Antibody responses to SARS-CoV-2 in COVID-19 patients: the perspective application of serological tests in clinical practice


Quan-xin Long, Hai-jun Deng, Juan Chen, Jieli Hu, Bei-zhong Liu, Pu Liao, Yong Lin, Li-hua Yu, Zhan Mo, Yin-yin Xu, Fang Gong, Gui-cheng Wu, Xian-xiang Zhang, Yao-kai Chen, Zhi-jie Li, Kun Wang, Xiao-li Zhang, Wen-guang Tian, Chang-chun Niu, Qing-jun Yang, Jiang-lin Xiang, Hong-xin Du, Hua-wen Liu, Chunhui Lang, Xiao-he Luo, Shao-bo Wu, Xiao-ping Cui, Zheng Zhou, Jing Wang, Cheng-jun Xue, Xiao-feng Li, Li Wang, Xiao-jun Tang, Yong Zhang, Jing-fu Qiu, Xia-mao Liu, Jin-jing Li, De-chun Zhang, Fan Zhang, Xue-fei Cai, Deqiang Wang, Yuan Hu, Ji-hua Ren, Ni Tang, Ping Liu, Qin Li, Ai-long Huang


We aim to investigate the profile of acute antibody response in COVID-19 patients, and provide proposals for the usage of antibody test in clinical practice.


A multi-center cross-section study (285 patients) and a single-center follow-up study (63 patients) were performed to investigate the feature of acute antibody response to SARS-CoV-2. A cohort of 52 COVID-19 suspects and 64 close contacts were enrolled to evaluate the potentiality of the antibody test.


The positive rate for IgG reached 100% around 20 days after symptoms onset. The median day of serocon-version for both lgG and IgM was 13 days after symptoms onset. Seroconversion of IgM occurred at the same time, or earlier, or later than that of IgG. IgG levels in 100% patients (19/19) entered a platform within 6 days after seroconversion. The criteria of IgG seroconversion and [≥] 4-fold increase in the IgG titers in sequential samples together diagnosed 82.9% (34/41) of the patients. Antibody test aided to confirm 4 patients with COVID-19 from 52 suspects who failed to be confirmed by RT-PCR and 7 patients from 148 close contacts with negative RT-PCR.


IgM and IgG should be detected simultaneously at the early phase of infection. The serological diagnosis criterion of seroconversion or [≥] 4-fold increase in the IgG titer is suitable for a majority of COVID-19 patients. Serologic test is helpful for the diagnosis of SARS-CoV-2 infection in suspects and close contacts.

Overview of SARS-COV-2 studies seroprevalence in context of the worldwide  COVID-19 pandemie. You can register a study here: Contribute
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