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10.1186/s12879-021-05878-2 http://scihub22266oqcxt.onion/10.1186/s12879-021-05878-2 33602152!7889711!33602152     free     free     free Deprecated: Implicit conversion from float 235.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 235.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 235.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 235.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       BMC+Infect+Dis 2021 ; 21 (1): 187 Nephropedia Template TP {{tp|p=33602152|t=2021. Stringent thresholds in SARS-CoV-2 IgG assays lead to under-detection of mild infections |pdf=|usr=}}{{33602152}} gab.com Text Stringent thresholds in SARS-CoV-2 IgG assays lead to under-detection of mild infections JO: BMC Infect Dis http://www.kidney.de/pget.php?&tw=1&pmid=33602152 #FOAvip BACKGROUND: Thresholds for SARS-CoV-2 antibody assays have typically been determined using samples from symptomatic, often hospitalised, patients. In this setting the sensitivity and specificity of the best performing assays can both exceed 98%. However, antibody assay performance following mild infection is less clear. METHODS: We assessed quantitative IgG responses in a cohort of healthcare workers in Oxford, UK, with a high pre-test probability of Covid-19, in particular the 991/11,475(8.6%) who reported loss of smell/taste. We use anosmia/ageusia and other risk factors as probes for Covid-19 infection potentially undiagnosed by immunoassays by investigating their relationship with antibody readings either side of assay thresholds. RESULTS: The proportion of healthcare workers reporting anosmia/ageusia increased at antibody readings below diagnostic thresholds using an in-house ELISA (n = 9324) and the Abbott Architect chemiluminescent microparticle immunoassay (CMIA; n = 11,324): 426/906 (47%) reported anosmia/ageusia with a positive ELISA, 59/449 (13.1%) with high-negative and 326/7969 (4.1%) with low-negative readings. Similarly, by CMIA, 518/1093 (47.4%) with a positive result reported anosmia/ageusia, 106/686 (15.5%) with a high-negative and 358/9563 (3.7%) with a low-negative result. Adjusting for the proportion of staff reporting anosmia/ageusia suggests the sensitivity of both assays in mild infection is lower than previously reported: Oxford ELISA 89.8% (95%CI 86.6-92.8%) and Abbott CMIA 79.3% (75.9-82.7%). CONCLUSION: Following mild SARS-CoV-2 infection 10-30% of individuals may have negative immunoassay results. While lowered diagnostic thresholds may result in unacceptable specificity, our findings have implications for epidemiological analyses and result interpretation in individuals with a high pre-test probability. Samples from mild PCR-confirmed infections should be included in SARS-CoV-2 immunoassay evaluations. Twit Text FOAVip Stringent thresholds in SARS-CoV-2 IgG assays lead to under-detection of mild infections ????BMC Infect Dis http://www.kidney.de/pget.php?&tw=1&pmid=33602152 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=33602152 #FOAvip English Wikipedia <ref>{{Cite pmid|33602152}}</ref> Stringent thresholds in SARS-CoV-2 IgG assays lead to under-detection of mild infections #MMPMID33602152 Eyre DW; Lumley SF; O'Donnell D; Stoesser NE; Matthews PC; Howarth A; Hatch SB; Marsden BD; Cox S; James T; Cornall RJ; Stuart DI; Screaton G; Ebner D; Crook DW; Conlon CP; Jeffery K; Walker TM; Peto TEA BMC Infect Dis 2021[Feb]; 21 (1): 187 PMID33602152show ga BACKGROUND: Thresholds for SARS-CoV-2 antibody assays have typically been determined using samples from symptomatic, often hospitalised, patients. In this setting the sensitivity and specificity of the best performing assays can both exceed 98%. However, antibody assay performance following mild infection is less clear. METHODS: We assessed quantitative IgG responses in a cohort of healthcare workers in Oxford, UK, with a high pre-test probability of Covid-19, in particular the 991/11,475(8.6%) who reported loss of smell/taste. We use anosmia/ageusia and other risk factors as probes for Covid-19 infection potentially undiagnosed by immunoassays by investigating their relationship with antibody readings either side of assay thresholds. RESULTS: The proportion of healthcare workers reporting anosmia/ageusia increased at antibody readings below diagnostic thresholds using an in-house ELISA (n = 9324) and the Abbott Architect chemiluminescent microparticle immunoassay (CMIA; n = 11,324): 426/906 (47%) reported anosmia/ageusia with a positive ELISA, 59/449 (13.1%) with high-negative and 326/7969 (4.1%) with low-negative readings. Similarly, by CMIA, 518/1093 (47.4%) with a positive result reported anosmia/ageusia, 106/686 (15.5%) with a high-negative and 358/9563 (3.7%) with a low-negative result. Adjusting for the proportion of staff reporting anosmia/ageusia suggests the sensitivity of both assays in mild infection is lower than previously reported: Oxford ELISA 89.8% (95%CI 86.6-92.8%) and Abbott CMIA 79.3% (75.9-82.7%). CONCLUSION: Following mild SARS-CoV-2 infection 10-30% of individuals may have negative immunoassay results. While lowered diagnostic thresholds may result in unacceptable specificity, our findings have implications for epidemiological analyses and result interpretation in individuals with a high pre-test probability. Samples from mild PCR-confirmed infections should be included in SARS-CoV-2 immunoassay evaluations. |Adult[MESH] |Ageusia/virology[MESH] |Anosmia/virology[MESH] |Antibodies, Viral/*analysis[MESH] |Asymptomatic Infections[MESH] |COVID-19 Serological Testing/*standards[MESH] |COVID-19/*diagnosis[MESH] |Enzyme-Linked Immunosorbent Assay/standards[MESH] |Female[MESH] |Health Personnel[MESH] |Humans[MESH] |Immunoassay/standards[MESH] |Immunoglobulin G/*analysis[MESH] |Male[MESH] |Middle Aged[MESH] |Sensitivity and Specificity[MESH] |Undiagnosed Diseases[MESH]Stringent thresholds in SARS-CoV-2 IgG assays lead to under-detection (epmc).pdf DeepDyve Pubget Overpricing