昆明地区COVID-19患者多种生物样本的病毒核酸检测结果

The Detection Results of Viral Nucleic Acid in Various Biological Samples of Patients with COVID-19 in Kunming

目的通过国产2019-nCoV(新型冠状病毒)核酸测定试剂,测定确诊的COVID-19(新型冠状病毒肺炎)患者的多种生物样本内SARS-CoV-2核酸的携病毒情况,对机体不同系统中SARS-CoV-2的状态展开观察,并分析其临床价值,为诊断和治疗提供参考。方法收集昆明市第三人民医院53例确诊的新型冠状病毒肺(COVID-19)患者的鼻拭子、咽拭子、痰液、粪便和尿液样本,实时荧光逆转录聚合酶链反应(RT-PCR)测定法,来平行测定病毒ORF1ab基因与N基因核酸,比较不同类型样本的阳性率和一致性。结果患者的多种生物标本核酸Ct值的变化与病程都高度相关,发病15 d前后来分析核酸检测结果,发现在发病15 d后病毒核酸Ct值与15 d内相比病毒核酸载量,差异有统计学意义(P<0.05)。在发病第1~7天和8~14 d,鼻拭子阳性检出率为88.67%(47/53)和79.24%(42/53),而咽拭子阳性检出率为73.58%(39/53)和53.85%(28/52)。粪便样本核酸检测阳性率12.28%(7/57),尿液样本均未检测出病毒核酸。结论在新冠肺炎患者发病的不同阶段,鼻拭子、咽拭子、痰液样本有较高的核酸检出率;在阳性检出率方面,鼻拭子相较咽拭子偏高;SARS-CoV-2有粪-口传播可能,同时病毒液可能会潜在感染消化道。

Objective To detect the viral status of SARS-CoV-2 nucleic acid in various biological samples of patients diagnosed with New Coronavirus pneumonia(COVID-19)by using the nucleic acid reagents of New Coronavirus(2019-nCoV).The status and clinical significance of SARS-CoV-2 in different body systems were observed,providing reference for diagnosis and treatment.Methods The nasal swabs,throat swabs,sputum,feces and urine samples of 53 patients diagnosed with New Coronavirus lung(COVID-19)in Kunming Third People’s Hospital were collected.Real-time fluorescence reverse transcription polymerase chain reaction(RT-PCR)was used to detect the ORF1 ab gene and N gene nucleic acid in parallel.The positive rates and consistency of different samples were compared.Results The results showed that the changes of CT value of nasal swab,pharyngeal swab,sputum sample and fecal sample were highly correlated with the course of disease.The analysis of nucleic acid detection results 15 days before and after the onset showed that the difference of CT value of viral nucleic acid 15 days after the onset was statistically significant compared with that within 15 days(P<0.05).The positive rate of nasal swab was 88.67%(47/53)and 79.24%(42/53),while that of pharyngeal swab was 73.58%(39/53)and 53.85%(28/52).The positive rate of nucleic acid detection in stool samples was 12.28%(7/57),and no viral nucleic acid was detected in urine samples.Conclusion In novel coronavirus pneumonia patients at different stages of onset,nasal swabs,throat swabs and sputum samples show higher nucleic acid detection rates.The positive rate of nasal swab is higher than that of pharyngeal swab.SARS-Co V-2 has the possibility of fecal oral transmission,and the digestive tract may be the potential target organ of virus infection.