JCI Insight. 2020 May 21;5(10):137662. doi: 10.1172/jci.insight.137662.
BACKGROUNDThe severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a novel viral pneumonia (COVID-19), which is rapidly spreading throughout the world. The positive result of nucleic acid test is a golden criterion to confirm SARS-CoV-2 infection, but the detection features remain unclear.METHODSWe performed a retrospective analysis in 5630 high-risk individuals receiving SARS-CoV-2 nucleic acid tests in Wuhan, China, and investigated their characteristics and diagnosis rates.RESULTSThe overall diagnosis rate was 34.7% (1952/5630). Male (P = 0.025) and older populations (P = 2.525 × 10-39) were at significantly higher risk of SARS-CoV-2 infection. People were generally susceptible, and most cases concentrated in people of 30-79 years. Furthermore, we investigated the association between diagnosis rate and the amount of testing in 501 subjects. Results revealed a 1.27-fold improvement (from 27.9% to 35.5%) of diagnosis rate from testing once to twice (P = 5.847 × 10-9) and a 1.43-fold improvement (from 27.9% to 39.9%) from testing once to 3 times (P = 7.797 × 10-14). More than 3 testing administrations was not helpful for further improvement. However, this improvement was not observed in subjects with pneumonia (P = 0.097).CONCLUSIONAll populations are susceptible to SARS-CoV-2 infection, and male and older-aged populations are at significantly higher risk. Increasing the amount of testing could significantly improve diagnosis rates, except for subjects with pneumonia. It is recommended to test twice in those high-risk individuals whose results are negative the first time, and performing 3 tests is better, if possible.FUNDINGThis work was supported by National Mega Project on Major Infectious Disease Prevention (no. 2017ZX10103005-007) and National Key Research and Development Program of China (no. 2018YFE0204500).
严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)引起了一种新型病毒性肺炎(COVID-19),该病毒正在迅速在全球范围内传播。核酸检测阳性结果是确认 SARS-CoV-2 感染的金标准,但检测特征仍不清楚。
我们对在中国武汉接受 SARS-CoV-2 核酸检测的 5630 名高危人群进行了回顾性分析,并调查了他们的特征和诊断率。
总体诊断率为 34.7%(1952/5630)。男性(P = 0.025)和年龄较大的人群(P = 2.525×10-39)感染 SARS-CoV-2 的风险显著更高。人群普遍易感,大多数病例集中在 30-79 岁的人群。此外,我们调查了 501 名受试者中诊断率与检测量之间的关系。结果表明,从检测一次到两次,诊断率提高了 1.27 倍(从 27.9%提高到 35.5%)(P = 5.847×10-9),从检测一次到三次,诊断率提高了 1.43 倍(从 27.9%提高到 39.9%)(P = 7.797×10-14)。进行超过 3 次检测并不能进一步提高诊断率。然而,在患有肺炎的受试者中未观察到这种改善(P = 0.097)。
所有人群均易感染 SARS-CoV-2,男性和年龄较大的人群感染风险显著更高。增加检测量可以显著提高诊断率,但肺炎患者除外。建议对第一次检测结果为阴性的高危人群进行两次检测,如果可能的话,进行 3 次检测更好。
本工作得到国家重大传染病防治科技重大专项(编号:2017ZX10103005-007)和国家重点研发计划(编号:2018YFE0204500)的支持。