The complexities of SARS-CoV-2 serology
Catherine Houlihan, Rupert Beale
Abstract
Diagnosing previous infection with respiratory viruses is challenging. Our understanding of individual and population-level immunity to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains incomplete and developing reliable serological assays to detect previous infection has been an intense focus of the global scientific effort. For public health planning we need scalable assays validated against large banks of samples from individuals who had proven seasonal (non-severe acute respiratory syndrome) coronaviruses and those who had well characterised symptomatic and asymptomatic confirmed SARS-CoV-2 infection. False-positive results, due to cross-reactivity with seasonal coronaviruses, are important to avoid, particularly if seropositive-individuals consider themselves immune. In The Lancet Infectious Diseases, the National SARS-CoV-2 Serology Assay Evaluation Group 1 provide the first large comparative investigation of the performance of four widely available commercial assays and a single in-house assay.