Department of Laboratory Medicine, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
Department of Neurology, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
Emerg Microbes Infect. 2020 Dec;9(1):1233-1237. doi: 10.1080/22221751.2020.1771219.
Real-time reverse transcriptase-polymerase chain reaction (RT-PCR) assay on anal swabs was recently reported to be persistently positive even after throat testing was negative during severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, data about the consistent performance of RT-PCR assay on throat and anal swabs remain limited in paediatric patients. Here, we retrospectively reviewed RT-PCR-testing results of 212 paediatric patients with suspected SARS-CoV-2 infection at Wuhan Children's Hospital. The diagnostic potential of these two types of specimens showed significant difference (positive rate: 78.2% on throat swabs vs. 52.6% on anal swabs, McNemar Test = 0.0091) and exhibited a weak positive consistency (Kappa value was 0.311, < 0.0001) in paediatric patients. Furthermore, viral loads detected on both throat and anal swabs also showed no significant difference ( = 0.9511) and correlation (Pearson = 0.0434, = 0.8406), and exhibited an inconsistent kinetic change through the course of SARS-CoV-2 infection. Besides, viral loads in the throat and anal swabs were correlated with different types of immune states, immune-reactive phase, and the resolution phase/immunologic tolerance, respectively. These findings revealed that RT-PCR-testing on throat and anal swabs showed significant difference for monitoring SARS-CoV-2 infection and correlated with different immune state in paediatric patients.
实时逆转录-聚合酶链反应（RT-PCR）检测分析肛拭子样本，在严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染期间，即使咽拭子检测结果为阴性，肛拭子 RT-PCR 检测结果仍持续呈阳性。然而，在儿科患者中，关于咽拭子和肛拭子 RT-PCR 检测结果一致性的相关数据仍然有限。在此，我们回顾性分析了 212 例武汉儿童医院疑似 SARS-CoV-2 感染的儿科患者的 RT-PCR 检测结果。两种类型标本的诊断潜力有显著差异（咽拭子标本阳性率：78.2% vs. 肛拭子标本阳性率：52.6%，McNemar 检验 = 0.0091），在儿科患者中表现出较弱的阳性一致性（Kappa 值为 0.311，<0.0001）。此外，在咽拭子和肛拭子上检测到的病毒载量也无显著差异（ = 0.9511）和相关性（Pearson = 0.0434， = 0.8406），且在 SARS-CoV-2 感染过程中表现出不一致的动力学变化。此外，咽拭子和肛拭子中的病毒载量与不同类型的免疫状态、免疫反应期和缓解期/免疫耐受期分别相关。这些研究结果表明，RT-PCR 检测咽拭子和肛拭子对监测 SARS-CoV-2 感染具有显著差异，并与儿科患者的不同免疫状态相关。
