Experts worry about false COVID-19 antibody test results

False positive results from COVID-19 antibody testing are cause for concern, researchers argue.

As stay-at-home orders lift around the country and public life begins to return, health experts continue to emphasize the importance of testing for COVID-19 to prevent a second—and potentially worse—wave of infections.

There are two kinds of COVID-19 tests, both critical to controlling the pandemic. Molecular diagnostic tests, first developed in January, detect parts of the COVID-19-causing virus on swabs from people’s noses or throats. These tests can identify people with active infections, even when they have no symptoms.

Widespread and rapid diagnostic testing can quickly identify people with the virus, who can then be isolated, and anyone that came in contact with them can be quarantined and tested as well. Such surveillance and isolation measures can prevent a few cases from mushrooming into an outbreak.

Antibody, or serology, tests became available in April. They detect antibodies the body produces in response to the virus in a blood sample. A positive test indicates that a person became infected at some time in the past.

In a new paper in the journal Clinical Chemistry, Neil Anderson, an assistant professor of pathology and immunology at Washington University School of Medicine in St. Louis and the assistant medical director of the Clinical Microbiology Laboratory at Barnes-Jewish Hospital, and Christopher Farnsworth, an instructor of pathology and immunology at the School of Medicine, emphasize the importance of the appropriate use of antibody tests.

Here, they discuss how these tests should—and should not—be used:

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