Potential false-positive reasons for SARS-CoV-2 antibody testing and its solution

Area of Science:

• Clinical diagnostics
• Immunology
• Infectious disease

Background:

• Coronavirus disease 2019 (COVID-19) significantly impacts global health and economies.
• Accurate diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is crucial for controlling the pandemic.
• SARS-CoV-2 antibody detection is a key diagnostic criterion, but prone to false positives.

Purpose of the Study:

• To summarize and elucidate the causes of false-positive SARS-CoV-2 antibody detection in clinical practice.
• To provide insights into factors that can lead to inaccurate diagnostic results.

Main Methods:

• Literature review and summary of reported causes for false-positive SARS-CoV-2 antibody tests.
• Categorization of interferences into endogenous and exogenous factors.

Main Results:

• Common endogenous interferences include rheumatoid factor, heterophile antibodies, human anti-animal antibodies, lysozyme, complement, and cross-antigens.
• Exogenous interferences primarily involve specimen issues like incomplete coagulation or contamination, and inadequate diagnostic kit optimization.

Conclusions:

• Understanding these interference factors is essential for improving the reliability of SARS-CoV-2 antibody testing.
• Minimizing false positives will enhance clinical diagnosis accuracy and aid in effective epidemic control.