background: COVID-19 serology has an evolving role in the diagnosis of SARS-CoV-2 infection. However, its use in hospitalised patients with acute respiratory symptoms remains unclear.
methods: Hospitalised patients with acute respiratory illness admitted to an isolation ward were recruited. All patients had negative nasopharyngeal swab polymerase chain reaction (PCR) for SARS-CoV-2. Serological studies using 4 separate assays (cPass: surrogate neutralising ELISA; Elecsys: N-antigen based chemiluminescent assay; SFB: S protein flow-based; epitope peptide-based ELISA;) were performed on stored plasma collected from patients during the initial hospital stay, and a convalescent visit 4-12 weeks later.
results: Of t... More
background: COVID-19 serology has an evolving role in the diagnosis of SARS-CoV-2 infection. However, its use in hospitalised patients with acute respiratory symptoms remains unclear.
methods: Hospitalised patients with acute respiratory illness admitted to an isolation ward were recruited. All patients had negative nasopharyngeal swab polymerase chain reaction (PCR) for SARS-CoV-2. Serological studies using 4 separate assays (cPass: surrogate neutralising ELISA; Elecsys: N-antigen based chemiluminescent assay; SFB: S protein flow-based; epitope peptide-based ELISA;) were performed on stored plasma collected from patients during the initial hospital stay, and a convalescent visit 4-12 weeks later.
results: Of the 51 patients studied (aged 54, IQR 21-84; 62.7% male), no patients tested positive on the Elecsys or cPass assays. 5/51 patients had antibodies detected on B-cell Epitope Assay, and 3/51 had antibodies detected on SFB assay. These 8 patients with positive serological test to COVID-19 were more likely to have a high-risk occupation (p=0.039), bacterial infection (p=0.028) and neutrophilia (p=0.013) during their initial hospital admission.
conclusions: Discrepant COVID-19 serological findings were observed amongst those with recent hospital admissions and bacterial infections. The positive serological findings within our cohort raise important questions about the interpretation of sero-epidemiology during the current pandemic. This article is protected by copyright. All rights reserved.
