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严重急性呼吸综合征冠状病毒2型感染的病毒学诊断。

SARS-CoV-2 infection virological diagnosis.

作者信息

Thabet Lamia, Mhalla Salma, Naija Habiba, Jaoua Mohamed Amine, Hannachi Naila, Fki-Berrajah Lamia, Toumi Adnene, Karray-Hakim Héla

出版信息

Tunis Med. 2020 Apr;98(4):304-308.

Abstract

SARS-CoV-2 infection has to be confirmed by virological diagnosis. Multiple diagnostic tests are available without enough perspective on their reliability. Therefore, it is important to choose the most suitable test according to its sensitivity and specificity but also to the stage of the disease. Currently, the RT-PCR detection of the viral genome in respiratory samples is the most reliable test to confirm the diagnosis of an acute SARS-CoV-2 infection. It has to be done in Class II biological safety laboratory. However, it may lack sensitivity, particularly in the advanced phase of infection, and depends closely on the samples' quality. Rapid PCR by cartridge system reduces response times but is not suitable for laboratories with high throughput of requests. Detection of virus antigens on respiratory samples is a quick and easy to use technique; however it has not good specificity and sensitivity and cannot be used for diagnosis and patient management. The detection of specific antibodies against SARS-CoV-2 is better used for epidemiological analyses. Research should be encouraged to overcome the limits of the currently available diagnostic tests.

摘要

2019冠状病毒病感染必须通过病毒学诊断来确认。目前有多种诊断测试方法,但对其可靠性缺乏足够的了解。因此,根据测试的敏感性、特异性以及疾病阶段选择最合适的测试方法很重要。目前,呼吸道样本中病毒基因组的逆转录聚合酶链反应(RT-PCR)检测是确诊急性2019冠状病毒病感染最可靠的测试方法。该检测必须在二级生物安全实验室进行。然而,它可能缺乏敏感性,尤其是在感染后期,并且密切依赖于样本质量。采用试剂盒系统的快速PCR可缩短反应时间,但不适合检测需求高的实验室。呼吸道样本中病毒抗原的检测是一种快速且易于使用的技术;然而,它的特异性和敏感性不佳,不能用于诊断和患者管理。针对2019冠状病毒病的特异性抗体检测更适合用于流行病学分析。应鼓励开展研究以克服现有诊断测试的局限性。

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