比较 353 例同时接受两种标本检测的患者的鼻咽拭子和口咽拭子在 SARS-CoV-2 检测中的应用。
Comparison of nasopharyngeal and oropharyngeal swabs for SARS-CoV-2 detection in 353 patients received tests with both specimens simultaneously.
机构信息
Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Infection Control, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
出版信息
Int J Infect Dis. 2020 May;94:107-109. doi: 10.1016/j.ijid.2020.04.023. Epub 2020 Apr 18.
BACKGROUND
Since the outbreak of coronavirus disease (COVID-19) in Wuhan in December 2019, by March 10, 2020, a total of 80,932 confirmed cases have been reported in China. Two consecutively negative RT-PCR test results in respiratory tract specimens is required for the evaluation of discharge from hospital, and oropharyngeal swabs were the most common sample. However, false negative results occurred in the late stage of hospitalization, and avoiding false negative result is critical essential.
METHODS
We reviewed the medical record of 353 patients who received tests with both specimens simultaneously, and compared the performance between nasopharyngeal and oropharyngeal swabs.
RESULTS
Of the 353 patients (outpatients, 192; inpatients, 161) studied, the median age was 54 years, and 177 (50.1%) were women. Higher positive rate (positive tests/total tests) was observed in nasopharyngeal swabs than oropharyngeal swabs, especially in inpatients. Nasopharyngeal swabs from inpatients showed higher positive rate than outpatients. Nasopharyngeal swabs from male showed higher positive rate than female, especially in outpatients. Detection with both specimens slightly increased the positive rate than nasopharyngeal swab only. Moreover, the consistency between from nasopharyngeal and oropharyngeal swabs were poor (Kappa=0.308).
CONCLUSION
In conclusion, our study suggests that nasopharyngeal swabs may be more suitable than oropharyngeal swab at this stage of COVID-19 outbreak.
背景
自 2019 年 12 月武汉爆发冠状病毒病（COVID-19）以来，截至 2020 年 3 月 10 日，中国已报告确诊病例 80932 例。两次连续呼吸道标本 RT-PCR 检测阴性结果是出院评估的要求，最常用的样本是咽拭子。然而，在住院后期出现了假阴性结果，避免假阴性结果至关重要。
方法
我们回顾了同时接受两种标本检测的 353 例患者的病历，并比较了鼻咽拭子和口咽拭子的检测性能。
结果
在 353 例患者（门诊 192 例，住院 161 例）中，中位年龄为 54 岁，女性 177 例（50.1%）。鼻咽拭子的阳性率（阳性检测/总检测）高于口咽拭子，尤其是住院患者。住院患者的鼻咽拭子阳性率高于门诊患者。男性的鼻咽拭子阳性率高于女性，尤其是门诊患者。同时使用两种标本检测的阳性率略高于仅使用鼻咽拭子检测。此外，鼻咽拭子和口咽拭子之间的一致性较差（Kappa=0.308）。
结论
总之，本研究表明，在 COVID-19 疫情现阶段，鼻咽拭子可能比口咽拭子更适用。
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