An evaluation of COVID-19 serological assays informs future diagnostics and exposure assessment

GeurtsvanKessel, Corine H.; Okba, Nisreen M. A.; Igloi, Zsofia; Bogers, Susanne; Embregts, Carmen W. E.; Laksono, Brigitta M.; Leijten, Lonneke; Rokx, Casper; Rijnders, Bart; Rahamat-Langendoen, Janette; van den Akker, Johannes P. C.; van Kampen, Jeroen J. A.; van der Eijk, Annemiek A.; van Binnendijk, Rob S.; Haagmans, Bart; Koopmans, Marion

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.