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对于聚合酶链反应阴性的新冠肺炎患者,我们是否应仅依靠筛查测试来进行进一步治疗?病例系列研究

Should We Rely on Screening Tests for Further Management Alone in Polymerase Chain Reaction Negative COVID-19 Patients? A Case Series.

作者信息

Iqbal Phool, Ata Fateen, Rose Samman, Chaudhry Hammad S, Rahil Ali

机构信息

Internal Medicine, Hamad General Hospital, Doha, QAT.

Internal Medicine, Hamad Medical Corporation, Doha, QAT.

出版信息

Cureus. 2020 Sep 20;12(9):e10555. doi: 10.7759/cureus.10555.

DOI:10.7759/cureus.10555
PMID:33101802
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7575294/
Abstract

Since the declaration of coronavirus disease 2019 (COVID-19) disease as a pandemic by the World Health Organization (WHO), it has been a challenge to the whole medical community. Researchers and clinicians have been trying to explain and explore its mechanism and pathophysiology to get a better understanding of this disease, as it has exhausted the healthcare resources and has impacted human life in general. Many tests have been developed including polymerase chain reaction (PCR) of the virus and rapid diagnostic testing in patients based on IgM/IgG serology. But owing to variable sensitivity and specificity of these tests, it has created a challenging situation to proceed with the further management plan. We are reporting a case series where we experienced the dilemma of diagnosing COVID-9 disease in our patients and further plan of care.

摘要

自世界卫生组织(WHO)宣布2019冠状病毒病(COVID-19)为大流行病以来,它一直是整个医学界面临的一项挑战。研究人员和临床医生一直在努力解释和探索其机制及病理生理学,以便更好地了解这种疾病,因为它已经耗尽了医疗资源并总体上影响了人类生活。已经开发了许多检测方法,包括病毒的聚合酶链反应(PCR)以及基于IgM/IgG血清学对患者进行快速诊断检测。但由于这些检测方法的敏感性和特异性各不相同,这给推进进一步的管理计划带来了具有挑战性的局面。我们报告了一个病例系列,在其中我们遇到了诊断患者COVID-19疾病的困境以及进一步的护理计划。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2ad/7575294/e6f5b75fdbcd/cureus-0012-00000010555-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2ad/7575294/7be5a930e4f3/cureus-0012-00000010555-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2ad/7575294/e6f5b75fdbcd/cureus-0012-00000010555-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2ad/7575294/7be5a930e4f3/cureus-0012-00000010555-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2ad/7575294/e6f5b75fdbcd/cureus-0012-00000010555-i02.jpg

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本文引用的文献

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A Recurrent Mutation at Position 26340 of SARS-CoV-2 Is Associated with Failure of the E Gene Quantitative Reverse Transcription-PCR Utilized in a Commercial Dual-Target Diagnostic Assay.SARS-CoV-2 第 26340 位的一个频发突变与商业双靶标诊断检测中 E 基因定量 RT-PCR 失败相关。
J Clin Microbiol. 2020 Sep 22;58(10). doi: 10.1128/JCM.01598-20.
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Serology testing in the COVID-19 pandemic response.新冠疫情应对中的血清学检测。
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COVID-19 presenting with diarrhoea and hyponatraemia.
新冠病毒感染表现为腹泻和低钠血症。
BMJ Case Rep. 2020 Jun 7;13(6):e235456. doi: 10.1136/bcr-2020-235456.
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Covid-19: WHO halts hydroxychloroquine trial to review links with increased mortality risk.新冠疫情:世界卫生组织暂停羟氯喹试验以审查其与死亡风险增加之间的关联。
BMJ. 2020 May 28;369:m2126. doi: 10.1136/bmj.m2126.
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Does lopinavir really inhibit SARS-CoV-2?洛匹那韦真的能抑制新型冠状病毒吗?
Pharmacol Res. 2020 Aug;158:104898. doi: 10.1016/j.phrs.2020.104898. Epub 2020 May 11.
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Effects of age and sex on recovery from COVID-19: Analysis of 5769 Israeli patients.年龄和性别对新型冠状病毒肺炎康复的影响:对5769名以色列患者的分析。
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Interpreting a covid-19 test result.解读新冠病毒检测结果。
BMJ. 2020 May 12;369:m1808. doi: 10.1136/bmj.m1808.
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COVID-19 Testing: The Threat of False-Negative Results.新冠病毒检测:假阴性结果的威胁。
Mayo Clin Proc. 2020 Jun;95(6):1127-1129. doi: 10.1016/j.mayocp.2020.04.004. Epub 2020 Apr 11.