The Accuracy of Enzyme-Linked Immunosorbent Assay in the Diagnosis of COVID-19 in Iranian Children

Tarmahi, Vahid; Afghan, Mohammadreza; Raeisi, Sina; Yousefi Nodeh, Hamid Reza; Tamaddon, Mona; Moahamadzadeh, Fatemeh; Mohammadzadeh, Nader; Ebadi, Zakiyeh

doi:10.22038/ijp.2020.54348.4299

The Accuracy of Enzyme-Linked Immunosorbent Assay in the Diagnosis of COVID-19 in Iranian Children

Document Type : original article

Authors

Vahid Tarmahi ¹

Mohammadreza Afghan ¹

Sina Raeisi ¹

Hamid Reza Yousefi Nodeh ¹

Mona Tamaddon ²

Fatemeh Moahamadzadeh ³

Nader Mohammadzadeh ⁴

Zakiyeh Ebadi ¹

¹ Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

² Stem Cell Technology Research Center, Tehran, Iran

³ Department of Laboratory Sciences, Marand Branch, Islamic Azad University, Marand, Iran

⁴ Department of Bacteriology and Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran

10.22038/ijp.2020.54348.4299

Abstract

Background
The present study aimed to evaluate the accuracy of enzyme-linked immunosorbent assay (ELISA) compared to the real-time reverse transcription-polymerase chain reaction (rRT-PCR) in the diagnosis of coronavirus disease 2019 (COVID-19) in Iranian children.
Materials and Methods
In this cross-sectional study, 90 children under 15 years of age were randomly selected from suspects of COVID-19 referred to the Tabriz Children Hospital, the main pediatric COVID-19 diagnostic center of Tabriz, from May 21, 2020 to June 21, 2020. Blood and nasopharyngeal samples were taken simultaneously at the referring time. The diagnostic accuracy of ELISA-based IgM and IgG antibody tests for COVID-19 were compared with the rRT-PCR.
Results
The calculated sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, overall diagnostic accuracy, and diagnostic odds ratio were 0.5745, 0.9767, 0.9643, 0.6774, 24.66, 0.4357, 0.7667, and 56.60 for IgM; and 0.6170, 0.9302, 0.9355, 0.6897, 8.84, 0.4117, 0.7667, and 21.47 for IgG, respectively.
Conclusion
Due to the lower sensitivity of antibody detection-based serological tests compared to rRT-PCR, they cannot be considered as initial and reliable tests for the diagnosis of COVID-19. It can be suggested that the serological tests be only used as complementary tests to rRT-PCR or for monitoring the immune response of children with COVID-19.

Keywords

Children

COVID-19

Diagnosis

Real-time RT-PCR

SARS-CoV-2