Specificity of SARS-CoV-2 antibody detection assays against S and N proteins among pre-COVID-19 sera from patients with protozoan and helminth parasitic infections

Cedric P Yansouni, Jesse Papenburg, Matthew P Cheng, Rachel Corsini, Chelsea Caya, Fabio Vasquez Camargo, Luke B Harrison, Gerasimos Zaharatos, Philippe Büscher, Babacar Faye, Magatte Ndiaye, Greg Matlashewski, Momar Ndao

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    We aimed to assess the specificity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody detection assays among people with tissue-borne parasitic infections. We tested three SARS-CoV-2 antibody-detection assays (cPass SARS-CoV-2 neutralization antibody detection kit [cPass], Abbott SARS-CoV-2 IgG assay [Abbott Architect], and Standard Q COVID-19 IgM/IgG combo rapid diagnostic test [SD RDT IgM/SD RDT IgG]) among 559 pre-COVID-19 seropositive sera for several parasitic infections. The specificity of assays was 95 to 98% overall. However, lower specificity was observed among sera from patients with protozoan infections of the reticuloendothelial system, such as human African trypanosomiasis (Abbott Architect; 88% [95% CI, 75 to 95]) and visceral leishmaniasis (SD RDT IgG; 80% [95% CI, 30 to 99]), and from patients with recent malaria in areas of Senegal where malaria is holoendemic (ranging from 91% for Abbott Architect and SD RDT IgM to 98 to 99% for cPass and SD RDT IgG). For specimens from patients with evidence of past or present helminth infection overall, test specificity estimates were all ≥96%. Sera collected from patients clinically suspected of parasitic infections that tested negative for these infections yielded a specificity of 98 to 100%. The majority (>85%) of false-positive results were positive by only one assay. The specificity of SARS-CoV-2 serological assays among sera from patients with tissue-borne parasitic infections was below the threshold required for decisions about individual patient care. Specificity is markedly increased by the use of confirmatory testing with a second assay. Finally, the SD RDT IgG proved similarly specific to laboratory-based assays and provides an option in low-resource settings when detection of anti-SARS-CoV-2 IgG is indicated.

    Original languageEnglish
    Article numbere0171721
    JournalJournal of Clinical Microbiology
    Issue number1
    Number of pages12
    Publication statusPublished - 2022


    • Animals
    • Antibodies, Viral
    • COVID-19
    • Helminths
    • Humans
    • Immunoglobulin M
    • Parasitic Diseases
    • SARS-CoV-2
    • Sensitivity and Specificity
    • Serologic Tests


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