新型冠状病毒核酸检测阴性、特异性IgM及IgG抗体双阳性人群流行病学调查分析

Epidemiological Investigation and Analysis on Population with Negative Nucleic Acid Test Result and Double Positive IgM and IgG Antibodies Specific against Novel Coronavirus

目的调查新型冠状病毒核酸检测阴性、特异性IgM及IgG抗体双阳性人群的流行病学特征。方法选取湖北六七二中西医结合骨科医院2020年3月1-12日收治的新型冠状病毒核酸检测连续2次阴性、血清新型冠状病毒特异性IgM和IgG抗体双阳性患者119例为调查对象,调查内容包括患者的一般情况(性别、年龄)、新型冠状病毒抗体(IgM、IgG)检测结果、临床症状(胸闷、咳嗽、咳痰、发热等)、胸部CT表现(片状阴影、条索状影、纹理增粗等)。结果119例患者中,男61例(51.26%),女58例(48.74%);年龄7~77岁,平均(50.48±13.29)岁,其中55~65岁年龄段占比最高,为35.28%(42/119);IgM抗体阳性109例(91.60%)、阳+10例(8.40%),IgG抗体阳性4例(3.36%)、阳+10例(8.40%)、阳105例(88.24%);临床表现以无症状为主,占94.12%(112/119),无发热患者;胸部CT表现:片状阴影46例(38.66%)、条索状阴影21例(17.65%)、肺纹理增粗12例(10.08%)、正常/恢复40例(33.61%)。结论新型冠状病毒核酸检测阴性、特异性IgM和IgG抗体双阳性患者中男性略多于女性,55~65岁年龄段患者居多,特异性抗体以IgM(阳)和IgG(阳)为主,大多无明显临床症状,胸部CT以吸收后改变多见,但肺部仍有可能存在感染,因此此类特殊患者存在一定概率传染性可能,出院时或出院后均应重点监测。

Objective To investigate the epidemiologic features of population with negative nucleic acid test result and double positive IgM and IgG antibodies specific against novel coronavirus.Methods Totally 119 patients admitted to Hubei 672 Orthopedic Hospital of Integrated Chinese and Western Medicine from March 1 to March 12,2020 for two consecutive negative novel coronavirus nucleic acid tests and double positive novel coronavirus-specific IgM and IgG antibodies were selected as the subjects.The general conditions(gender and age),novel coronavirus-specific antibodies(IgM and IgG),clinical symptoms(chest tightness,cough,sputum expectoration,fever,etc.),and chest CT findings(patchy shadow,strip-shaped shadow,texture enlargement,etc.)were observed in all the patients.Results Among the 119 patients,61 were males(51.26%)and 58 were females(48.74%),with an average age of(50.48±13.29)years(range,7 to 77 years old).The proportion of those aged 55-65 years was the highest among these patients(35.28%,42/119).The IgM antibody was positive in 109 patients(91.60%)and positive+in 10 patients(8.40%).The IgG antibody was positive in 4 patients(3.36%),positive+in 10 patients(8.40%),and positivein 104 patients(88.24%).One hundred and twelve patients(94.12%,112/119)remained asymptomatic,and no patients had fever.Chest CT showed patchy shadow in 46 cases(38.66%),strip-shaped shadow in 21 cases(17.65%),texture enlargement in 12 cases(10.08%),and normal/recovery in 40 cases(33.61%).Conclusion The incidence of COVID-19 negative for nucleic acid test and double positive for IgM and IgG antibodies in males was higher than that in females,and most of the patients were 55-65 years old.The specific antibodies were mainly IgM positive and IgG positive,and most patients had no obvious clinical symptoms.Changes after absorption were common chest CT manifestations,but there might still be infections in the lungs.Therefore,there is a certain probability that such special patients may be contagious,and monitoring should be emphasized at or after hospital discharge.