Comparison of the diagnostic sensitivity of SARS-CoV-2 nucleoprotein and glycoprotein-based antibody tests

J Clin Virol. 2020 Aug;129:104544. doi: 10.1016/j.jcv.2020.104544. Epub 2020 Jul 6.


The emergence of the severe acute respiratory syndrome coronavirus-2 (SARS CoV-2) has been followed by the rapid development of antibody tests. To assess the utility of the tests for clinical use and seroepidemiologic studies, we examined the sensitivity of commercial antibody tests from Roche, Abbott, Novatec, Virotech Siemens, Euroimmun, and Mediagnost in a prospective diagnostic study. The tests were evaluated with 73 sera from SARS CoV-2 RNA positive individuals with mild to moderate disease or asymptomatic infection. Sera were obtained at 2-3 weeks (N = 25) or > 4 weeks (N = 48) after symptom onset and viral RNA test. The overall sensitivity of the tests ranged from 64.4-93.2%. The most sensitive assays recognized 95.8-100 % of the sera obtained after 4 weeks or later. Sera drawn at 2-3 weeks were recognized with lower sensitivity indicating that the optimal time point for serologic testing is later than 3 weeks after onset of the disease. Nucleoprotein- and glycoproteinbased assays had similar sensitivity indicating that tests with both antigens are suitable for serological diagnostics. Breakdown of the test results showed that nucleoprotein- and glycoprotein-based tests of comparable sensitivity reacted with different sets of sera. The observation indicates that a combination of nucleoprotein- and glycoprotein-based tests would increase the percentage of positive results.

Keywords: Antibody test; Covid-19; Glycoprotein; Nucleoprotein; Sensitivity; Severe acute respiratory syndrome coronavirus-2.

Publication types

  • Evaluation Study

MeSH terms

  • Antibodies, Viral / blood*
  • Antigens, Viral / immunology*
  • Betacoronavirus / immunology
  • Betacoronavirus / isolation & purification*
  • COVID-19
  • COVID-19 Testing
  • Clinical Laboratory Techniques / methods*
  • Coronavirus Infections / diagnosis*
  • Glycoproteins / immunology
  • Humans
  • Nucleoproteins / immunology
  • Pandemics
  • Pneumonia, Viral / diagnosis*
  • Prospective Studies
  • SARS-CoV-2
  • Sensitivity and Specificity
  • Serologic Tests / methods*
  • Time Factors
  • Viral Structural Proteins / immunology*


  • Antibodies, Viral
  • Antigens, Viral
  • Glycoproteins
  • Nucleoproteins
  • Viral Structural Proteins