patients with high clinical suspicion and repeatedly negative nucleic acid tests. However, Investigators found that Serologic testing for multisystem inflammatory syndrome in children, suggesting IgG, IgG/IgM, or total antibody testing 3-5 weeks post-symptom onset to prior infection and advising against routine serologic testing for individuals with previous infection or vaccination, though noting the potential utility antibody tests in identifying immunocompromised patients eligible for the immune system.
Investigators concluded that testing for COVID-19 antibodies may be less helpful because many already have them. Better tests are needed for future studies.
Source: academic.oup.com/cid/advance-article/doi/10.1093/cid/ciae121/7629672
