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Clinical and Diagnostic Laboratory Immunology, July 2004, p. 699-703, Vol. 11, No. 4
1071-412X/04/$08.00+0     DOI: 10.1128/CDLI.11.4.699-703.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Evaluation and Validation of an Enzyme-Linked Immunosorbent Assay and an Immunochromatographic Test for Serological Diagnosis of Severe Acute Respiratory Syndrome

Ming Guan,1* Kwok Hung Chan,2 J. S. Malik Peiris,2 See Wai Kwan,2 Siu Yan Lam,2 Chiu Mei Pang,2 Ka Wing Chu,2 Kit Man Chan,2 Hsiao Ying Chen,1 Ewe Beng Phuah,1 and Caiqin Jane Wong1

Genelabs Diagnostics Pte Ltd., Singapore, Republic of Singapore,1 Department of Microbiology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, Special Administrative Region, People’s Republic of China2

Received 18 February 2004/ Returned for modification 1 April 2004/ Accepted 20 April 2004

A newly developed severe acute respiratory syndrome (SARS)-specific enzyme-linked immunosorbent assay (ELISA) was further validated to confirm cutoff values and evaluate its diagnostic performance with clinical samples. In parallel, an immunochromatographic test was also evaluated. A total of 227 clinical serum specimens collected from SARS patients were used in the study, together with 385 samples from healthy donors. By use of an immunofluorescent (IF) test as the "gold standard, " both the ELISA and the immunochromatographic test were able to detect immunoglobulin G antibodies to SARS not only from late-convalescent-stage samples (>21 days from the onset of clinical symptoms), as previously established, but also from early-acute-phase samples (1 to 10 days from onset). The ELISA, using an optical density (OD) of 0.25 as its cutoff value, produced the best sensitivity while maintaining high specificity. It detected SARS-specific antibodies in 58, 70, 75, and 95%, respectively, of the four groups of samples collected from patients 1 to 10 days, 11 to 20 days, 21 to 30 days, and more than 30 days after the onset of clinical symptoms. Similarly, the immunochromatographic test detected SARS-specific antibodies in 55, 68, 81, and 79% of the four groups, respectively. The overall specificities for the ELISA and the rapid test were 99.5 and 97.7%, respectively. Although the positive correlation observed between the ELISA OD values and the IF titers was moderate (r = 0.6915; P < 0.001), the detection rates of both the ELISA and the rapid test were found well in agreement with the IF titers.

* Corresponding author. Mailing address: Genelabs Diagnostics Pte Ltd., 85 Science Park Dr. #04-01, Singapore Science Park, Singapore 118259, Republic of Singapore. Phone: (65) 67750008. Fax: (65) 67754536. E-mail: guanming{at}mail.genelabs.com.sg.

Clinical and Diagnostic Laboratory Immunology, July 2004, p. 699-703, Vol. 11, No. 4
1071-412X/04/$08.00+0     DOI: 10.1128/CDLI.11.4.699-703.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.



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