Sensitivity of anti-SARS-CoV-2 serological assays in a high-prevalence setting

Eur J Clin Microbiol Infect Dis. 2021 May;40(5):1063-1071. doi: 10.1007/s10096-021-04169-7. Epub 2021 Feb 3.


Evaluation and power of seroprevalence studies depend on the performed serological assays. The aim of this study was to assess four commercial serological tests from EUROIMMUN, DiaSorin, Abbott, and Roche as well as an in-house immunofluorescence and neutralization test for their capability to identify SARS-CoV-2 seropositive individuals in a high-prevalence setting. Therefore, 42 social and working contacts of a German super-spreader were tested. Consistent with a high-prevalence setting, 26 of 42 were SARS-CoV-2 seropositive by neutralization test (NT), and immunofluorescence test (IFT) confirmed 23 of these 26 positive test results (NT 61.9% and IFT 54.8% seroprevalence). Four commercial assays detected anti-SARS-CoV-2 antibodies in 33.3-40.5% individuals. Besides an overall discrepancy between the NT and the commercial assays regarding their sensitivity, this study revealed that commercial SARS-CoV-2 spike-based assays are better to predict the neutralization titer than nucleoprotein-based assays are.

Keywords: COVID-19; Immunofluorescence test; Neutralizing antibodies; SARS-CoV-2; Serology; Seroprevalence.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antibodies, Neutralizing / blood
  • Antibodies, Viral / blood
  • COVID-19 / blood
  • COVID-19 / diagnosis*
  • COVID-19 / epidemiology*
  • COVID-19 Serological Testing / methods*
  • COVID-19 Serological Testing / standards
  • Contact Tracing
  • Female
  • Humans
  • Immunoassay
  • Male
  • Middle Aged
  • Neutralization Tests
  • Prevalence
  • SARS-CoV-2 / immunology
  • SARS-CoV-2 / isolation & purification*
  • Sensitivity and Specificity
  • Young Adult


  • Antibodies, Neutralizing
  • Antibodies, Viral