#sars #lab #ab
新冠肺炎病毒抗體檢驗的正確性
-大部的研究都是針對有症狀的住院病人,因此抗體檢驗對症狀前期、無症狀者的用處仍未知
Antibody testing for coronavirus disease 2019: not ready for prime time
https://www.bmj.com/content/370/bmj.m2655
病毒抗體檢驗在新冠肺炎的用途仍未成熟。
Diagnostic accuracy of serological tests for covid-19: systematic review and meta-analysis
https://www.bmj.com/content/370/bmj.m2516
統合分析(40 個研究,N = 29842)發現抗體(IgG or IgM)的敏感性是 ELISA 84.3% (95% confidence interval 75.6%-90.9%),LFIA 是 66.0% (49.3%-79.3%),CLIA 是 97.8% (46.2%-100%)。敏感性在 1 週內是 13.4%-50.3%,在 3 週以上是 69.9%-98.9%。特異性是 96.6%-99.7%。
LFIA:lateral flow immunoassay
CLIA: chemiluminescent immunoassay(例如:彰化篩檢用的 Roche Elecsys)
What is the diagnostic accuracy of antibody tests for the detection of infection with the COVID-19 virus?
https://www.cochrane.org/CD013652/INFECTN_what-diagnostic-accuracy-antibody-tests-detection-infection-covid-19-virus
統合分析(38 個研究)發現症狀 1 週測定抗體的假陰性率 70%,症狀 2 週測定抗體的假陰性率 30%,症狀 3 週測定抗體的假陰性率 8%。假陽性率是 2%。假設 COVID-19 的盛行率是 5%,在症狀 3 週測定 1000 個人的抗體,那麼會有 50 個病人(其中有 4 個測驗陰性),950 個未感染者(其中有 19 個測驗陽性);有 65 個陽性,19/65(29%)是假陽性;有 935 個陰性,4/935(0.4%)是假陰性。
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