Manufacturer Signal-to-Cutoff Threshold Underestimates Cumulative Incidence of SARS-CoV-2 Infection: Evidence from the Los Angeles Firefighters Study

  1. Omar Toubat
  2. Anders H. Berg
  3. Kimia Sobhani
  4. Karen Mulligan
  5. Acacia M. Hori
  6. Jay Bhattacharya
  7. Neeraj Sood
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Abstract

While SARS-CoV-2 serologic testing is used to measure cumulative incidence of COVID-19, appropriate signal-to-cut off (S/Co) thresholds remain unclear. We demonstrate S/Co thresholds based on known negative samples significantly increases seropositivity and more accurately estimates cumulative incidence of disease compared to manufacturer-based thresholds.

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