Serologic Detections

of COVID-19
Webinar COVID-19, MARINE 30 April 2020

Uleng Bahrun
Department of Clinical Pathology Faculty of Medicine
Hasanuddin University

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Outline

1. The virus
2. Antibody Responses in COVID-19
3. Laboratory Modality of COVID-19 Management
4. Rapid Antibody Test for COVID-19
5. Interpretation
6. Take Home Message

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Coronavirus

6 major species are known to cause human infections

alphacoronavirus 229E
alphacoronavirus NL63
betacoronavirus OC43
betacoronavirus HKU1
Severe Acute Respiratory Illness Coronavirus (SARS-CoV)
Middle East Respiratory Syndrome Coronavirus (MERS-CoV)

 SARS-CoV-2 (betacoronavirus)

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SARS-CoV-2

COVID-19 differs from other coronaviruses by

encoding an additional glycoprotein that has
acetyl esterase and hemagglutination (HE)
properties6.

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S. KANNAN, COVID-19 (Novel Coronavirus 2019) –recent trends 4
Antibody Response in Covid-19

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 Antibody Response in Covid-19

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 Antibody Response in Covid-19

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Antibody Response to Covid-19
Guo et al (Clin Inf Dis 2020)
• ELISA based assay using the recombinant viral nucleocapsid
examined the host humoral response against SARS-CoV-2
(IgA, IgM and IgG) responses
• 208 plasma samples from 82 confirmed and 58 probable
cases
• The median duration of IgM and IgA antibody detection
were 5 days (IQR 3-6), while IgG was detected on 14 days
(IQR 10-18) after symptom onset, with a positive rate of
85.4%, 92.7% and 77.9% respectively
• In confirmed and probable cases, the positive rates of IgM
antibodies were 75.6% and 93.1%, respectively. The
detection efficiency by IgM ELISA was higher than that of
qPCR method after 5.5 days of symptom onset
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 Antibody Response in Covid-19
The positive detection rate was significantly increased (98.6%) when
combined IgM ELISA assay with PCR compare with a singleqPCR test
(51.9%)

Guo et al (Clin Inf Dis 2020)

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Laboratory Modality for Management of COVID-19

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Prof. dr. Aryati, SpPK(K). Webinar Perspektif dan Tantangan Laboratoriumdi Indonesia
10
dalam Menghadapi COVID-19. Kerjasam PDS Patklin dan Midray. Selasa 14 April 2020
Rapid Antibody Test

 mendeteksi antibodi (IgM dan IgG)

terhadap SARS-CoV-2
 Sampel: darah kapiler, serum, plasma
 metode lateral flow imunokromatografi
 sensitivitas 88,66% dan spesifisitas 90,63%
 Hasil cepat (2-10 mnt)  manajemen
pasien lebih cepat
 Simple
 time-saving procedure
Vol specimens sedikit
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 Alur Pemeriksaan Rapid Tes

Perhimpunan Dokter Spesialis Patologi

Klinik dan Kedokteran Laboratorium
Indonesia, Maret 2020

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Rapid Antibody Test ~ Immunochromatography

Healgrn Scientific, Kit Insert

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 Interpretasi Rapid Antibody Test
IgM & IgG non reaktif:
IgM reaktif IgG non
 tidak terinfeksi SARS-CoV-2
reaktif:
 Window period ( terinfeksi namun
 Paparan/ infeksi SARS-
antibodi belum terbentuk)
CoV-2, fase awal
 Gangguan pembentukan antibodi
 Reaksi silang dengan
(misal: Immunocompromised, atau
antibodi terhadap
konsumsi obat yang menekan daya
coronavirus lain/virus
tahan tubuh, malnutrisi dan kondisi lain
lain yang menyerupai
yang menyebabkan gangguan dalam
produksi antibodi)
 Kadar antibodi dibawah batas deteksi
alat
IgM non reaktif, IgG reaktif:
IgM & IgG reaktif :
 Infeksi SARS-CoV-2/ Late phase atau
 Paparan/ infeksi SARS-CoV-2
infeksi di masa lampau / sembuh
 Reaksi silang dengan antibody
 Reaksi silang dengan antibodi
coronavirus lain/virus lain yang
terhadap coronavirus lain/virus lain
menyerupai
yang serupa 14
Take Home Message

• COVID-19  patogenesis msh dinamis

• Hati-hati dalam menginterpretasi hasil Rapid
test Ab  false positive/false negative
• Interpretasi kombinasi antibodi dan molekuler
saling melengkapi
• Hati-hati memilih rapid antibody kit test

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 Prof. dr. Aryati, SpPK(K). Webinar Perspektif dan Tantangan Laboratoriumdi Indonesia
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dalam Menghadapi COVID-19. Kerjasam PDS Patklin dan Midray. Selasa 14 April 2020
04/05/2020 Gugus Tugas Percepatan Penanganan COVID-19, 17
rekomendasi WHO, 21 April 2020
 THANK YOU

Enjoy stay at home

Keep healthy
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