Zhang Haixia, Chen Meiling, Zhang Yanhua, Wen Jing, Wang Yajie, Wang Liming, Guo Jinjin, Liu Chen, Li Daijing, Wang Ying, Bai Jing, Gao Guiju, Wang Sa, Yang Di, Yu Fengting, Yan Liting, Wan Gang, Zhang Fujie
The Nursing Department, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
The Medical Statistic Department, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
Open Forum Infect Dis. 2020 Aug 26;7(10):ofaa379. doi: 10.1093/ofid/ofaa379. eCollection 2020 Oct.
Few studies have compared the yield of reverse transcription polymerase chain reaction (RT-PCR) assays in nasopharyngeal swabs, oropharyngeal swabs, and sputum for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection.
We conducted an observational study in Beijing Ditan Hospital, China. Specimens including nasopharyngeal swabs, oropharyngeal swabs, and sputum from confirmed coronavirus 2019 patients were collected for RT-PCR testing. Disease duration was calculated from the date of symptom onset to the date of specimen collection and divided into 3 groups: ≤14 days, 14-21 days, and >21 days. We compared positive rates across the 3 specimens collected. The kappa coefficient was used to evaluate the consistency of RT-PCR results between different specimens.
A total of 291 specimens were collected and tested from 43 confirmed patients. Among specimens collected with a disease duration of ≤14 days, the positive rate was highest in sputum (79.2%); this rate was significantly higher than that in nasopharyngeal swabs (37.5%; = .003) and oropharyngeal swabs (20.8%; < .001). Similar findings were observed with the disease durations of 14-21 days and >21 days. The consistency of testing results between nasopharyngeal swabs and oropharyngeal swabs was low with the disease durations of ≤14 days and >21 days. The consistency between the sputum and oropharyngeal swabs and between the sputum and nasopharyngeal swabs was very low across all 3 disease durations, with statistical significance.
Compared with nasopharyngeal swabs and oropharyngeal swabs, sputum had the highest yield of SARS-CoV-2 detection. Nasopharyngeal swabs and oropharyngeal swabs had a similar yield. If sputum is not feasible, a nasopharyngeal swab can be recommended for the detection of SARS-CoV-2, and early testing is needed.
很少有研究比较鼻咽拭子、口咽拭子和痰液中逆转录聚合酶链反应（RT-PCR）检测严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的阳性率。
我们在中国北京地坛医院进行了一项观察性研究。收集确诊的2019冠状病毒病患者的鼻咽拭子、口咽拭子和痰液等标本进行RT-PCR检测。从症状出现日期到标本采集日期计算病程，并分为3组：≤14天、14-21天和>21天。我们比较了采集的3种标本的阳性率。kappa系数用于评估不同标本之间RT-PCR结果的一致性。
共收集并检测了43例确诊患者的291份标本。在病程≤14天采集的标本中，痰液的阳性率最高（79.2%）；该率显著高于鼻咽拭子（37.5%；P = .003）和口咽拭子（20.8%；P < .001）。在病程为14-21天和>21天时也观察到类似结果。在病程≤14天和>21天时，鼻咽拭子和口咽拭子检测结果的一致性较低。在所有3个病程中，痰液与口咽拭子以及痰液与鼻咽拭子之间的一致性都非常低，具有统计学意义。
与鼻咽拭子和口咽拭子相比，痰液检测SARS-CoV-2的阳性率最高。鼻咽拭子和口咽拭子的阳性率相似。如果无法获取痰液，可推荐使用鼻咽拭子检测SARS-CoV-2，且需要尽早检测。
