Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
Department of Pulmonary and Critical Care Medicine of Renmin Hospital, Wuhan University, Wuhan, 430060, China.
J Transl Med. 2020 Nov 2;18(1):411. doi: 10.1186/s12967-020-02580-w.
The SARS-CoV-2 RNA was detected positive again after discharged from hospital in some COVID-19 patients, with or without clinical symptoms such as fever or dry cough.
1008 severe COVID-19 patients, with SARS-CoV-2 RNA positive detected with the mixed specimen of nasopharyngeal swab and oropharyngeal swab by real-time fluorescence quantitative PCR (RT-qPCR), were selected to monitor SARS-CoV-2 RNA with the 12 types of specimens by RT-qPCR during hospitalization. All of 20 discharged cases with COVID-19 were selected to detect SARS-CoV-2 RNA in isolation period with 7 types of specimens by RT-qPCR before releasing the isolation period.
Of the enrolled 1008 severe patients, the nasopharyngeal swab specimens showed the highest positive rate of SARS-CoV-2 RNA (71.06%), followed by alveolar lavage fluid (66.67%), oropharyngeal swab (30.77%), sputum (28.53%), urine (16.30%), blood (12.5%), stool (12.21%), anal swab (11.22%) and corneal secretion (2.99%), and SARS-CoV-2 RNA couldn't be detected in other types of specimen in this study. Of the 20 discharged cases during the isolation period, the positive rate of SARS-CoV-2 RNA was 30% (6/20): 2 cases were positive in sputum at the eighth and ninth day after discharge, respectively, 1 case was positive in nasopharynx swab at the sixth day after discharge, 1 case was positive in anal swab at the eighth day after discharge, and 1 case was positive in 3 specimens (nasopharynx swab, oropharynx swab and sputum) simultaneously at the fourth day after discharge, and no positive SARS-CoV-2 RNA was detected in other specimens including stool, urine and blood at the discharged patients.
SARS-CoV-2 RNA should be detected in multiple specimens, such as nasopharynx swab, oropharynx swab, sputum, and if necessary, stool and anal swab specimens should be performed simultaneously at discharge when the patients were considered for clinical cure and before releasing the isolation period.
部分 COVID-19 患者出院后，其咽拭子和/或口咽拭子混合标本的实时荧光定量 PCR（RT-qPCR）检测到 SARS-CoV-2 RNA 再次阳性，伴有或不伴有发热或干咳等临床症状。
选择 1008 例 SARS-CoV-2 RNA 阳性的重型 COVID-19 患者，通过实时荧光定量 PCR（RT-qPCR）检测鼻咽拭子和口咽拭子混合标本，住院期间共监测 12 种标本的 SARS-CoV-2 RNA。选择 20 例符合出院标准的患者，在隔离期结束前，通过 RT-qPCR 检测 7 种标本的 SARS-CoV-2 RNA。
纳入的 1008 例重型患者中，鼻咽拭子标本 SARS-CoV-2 RNA 阳性率最高（71.06%），其次为肺泡灌洗液（66.67%）、口咽拭子（30.77%）、痰（28.53%）、尿液（16.30%）、血液（12.5%）、粪便（12.21%）、肛拭子（11.22%）和角膜分泌物（2.99%），本研究其他类型标本均未检测到 SARS-CoV-2 RNA。20 例隔离期出院患者中，SARS-CoV-2 RNA 阳性率为 30%（6/20）：出院后第 8 天和第 9 天分别有 2 例患者痰中阳性，出院后第 6 天 1 例患者鼻咽拭子阳性，出院后第 8 天 1 例患者肛拭子阳性，出院后第 4 天 1 例患者 3 种标本（鼻咽拭子、口咽拭子和痰）同时阳性，出院患者其他标本（粪便、尿液和血液）均未检测到 SARS-CoV-2 RNA 阳性。
SARS-CoV-2 RNA 应在多个标本中检测，如鼻咽拭子、口咽拭子、痰等，必要时应在临床治愈出院并解除隔离前，同时进行粪便和肛拭子标本检测。
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