Department of Pulmonary and Critical Care Medicine, Affiliated Hospital of Guangdong Medical University , Zhanjiang, Guangdong, China.
Infectious Disease Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University , Guangzhou, Guangdong, China.
Virulence. 2020 Dec;11(1):1394-1401. doi: 10.1080/21505594.2020.1831342.
We previously reported that sputum induction was more sensitive than throat swabs for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in two convalescent coronavirus disease 2019 (COVID-19) patients; however, the value and safety of induced sputum testing require further study. We conducted a prospective multi-center cross-sectional study to compare induced sputum to throat swabs for SARS-CoV-2 detection. Confirmed COVID-19 patients from six hospitals in six cities across China who received one or more negative RT-PCR result for SARS-CoV-2 were enrolled, and paired specimens (induced sputum and throat swabs; 56 cases) were assayed. In three paired samples, both the induced sputum and throat swabs were positive for SARS-CoV-2. The positive rate for induced sputum was significantly higher than for throat swabs both overall (28.6% vs 5.4%, respectively; p < 0.01). Patients were divided according to time span from onset of illness to sample collection into the more-than-30-day (n = 26) and less-than-30-day (n = 30) groups. The positive rate for induced sputum was also significantly higher than for throat swabs in the less-than-30-day group (53.3% vs 10.0%, respectively; p < 0.001). For the more-than-30-day group, all paired samples were negative for SARS-CoV-2. Blood oxygen saturation, respiratory rate, and heart rate remained stable during sputum induction and no staff were infected. Because induced sputum is more reliable and has a lower false-negative rate than throat swabs, we believe induced sputum is more useful for the confirmation of COVID-19 and is safer as a criterion for release from quarantine.
我们之前报道过，在两名恢复期的 2019 冠状病毒病（COVID-19）患者中，痰液诱导比咽喉拭子更敏感地检测到严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）；然而，诱导痰检测的价值和安全性需要进一步研究。我们进行了一项前瞻性多中心横断面研究，比较了诱导痰和咽喉拭子对 SARS-CoV-2 的检测。我们招募了来自中国六个城市六家医院的经证实的 COVID-19 患者，这些患者接受了一次或多次 SARS-CoV-2 的 RT-PCR 检测均为阴性，对配对标本（诱导痰和咽喉拭子；56 例）进行了检测。在三个配对样本中，诱导痰和咽喉拭子均为 SARS-CoV-2 阳性。诱导痰的阳性率明显高于咽喉拭子，总体阳性率分别为 28.6%和 5.4%（分别为；p < 0.01）。根据从发病到采集样本的时间跨度，患者分为 30 天以上（n = 26）和 30 天以内（n = 30）组。在 30 天以内组，诱导痰的阳性率也明显高于咽喉拭子，分别为 53.3%和 10.0%（分别为；p < 0.001）。对于 30 天以上组，所有配对样本均为 SARS-CoV-2 阴性。在诱导痰期间，血氧饱和度、呼吸频率和心率保持稳定，没有工作人员感染。由于诱导痰比咽喉拭子更可靠，假阴性率更低，我们认为诱导痰更有助于 COVID-19 的确诊，作为解除隔离的标准更安全。
