Meta-analysis of diagnostic performance of serological tests for SARS-CoV-2 antibodies up to 25 April 2020 and public health implications

Euro Surveill. 2020 Jun;25(23). doi: 10.2807/1560-7917.ES.2020.25.23.2000980.

Abstract

We reviewed the diagnostic accuracy of SARS-CoV-2 serological tests. Random-effects models yielded a summary sensitivity of 82% for IgM, and 85% for IgG and total antibodies. For specificity, the pooled estimate were 98% for IgM and 99% for IgG and total antibodies. In populations with ≤ 5% of seroconverted individuals, unless the assays have perfect (i.e. 100%) specificity, the positive predictive value would be ≤ 88%. Serological tests should be used for prevalence surveys only in hard-hit areas.

Keywords: SARS-CoV-2; meta-analysis; predictive values; sensitivity; serological tests; specificity; systematic review.

Publication types

  • Meta-Analysis

MeSH terms

  • Antibodies, Viral / blood*
  • Betacoronavirus
  • Clinical Laboratory Techniques / methods*
  • Clinical Laboratory Techniques / standards
  • Coronaviridae Infections / diagnosis*
  • Coronavirus / immunology*
  • Coronavirus / isolation & purification
  • Coronavirus Infections / diagnosis*
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / immunology
  • Humans
  • Immunoglobulin G / blood
  • Immunoglobulin M / blood
  • Pandemics
  • Pneumonia, Viral / diagnosis*
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / immunology
  • Predictive Value of Tests
  • Sensitivity and Specificity
  • Serologic Tests / methods
  • Serologic Tests / standards*
  • Severe Acute Respiratory Syndrome / blood
  • Severe Acute Respiratory Syndrome / immunology*

Substances

  • Antibodies, Viral
  • Immunoglobulin G
  • Immunoglobulin M

Supplementary concepts

  • COVID-19
  • COVID-19 diagnostic testing
  • severe acute respiratory syndrome coronavirus 2