新型冠状病毒肺炎患者多类型样本SARS-CoV-2核酸检测在临床诊疗中的意义

Clinical Significance of Detection of SARS-CoV-2 Nucleic Acid in Patients with COVID-19

目的探讨不同类型样本新冠核酸检测结果在新型冠状病毒肺炎(COVID-19)临床诊治和疫情防控中的意义。方法选取2020年1月23日~2月22日延安大学附属医院确诊的5例COVID-19患者,采集不同部位标本进行核酸检测,并进行统计学分析。结果采集的123例标本严重急性呼吸综合征冠状病毒2(SARS-CoV-2)核酸检测结果表明,咽拭子25例,阳性率44.0%(11/25);鼻拭子40例,阳性率25.0%(10/40);肛拭子40例,阳性率70.0%(28/40);18例血标本核酸检测均阴性,5例患者符合出院标准时粪便核酸检测均阳性。截止3月5日对5例患者出院后追踪发现,出院2周或更长时间粪便SARS-CoV-2核酸仍阳性。结论多样本新冠核酸检测对于新冠感染患者的确诊有重要价值;患者治愈出院后应加强随访、教育和复查,做好排泄物的管理,有利于巩固疫情防控效果,减少接触感染的发生。

Objective To investigate the significance of the detection results of different types of samples in the clinical diagnosis and treatment of new coronavirus pneumonia(COVID-19)and the prevention and control of epidemic situation.Methods From January 23,2020 to February 22,2020,5 patients with COVID-19 were selected from the Affiliated Hospital of Yan’an University to collect samples from different parts for nucleic acid detection and statistical analysis.Results The results showed that 25 throat swabs were positive in 44.0%(11/25),40 nose swabs were positive in 25.0%(10/40),40 anal swabs were positive in 70.0%(28/40).18 blood samples were negative in nucleic acid test,and 5 patients were positive in fecal nucleic acid test when they met the discharge standard.As of March 5,5 patients were found to be positive for COV-2 nucleic acid in stool for 2 weeks or longer after discharge.Conclusion The detection of different kinds of new crown nucleic acid has important value for the diagnosis of new crown infection.The patients should strengthen follow-up,education and reexamination after cure and discharge,and manage excreta well,which is helpful to consolidate the effect of epidemic prevention and control and reduce the occurrence of contact infection.