Serological assays for emerging coronaviruses: challenges and pitfalls

Area of Science:

• Virology
• Immunology
• Public Health

Background:

• The emergence of novel coronaviruses, such as Middle East respiratory syndrome (MERS)-CoV, necessitates rapid diagnostic tools.
• Serological assays are vital for detecting past infections and understanding virus spread, complementing nucleic acid detection methods.
• Previous experience with severe acute respiratory syndrome (SARS)-CoV highlighted challenges in serological diagnostics, including cross-reactivity.

Purpose of the Study:

• To review the performance of serological assays used during the SARS-CoV outbreak.
• To evaluate the utility of spike and nucleocapsid proteins as antigens in SARS-CoV serological tests.
• To identify challenges and potential pitfalls in diagnosing novel coronaviruses like MERS-CoV using serological methods.

Main Methods:

• Review of serological diagnostic assays developed during the SARS-CoV epidemic.
• Analysis of antigen applicability (spike and nucleocapsid proteins).
• Examination of cross-reactivity issues and animal serum testing.

Main Results:

• Various serological assays for SARS-CoV demonstrated high sensitivity and specificity.
• Cross-reactivity with common cold-associated coronaviruses was a significant issue.
• Challenges exist in identifying viral reservoirs through animal serum testing.

Conclusions:

• Acknowledging past SARS-CoV diagnostic challenges is essential for MERS-CoV preparedness.
• Improvements in serological testing schemes and antigen selection are needed for novel coronaviruses.
• Enhanced strategies are required for accurate serological diagnosis and outbreak containment.