Value and Validity of Coronavirus Antibody Testing

Background: The interventional pain management community saw the COVID-19 pandemicdecimate elective interventional procedures and new patient visits across the United States untilthe reopening of America and the restarting of interventional procedures and elective surgicalprocedures began again. Health care providers, along with essential workers and patients,continue to be concerned about functioning in a safe and responsible manner. Consequently, alevel of comfort is created by the testing health care workers with long exposure to new patientsand patients undergoing interventions in high risk environments.As the United States and the world suffers from an ongoing infodemic, there are substantialamounts of misinformation, and some appropriate information being produced on molecular,antigen and antibody testing. Consequently, this manuscript is undertaken to describe the valueand validity of coronavirus antibody testing.Methods: Literature review.Results: Antibody tests detect antibodies or immunoglobulins that are produced as the humanimmune response to SARS-CoV-2 infection. A positive result suggests that the individual haspotentially been exposed to SARS-CoV-2. When immunoglobulins M (IgM) antibodies are present,they can indicate an active or recent infection, whereas immunoglobulin G (IgG) antibodies showup later in the infection process and can often indicate a past infection, but does not excluderecently infected patients who can still be contagious, especially when IgM antibodies are alsoconcurrently detected. While past knowledge indicates that for viral infections, IgG antibodiesusually persist longer than IgM antibodies and provide immunity from re-infection, it is not clearlyknown if that is true for COVID-19.Limitations: A narrative review with paucity of literature.Conclusion: Antibody tests have been developed to detect IgG only, both IgG and IgM, or totalantibodies. At present, multiple antibody tests are available for use in the United States. In a reviewof 54 available studies through the end of April, mostly from China, the accuracy of pooled resultsfor combination IgG/IgM tests was 91.4% (95% CI, 87.0 - 96.6) for 15 to 21 days post-symptomonset. Thus, antibody tests provide a promise and a peril in the ongoing Covid-19 pandemic.Key words: Corona, COVID-19, antigen testing, antibody testing, IgM antibodies, IgG antibodies