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Antibody testing for coronavirus disease 2019: not ready for prime time

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2655 (Published 03 July 2020) Cite this as: BMJ 2020;370:m2655

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Re: Antibody testing for coronavirus disease 2019: not ready for prime time

Dear Editor

In their editorial “Antibody testing for coronavirus disease 2019: not ready for prime time” [1] Duong et al claim that our Cochrane review of antibody tests [2] concludes:

“serologic assays for SARS-CoV-2 antibodies, especially point-of-care tests, are not ready for widespread use by clinicians, the general public, or policy makers.”

This is a misrepresentation of the conclusions of our review. At no point in are these statements made.

The conclusions (from our lay summary) states: “The review shows that antibody tests could have a useful role in detecting if someone has had COVID‐19, but the timing of when the tests are used is important. Antibody tests may help to confirm COVID‐19 infection in people who have had symptoms for more than two weeks and do not have a RT‐PCR test, or have negative RT‐PCR test results. The tests are better at detecting COVID‐19 in people two or more weeks after their symptoms started, but we do not know how well they work more than five weeks after symptoms started. We do not know how well the tests work for people who have milder disease or no symptoms, because the studies in the review were mainly done in people who were in hospital. In time, we will learn whether having previously had COVID‐19 provides individuals with immunity to future infection.”

We carefully did not draw any conclusions concerning differences between test technologies due to the degree of confounding in comparisons of test technologies with time from onset of symptoms.

We would appreciate the authors and journal taking note of this error and correcting the editorial.

Yours

Jon Deeks

[1] Duong YT, Wright CG, Justman J. Antibody testing for coronavirus disease 2019: not ready for prime time. BMJ 2020;370:m2655

[2] Deeks JJ, Dinnes J, Takwoingi Y, et al., Cochrane COVID-19 Diagnostic Test Accuracy Group. Antibody tests for identification of current and past infection with SARS-CoV-2. Cochrane Database Syst Rev2020;6:CD013652. doi:10.1002/14651858.CD013652. pmid:32584464

Competing interests: No competing interests

05 July 2020
Jonathan Deeks
Professor of Biostatistics
University of Birmingham
Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK