SARS-CoV-2 antibody responses do not predict COVID-19 disease severity

William S. Phipps, Jeffrey A. SoRelle, Quan-zhen Li, Lenin Mahimainathan, Ellen Araj, John Markantonis, Chantale Lacelle, Jyoti Balani, Hiren Parikh, E. Blair Solow, David R. Karp, Ravi Sarode, Alagarraju Muthukumar

Research output: Contribution to journalArticlepeer-review

48 Scopus citations


Objectives: Initial reports indicate adequate performance of some serology-based severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) assays. However, additional studies are required to facilitate interpretation of results, including how antibody levels impact immunity and disease course. Methods: A total of 967 subjects were tested for IgG antibodies reactive to SARS-CoV-2, including 172 suspected cases of SARS-CoV-2, 656 plasma samples from healthy donors, 49 sera from patients with rheumatic disease, and 90 specimens from individuals positive for polymerase chain reaction (PCR)–based respiratory viral panel. A subgroup of SARS-CoV-2 PCR-positive cases was tested for IgM antibodies by proteome array method. Results: All specificity and cross-reactivity specimens were negative for SARS-CoV-2 IgG antibodies (0/795, 0%). Positive agreement of IgG with PCR was 83% of samples confirmed to be more than 14 days from symptom onset, with less than 100% sensitivity attributable to a case with severe immunosuppression. Virus-specific IgM was positive in a higher proportion of cases less than 3 days from symptom onset. No association was observed between mild and severe disease course with respect to IgG and IgM levels. Conclusions: The studied SARS-CoV-2 IgG assay had 100% specificity and no adverse cross-reactivity. Measures of IgG and IgM antibodies did not predict disease severity in our patient population.

Original languageEnglish (US)
Pages (from-to)459-465
Number of pages7
JournalAmerican journal of clinical pathology
Issue number4
StatePublished - Jun 27 2020


  • COVID-19
  • Coronavirus
  • Global health
  • Immunology
  • Microbiology
  • SARS-cov-2

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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