新型冠状病毒实验室诊断技术进展

Advances in the laboratory diagnosis for COVID-19 virus

2019年12月,一种可引起人呼吸道感染的新型冠状病毒(SARS-CoV-2)开始在我国武汉地区感染流行,并在短时间内蔓延至全国及世界其他国家。面对新发传染病,及早发现已感染病毒的携带者或患者对于控制传染源、切断传播途径、保护易感人群至关重要。因此,我国迅速推出了基于实时RT-PCR技术的新型冠状病毒RNA检测技术,病毒核酸检测阳性成为现行新型冠状病毒肺炎(COVID-19)诊疗方案对疑似病例确诊的主要依据。但由于SARS-CoV-2的感染特性,核酸检测的阳性率不足50%。在感染性疾病中,特异性抗体的产生是判断感染发生的重要标准之一,目前基于免疫学检验技术的抗-SARS-CoV-2特异性抗体检测也受到越来越多的重视,并被纳入了最新版诊疗方案中。现回顾COVID-19疫情爆发以来诊断标准的变迁,并在对各种检测方法的优缺点进行概述的基础上,对确诊和患者治愈出院相关标准的制定提出了新的见解。

In December 2019,a new type of coronavirus(SARS-CoV-2)that can cause human respiratory infections began to spread in Wuhan and spread to the whole country,China and other countries in the world within a short period of time. In the face of new infectious diseases,early detection of carriers or patients who have been infected with the virus is essential to control the source of infection,cut off the route of transmission,and protect vulnerable populations. Therefore,China has quickly introduced a new coronavirus RNA detection technology based on real-time fluorescence quantitative PCR(RT-PCR)technology. Positive detection of viral nucleic acids has become the main basis for the diagnosis of suspected cases in the current new coronavirus pneumonia(COVID-19) diagnosis and treatment program. However,due to the infection characteristics of SARS-CoV-2,the positive rate of nucleic acid detection is less than 50%. In infectious diseases,the production of specific antibodies is one of the important criteria for judging the occurrence of infections. At present,the detection of anti-SARS-CoV-2 specific antibodies based on immunological testing technology has also received more and more attention and has been included in the latest version of the diagnosis and treatment strategy. The changes in diagnostic criteria since the outbreak of the COVID-19 epidemic are reviewed. Based on an overview of the advantages and disadvantages of various detection methods,new insights are provided on the formulation of relevant standards for diagnosis and patient discharge.