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Comment & Response
March 21, 2022

Serology Test Results and Other Important Characteristics of Patients With Persistent COVID-19 Symptoms—Reply

Author Affiliations
  • 1Université de Paris, INSERM U1266, Institut de Psychiatrie et Neurosciences de Paris, F-75014 Paris, France
  • 2Service de Psychiatrie de l’adulte, AP-HP, Hôpital Hôtel-Dieu, F-75004 Paris, France
  • 3Université de Paris, “Population-based Cohorts Unit”, INSERM, Paris Saclay University, UVSQ, UMS 011, Paris, France
  • 4Université Lille, Centre Hospitalier de Tourcoing, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France
  • 5Sorbonne Université, Inserm, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Département de Santé Publique, Hôpital Saint-Antoine, AP-HP, Paris, France
JAMA Intern Med. 2022;182(5):577-578. doi:10.1001/jamainternmed.2022.0424

In Reply We agree with Dr Re’em and colleagues that serology findings may not be a robust marker of SARS-CoV-2 infection at the individual patient level. Samples with indeterminate results (ie, optical density ratio ≥0.8 and <1.1) were discarded, thereby reducing the risk of false-negative results but not false-positive results. Since the sensitivity and specificity of the test in our study1 were assessed in another setting, we acknowledge that we cannot properly estimate the prevalence of past infection in our study population. However, whatever the prevalence one may assume in our population, participants with positive (vs negative) results would be more likely to have had COVID-19. Serology testing is thus a useful tool to study the correlates of SARS-CoV-2 infection at the population level. This conclusion holds even assuming a sensitivity of 61.2%, encompassing non-seroconversion, antibodies waning, and non-detection as reported by Perez-Saez et al.2 Moreover, introducing the date of serology testing (ie, May or June 2020 [n = 5698] vs after June 2020 [n = 21 125]) in model 2, we found no interaction between serology results and the date of serology testing.

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