BMJ: New coronary pneumonia antibody detection the most complete strategy, a master!

With the development of the new coronary pneumonia pandemic, there is growing interest in antibody testing as a way to measure the spread of infection and identify individuals who may be immune.
Taking into account the different symptoms of covid-19 and the false negative results of the reverse transcription polymerase chain reaction (RT-PCR) trial, antibody testing has great clinical value, especially when the sensitivity of pharynx swabs and RT-PCR testing begins to decline five days after symptoms appear.
May, the British government announced that antibody tests should be conducted even if there are "no specific clinical symptoms" for those who want to know if they have SARS-CoV-2.
, however, there is no clear guidance on how doctors interpret these results or clarify the clinical path of antibody testing.
September 8, an article published on BMJ provided a detailed inventory of antibody testing.
article, the researchers provide a way to identify current or past SARS-CoV-2 infections in these patients through antibody testing.
When you are ready to do SARS-CoV-2 antibody testing, you first need to understand the following points: 1. Antibody positive indicates that you have been exposed to SARS-CoV-2 virus 2. Antibody testing should be at least two weeks after the onset of symptoms 3. Antibody test sensitivity and specificity change over time, the results should be based on clinical history to explain 4. Antibody testing may help diagnose In patients with late on-ongoing, prolonged symptoms, or reverse transcription polymerase chain reaction test results negative covid-19, where antibody testing is required?1. Antibody testing is required for people with symptoms that are currently suggested to be covid-19 but antigen detection fails to detect SARS-CoV-2, especially in people two weeks or more after symptoms appear (when antibody detection becomes more reliable).
2. For currently asymptomatic individuals, assess whether they have previously had SARS-CoV-2 infection.
may include people at high risk of serious illness or occupational infections, such as health care workers, to provide comfort.
3. When monitoring the quality and life of the immune response or vaccination response in previously diagnosed patients with covid-19, antibody testing will also be used to screen suitable volunteers if recovery plasma therapy is found to be effective for covid-19.
. What are the serum-reactive survey antibody tests for research and public health monitoring? Three main types of antibodies are produced for infection: IgA, IgG, and IgM.
IgM rose the fastest and then fell.
IgG and IgA persist, usually reflecting a longer-term immune response.
antibody tests typically use intravenous blood samples and can be performed in the laboratory using enzymatic immunosorption assays or chemical luminescent immunometric assays (CLIA).
the main tests currently used in the UK are Abbott's SARS-CoV-2 detection of IgG, and Roche's Elecsys detection of IgM and IgG.
both are CLIA tests that require intravenous blood.
accuracy of antibody testing is measured by comparing test results with gold standards, which typically detect viral RNA through PCR when symptoms occur (sensitivity may be as low as 70%).
Cochrane review of SARS-CoV-2 antibody testing included 57 papers from 54 cohort studies and 15,976 samples, of which 8,526 were from confirmed SARS-CoV-2 infections.
of diagnostic accuracy vary depending on the time of the test.
sensitivity and specificity of antibody detection after the onset of symptoms was 96% at a maximum sensitivity of 22-35 days after the onset of symptoms.
88.2% sensitivity was only 15-21 days after symptoms appeared.
35 of the 54 studies reported specificity, and all antibody tests were more than 98 percent specific.
data on the accuracy of antibody testing over 35 days.
should be tested five weeks after symptoms appear, as antibody levels may decrease and the sensitivity of the test may decrease.
antibody test results depends not only on the accuracy of the test itself, but also on the probability of pre-test infection.
when screening asymptomatic individuals, the probability of pre-testing is relatively low, while for individuals with suggestive symptoms, the probability of pre-testing may be higher.
asymptomatic, based on 1000 people's SARS-CoV-2 antibody test results of the introgram, pre-screening rate of 5% of the symptoms, based on 1000 people of SARS-CoV-2 antibody test results of the intrographic, pre-screening rate of 50% antibody detection and the body's immune response is an important component of the body's immune response, with specificity and memory function.
, however, there are some viral or intracellular infections that dominate cellular immunity, such as tuberculosis.
role of T-cells after SARS-CoV-2 infection is widely discussed, and researchers say it may be that B-cells and T-cell immunity are involved in the removal of covid-19 infections and the production of protective memories.
In order to understand whether our current antibody testing indicates protective immunity to SARS-CoV-2, ideally we need to conduct disease prevalence studies on individuals with known antibody status;
, antibody testing in patients with neo-coronary pneumonia also contributes to the study of antibody-related immune responses.
detection of antibody tests is based on population, no specific clinical index testing policy is basically equivalent to screening.
potential harm if the consequences of testing are not carefully considered.
, for example, if the tests are based on patient requirements rather than clinical drives, they are expected to be higher in wealthier populations, when in fact they are at a lower risk of contracting covid-19.
's not what the Institute of Medicine expects.
this also limits the usefulness of data for check-out rate predictions because a self-selecting group is not research representative.
concerns about the impact of the rapid introduction of antibody testing, scotland's chief medical officer does not recommend on-demand testing.
communication risks and uncertainties Clinicians should consider the risks and benefits of SARS-CoV-2 antibody testing and inform patients about the limitations of testing.
What patients need to know: 1. Antibody testing can help to understand whether you have ever been infected with covid-192. It is not clear whether you will be infected in the future 3. If the test results are positive, then it is likely that you have been infected with 4.negative test results can not rule out the possibility of you infected with covid-19 uncertainty: 1. At present, most of the research on antibody testing from hospital patients.
We don't know how effective these tests are in patients with or without mild symptoms who are not admitted to the hospital 2. More than 35 days of test sensitivity data deficiency 3. There is insufficient evidence of whether the presence of antibodies can provide lasting immunity to prevent secondary infections: Watson, J., Richter, A., samp; Deeks, J. (2020). Testing for SARS-CoV-2 antibodies. BMJ, m3325. doi:10.1136/bmj.m3325liangying Source: MedSci Original Copyright Notice: All text, images and audio and video materials on this website that indicate "Source: Mets Medicine" or "Source: MedSci Original" are owned by Mets Medicine and are not authorized to be reproduced by any media, website or individual.
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