An Indirect Comparison of Diagnostic Accuracy for Seven Different SARS-CoV-2 Serological Assays: A Meta-Analysis and Adjusted Indirect Comparison of Diagnostic Test Accuracy

IF 4.2 4区医学 Q1 INFECTIOUS DISEASES

Influenza and Other Respiratory Viruses Pub Date : 2025-09-09 DOI:10.1111/irv.70155

Minjie Zhang, Ying Zhao, Lijiang Fang, Weiwei Liang

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引用次数: 0

Abstract

Objectives

This study compared the diagnostic accuracy of seven different commercial serological assays for COVID-19, using RT-PCR as the gold standard, through meta-analysis and indirect comparison.

Methods

Fifty-seven studies, published from November 2019 to June 2024, were included. The diagnostic performance of IgA, IgG, and total antibody assays for SARS-CoV-2 was assessed. The netmeta, rjags, and gemtc packages in R software were used for adjusted indirect comparison to calculate the relative diagnostic odds ratio (RDOR).

Results

The pooled diagnostic odds ratio (DOR) for Abbott SARS-CoV-2 IgG was 542.81, for Elecsys Anti-SARS-CoV-2 N was 1022.34, for Elecsys Anti-SARS-CoV-2 total was 1701.56, for Euroimmun Anti-SARS-CoV-2 IgA was 45.91, for Euroimmun Anti-SARS-CoV-2 S1-IgG was 190.45, for Euroimmun Anti-SARS-CoV-2 N-IgG was 82.63, and for LIAISON SARS-CoV-2 S1/S2 IgG was 178.73. The pooled DOR for IgG, IgA, and total antibody assays was 241.43, 45.91, and 1124.48. The pooled DOR for the antinucleocapsid antigen (anti-N) was 604.29; for the antidomain of viral spike protein (anti-S1) and the antirecombinant S1 and S2 (anti-S1/S2) antigens, the pooled DORs were 119.88 and 178.73. ECLIA and CMIA methods had superior diagnostic performance compared with CLIA and ELISA, with no significant difference between ECLIA and CMIA. Total antibody assays showed the highest accuracy, followed by IgG, with IgA performing least effectively.

Conclusions

Elecsys Anti-SARS-CoV-2 total and N assays had the best overall diagnostic test accuracy. The diagnostic efficacy of the anti-N total, IgG antibodies was statistically significantly higher than that of anti-S IgG and IgA antibodies for COVID-19.

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7种不同SARS-CoV-2血清学检测方法诊断准确性的间接比较：诊断测试准确性的meta分析和调整后的间接比较

目的本研究以RT-PCR为金标准，通过meta分析和间接比较，比较7种不同的商用COVID-19血清学检测方法的诊断准确性。方法纳入2019年11月至2024年6月发表的57项研究。评估IgA、IgG和总抗体检测对SARS-CoV-2的诊断效果。采用R软件中的netmeta、rjags和gemtc软件包进行调整间接比较，计算相对诊断优势比（RDOR）。结果Abbott - cov -2 IgG的诊断优势比（DOR）为542.81，Elecsys anti - cov -2 N的诊断优势比为1022.34，Elecsys anti - cov -2 total的诊断优势比为1701.56，euroimmune anti - cov -2 IgA的诊断优势比为45.91，euroimmune anti - cov -2 S1-IgG的诊断优势比为190.45，euroimmune anti - cov -2 N-IgG的诊断优势比为82.63，LIAISON SARS-CoV-2 S1/S2 IgG的诊断优势比为178.73。IgG、IgA和总抗体检测的合并DOR分别为241.43、45.91和1124.48。抗核衣壳抗原（anti-N）的聚合DOR为604.29；病毒刺突蛋白反结构域（anti-S1）和抗重组抗原S1和S2 （anti-S1/S2）的合并DORs分别为119.88和178.73。ECLIA和CMIA方法的诊断效果优于CLIA和ELISA， ECLIA和CMIA方法的诊断效果无显著性差异。总抗体测定的准确性最高，IgG次之，IgA最低。结论Elecsys anti - cov -2总抗体和N抗体具有较好的综合诊断准确性。抗n总抗体、IgG抗体对COVID-19的诊断效能显著高于抗s IgG和IgA抗体。

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来源期刊

Influenza and Other Respiratory Viruses 医学-病毒学

CiteScore

7.20

自引率

4.50%

发文量

120

审稿时长

6-12 weeks

期刊介绍： Influenza and Other Respiratory Viruses is the official journal of the International Society of Influenza and Other Respiratory Virus Diseases - an independent scientific professional society - dedicated to promoting the prevention, detection, treatment, and control of influenza and other respiratory virus diseases. Influenza and Other Respiratory Viruses is an Open Access journal. Copyright on any research article published by Influenza and Other Respiratory Viruses is retained by the author(s). Authors grant Wiley a license to publish the article and identify itself as the original publisher. Authors also grant any third party the right to use the article freely as long as its integrity is maintained and its original authors, citation details and publisher are identified.