An evaluation of COVID-19 serological assays informs future diagnostics and exposure assessment
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Abstract
The world is entering a new era of the COVID-19 pandemic in which there is an increasing call for reliable antibody testing. To support decision making on the deployment of serology for either population screening or diagnostics, we present a detailed comparison of serological COVID-19 assays. We show that among the selected assays there is a wide diversity in assay performance in different scenarios and when correlated to virus neutralizing antibodies. The Wantai ELISA detecting total immunoglobulins against the receptor binding domain of SARS CoV-2, has the best overall characteristics to detect functional antibodies in different stages and severity of disease, including the potential to set a cut-off indicating the presence of protective antibodies. The large variety of available serological assays requires proper assay validation before deciding on deployment of assays for specific applications.
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A Wantai ELISA ratio of >10 has previously been shown to correspond to virus neutralization.
“Although the Wantai ELISA is a qualitative assay, a ratio of >10 has previously been shown to correspond to virus neutralization (44).”
From SARS-CoV-2 variants of concern partially escape humoral but not T cell responses in COVID-19 convalescent donors and vaccine recipients (2021) · cites this paper as [44]
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Self-citation
- Authors
- GeurtsvanKessel, C. H., Okba, N. M. A., Igloi, Z., Bogers, S., Embregts, C. W. E., Laksono, B. M., Leijten, L., Rokx, C., Rijnders, B., Rahamat-Langendoen, J., van den Akker, J. P. C., van Kampen, J. J. A., van der Eijk, A. A., van Binnendijk, R. S., Haagmans, B., & Koopmans, M.
- Affiliations
- Erasmus MC (NL)
- Radboud University Medical Center (NL)
- Corresponding author
- GeurtsvanKessel, Corine H.
- ORCID
- Venue
- Nature Communications
- Published
- 2020-07-06
- Volume
- 11
- Issue
- 1
- Pages
- 3436-3436
- ISSN
- 2041-1723 (ISSN-L)
- PMC
- PMC7338506
- OpenAlex
- W3039328844
- Cited by
- 361
- References
- 10
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 15 · 2023: 33 · 2022: 66 · 2021: 165 · 2020: 68
- FWCI
- 10.89
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Nature Communications (publishedVersion, cc-by)
- medRxiv (acceptedVersion)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, other-oa)
- RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Radboud Repository (Radboud University) (submittedVersion)
- Rivm Repository (Netherlands National Institute for Public Health and the Environment) (submittedVersion)
- Rivm (National Institute for Public Health and the Environment) (submittedVersion)
- Rivm (National Institute for Public Health and the Environment) (submittedVersion, other-oa)
- Radboud Repository (Radboud University) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 detection and testing
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Keywords
- COVID-19 pandemic, SARS-CoV-2, serological assays, antibody detection, ELISA, receptor binding domain, virus-neutralizing antibodies, assay validation, diagnostic accuracy, exposure assessment, mass screening, disease severity
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, COVID-19 Testing, Antibodies, Viral, Enzyme-Linked Immunosorbent Assay, Humans, Luminescent Measurements, Neutralization Tests, Pneumonia, Viral, Sensitivity and Specificity, Serologic Tests, Coronavirus Infections, Clinical Laboratory Techniques, Antibodies, Neutralizing, High-Throughput Screening Assays, Pandemics
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