2019新型冠状病毒特异性抗体假阳性患者的临床分析

Clinical analysis for patients with false positive results of novel 2019 coronavirus specific antibodyies detection

目的:分析严重急性呼吸综合征冠状病毒2(SARS-CoV-2)特异性IgM和/或IgG抗体检测假阳性患者的临床特点。方法:回顾性分析2020年1月20日至2020年12月31日,在首都医科大学北京安贞医院就诊的SARS-CoV-2特异性IgM和/或IgG抗体检测假阳性患者的临床资料,并将其纳入假阳性组;选择同期就诊于我院发热门诊经北京市疾病预防控制中心(CDC)复核后确诊的患者纳入新型冠状病毒肺炎(COVID-19)确诊组,并将同期就诊于我院体检中心体检且SARS-CoV-2特异性IgM和/或IgG抗体阴性的健康者纳入健康对照组。比较三组在临床表现及实验室检查方面之间的差异。结果:共入组符合条件的假阳性组患者43例,确诊组6例,健康对照组23例。确诊组有发热、肌痛、乏力及咳嗽、咳痰表现的患者比例均高于假阳性组,差异有统计学意义(均P<0.05);确诊组患者存在胸部影像异常的比例显著高于假阳性组,差异有统计学意义(P<0.001);假阳性组与确诊组的NLR及CRP水平均高于健康对照组,而LCR水平均低于健康对照组,差异有统计学意义(均P<0.05),但假阳性组与确诊组之间上述指标水平,差异无统计学意义(均P>0.05)。结论:SARS-CoV-2特异性IgM和/或IgG抗体检测假阳性患者发热、肌痛、乏力、咳嗽、咳痰症状及胸部影像异常少见,LCR水平均低于健康对照组,而CRP及NLR水平显著高于健康对照组。

Objective:To analyze the clinical characteristics of patients with false positive result of SARS-CoV-2 specific IgM and/or IgG antibodies.Methods:Retrospective-designed analysis of patients hospitalized with false positive result of severe acute respiratory syndrome corona virus 2(SARS-CoV-2)specific IgM and/or IgG antibodies detection in Beijing Anzhen Hospital from January 20,2020 to December 31,2020.These patients were included in the false positive group.Patients diagnosed with COVID-19 in the fever clinic of our hospital during the same period and rechecked by Beijing center for disease control and prevention(CDC)were included in the corona virus disease 2019(COVID-19)confirmed group,and healthy persons who were checked in the physical examination center of our hospital during the same period and negative for SARS-CoV-2-specific IgM and/or IgG antibodies were included in the healthy control group.Clinical manifestations and laboratory examinations were compared between the three groups.Results:A total of 43 patients were included in the false positive group,6 in the COVID-19 confirmed group and 23 in the healthy control group.The proportion of patients with fever,myalgia,fatigue,cough and expectoration in the confirmed group was higher than that in the false positive group,with statistical significance(all P<0.05).The proportion of chest imaging abnormalities in the confirmed group was significantly higher than that in the false positive group,and the difference was statistically significant(P<0.001).The levels of NLR and CRP in both the false positive group and the confirmed group were higher than those in the healthy control group,while the levels of LCR were lower than those in the healthy control group,and the differences were statistically significant(all P<0.05).But there was no statistically significant difference in the levels of the above indicators between the false positive group and the confirmed group(all P>0.05).Conclusions:Fever,myalgia,fatigue,cough,sputum symptoms and chest imaging abnormalities were rare in patients with false positive SARS-CoV-2 specific IgM and/or IgG antibody detection.LCR levels were lower than those in healthy control group,while CRP and NLR levels were significantly higher than those in healthy control group.