新型冠状病毒IgM/IgG抗体在病程监测中的临床意义

Clinical significance of SARS-CoV-2 IgM/IgG antibodies in monitoring of COVID-19

目的评价新型冠状病毒(SARS-CoV-2)IgM/IgG抗体检测(化学发光法)在新型冠状病毒肺炎(COVID-19)病程监测和转归方面的临床意义。方法回顾性研究。收集2020年1月20日至2020年3月1日在天津市疾病预防控制中心核酸检测阳性的COVID-19确诊患者88例(115例血清样本)作为疾病组,排除COVID-19(核酸检测阴性)的其他疾病患者245例(245例血清样本)作为对照组。用化学发光法检测SARS-CoV-2 IgM和IgG抗体。结果SARS-CoV-2 IgM抗体检测的敏感性、特异性分别为90.91%、100%;SARS-CoV-2 IgG抗体检测的敏感性、特异性分别为88.64%、100%;IgM和IgG抗体联合检测敏感性显著提高至96.59%,特异性为100%,与核酸检测的总符合率高达99.10%。SARS-CoV-2 IgM抗体水平在COVID-19病程中呈现先升高后降低的趋势,IgG抗体水平随着病程的进展逐渐升高。结论SARS-CoV-2 IgM和IgG抗体化学发光法联合检测敏感性高,可作为COVID-19一种有效的辅助诊断,在病程监测和转归方面有一定的意义。

Objective To evaluate the diagnostic value of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)IgM/IgG antibodies(chemiluminescence assay)in monitoring the prognosis of Corona Virus Disease 2019(COVID-19).Methods A retrospective study was performed.A total of 88 patients(115 serum samples)diagnosed as COVID-19 at Tianjin Center for Disease Control and Prevention from January 20,2020 to March 1,2020 were divided into disease group and 245 cases(245 serum samples)of the patients with other diseases excluding COVID-19(negative nucleic acid test)were used as control group.SARS-CoV-2 IgM/IgG antibodies was detected by chemiluminescence immunoassay.Results The sensitivity and specificity of SARS-CoV-2 IgM antibody detection were 90.91%and 100%and those of IgG antibody were 88.64%and 100%,respectively.The sensitivity of combined detection for IgM and IgG antibodies significantly improved the sensitivity to 96.59%and the specificity of 100%.The total coincidence rate of the detection IgM/IgG with nucleic acid detection was as high as 99.10%.The level of SARS-CoV-2 IgM antibody showed an increased trend firstly and then decreased during the course of COVID-19,but the level of IgG antibody increased gradually with the progression of the disease.Conclusion The simultaneous detection of SARS-CoV-2 IgM and IgG antibody with chemiluminescence method displayed high sensitivity,so it could be used as an effective helpful diagnostic method of COVID-19 for monitoring prognosis of the disease.