重型/危重型新型冠状病毒肺炎患者多种生物样本核酸检测结果分析

Detection of 2019-nCoV by real-time RT-PCR using multiple biological samples in severe/critically ill patients

目的分析重型/危重型2019冠状病毒病(coronavirus disease 2019,COVID-19)患者多种生物样本核酸检测阳性率,并探讨其临床意义。方法分析武汉大学人民医院东院感染性疾病五病区2020年1月31日-2020年2月19日定点收治的重型/危重型COVID-19确诊病例,比较患者鼻咽拭子、痰液、血液、粪便、肛门拭子的病毒核酸实时荧光逆转录聚合酶链反应检测的阳性率。结果共纳入19例重型/危重型COVID-19病例。治疗两周后复测鼻咽拭子新型冠状病毒(2019-nCoV)核酸检测阳性率42.10%(8/19),痰液2019-nCoV核酸检测阳性率68.42%(13/19),血液2019-nCoV核酸检测阳性率5.26%(1/19),粪便2019-nCoV核酸检测阳性率21.05%(4/19),肛门拭子2019-nCoV核酸检测阳性率10.52%(2/19)。结论重型/危重症COVID-19患者痰液2019-nCoV核酸检测阳性率高于鼻咽拭子,消化道(粪便/肛拭子)亦有病毒核酸检出。重型/危重型COVID-19病例多种生物样本检测能提高2019-nCoV核酸检出率,降低出院病例2019-nCoV假阴性率。

Objective To analyze the positive rates of 2019-nCoV by real-time RT-PCR using various biological samples in severe/critically ill patients,and explore their clinical significance.Methods The confirmed severe/critically ill cases of COVID-19 in the fifth ward of Renmin Hospital of Wuhan University from January 31 to February 19 in 2020 were tested for 2019-nCoV by real-time fluorescence reverse transcriptase polymerase chain reaction.Positive rates of different specimens including nasopharyngeal swabs,sputum,blood,feces and anal swabs were compared.Results A total of 19 severe/critically ill COVID-19 cases were included.After two weeks’treatment,positive rate of 2019-nCoV in the nasopharyngeal swab specimens was 42.10%(8/19),and it was 68.42%(13/19)in the sputum,5.26%(1/19)in the blood,21.05%(4/19)in the feces,10.52%(2/19)in the anal swab.Conclusion Thepositive rate of 2019-nCoV nucleic acid from sputum specimens of severe/critical ill COVID-19 patients is higher than that of nasopharyngeal swabs,blood and fecal/anal swabs.The detection using multiple biological samples can increase the detection rate of 2019-nCoV infection and reduce the false negative rate in discharged cases.