新型冠状病毒肺炎检测的合理应用。
The Appropriate Use of Testing for COVID-19.
机构信息
Kendall Regional Medical Center, Department of Emergency Medicine, Miami, Florida; Nova Southeastern University, Dr. Kiran C. Patel College of Allopathic Medicine, Davie, Florida.
出版信息
West J Emerg Med. 2020 Apr 13;21(3):470-472. doi: 10.5811/westjem.2020.4.47370.
Abstract
Many public officials are calling for increased testing for the 2019 novel coronavirus disease (COVID-19), and some governments have taken extraordinary measures to increase the availability of testing. However, little has been published about the sensitivity and specificity of the reverse transcriptase-polymerase chain reaction (RT-PCR) nasopharyngeal swabs that are commonly used for testing. This narrative review evaluates the literature regarding the accuracy of these tests, and makes recommendations based on this literature. In brief, a negative RT-PCR nasopharyngeal swab test is insufficient to rule out COVID-19. Thus, over-reliance on the results of the test may be dangerous, and the push for widespread testing may be overstated.
摘要
许多政府官员呼吁增加对 2019 年新型冠状病毒病（COVID-19）的检测，一些政府已经采取了非凡的措施来增加检测的可用性。然而，对于通常用于检测的逆转录-聚合酶链反应（RT-PCR）鼻咽拭子的敏感性和特异性，发表的内容很少。本叙述性综述评估了有关这些测试准确性的文献，并根据这些文献提出了建议。简而言之，阴性 RT-PCR 鼻咽拭子检测不足以排除 COVID-19。因此，过度依赖检测结果可能是危险的，而广泛检测的推动可能被夸大了。
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2
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JAMA. 2020 Apr 21;323(15):1488-1494. doi: 10.1001/jama.2020.3204.
3
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Int J Infect Dis. 2020 Apr;93:264-267. doi: 10.1016/j.ijid.2020.02.050. Epub 2020 Feb 27.
4
Clinical Characteristics of Imported Cases of Coronavirus Disease 2019 (COVID-19) in Jiangsu Province: A Multicenter Descriptive Study.江苏省输入性新型冠状病毒肺炎（COVID-19）病例的临床特征：一项多中心描述性研究。
Clin Infect Dis. 2020 Jul 28;71(15):706-712. doi: 10.1093/cid/ciaa199.
5
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6
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Radiology. 2020 Aug;296(2):E115-E117. doi: 10.1148/radiol.2020200432. Epub 2020 Feb 19.
7
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8
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Euro Surveill. 2020 Jan;25(3). doi: 10.2807/1560-7917.ES.2020.25.3.2000045.
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