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血清 IgM 和 IgG 对 2019 年冠状病毒病的临床意义。

Clinical significance of the serum IgM and IgG to SARS-CoV-2 in coronavirus disease-2019.

机构信息

Department of Clinical Laboratory, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, Chongqing, China.

Department of Clinical Laboratory, Chongqing Public Health Medical Treatment Center, Chongqing, China.

出版信息

J Clin Lab Anal. 2021 Jan;35(1):e23649. doi: 10.1002/jcla.23649. Epub 2020 Nov 13.

Abstract

OBJECTIVE

To explore the clinical value of serum IgM and IgG to SARS-CoV-2 in COVID-19.

METHODS

105 COVID-19 patients were enrolled as the disease group. 197 non-COVID-19 patients served as the control group. Magnetic chemiluminescent immunoassay (MCLIA) was used to detect the IgM and IgG.

RESULTS

The peak of positive rates of SARS-CoV-2 IgM was about 1 week earlier than that of IgG. It reached to peak within 15-21 days and then began a slowly decline. The positive rates of IgG were increased with the disease course and reached the peak between 22 and 39 days. The differences in sensitivity of the three detection modes (IgM, IgG, and IgM + IgG) were statistically significant. The largest group of test cases (illness onset 15-21 days) showed that the positive rate of IgG was higher than IgM. Also, the sensitivity of IgM combined with IgG was higher than IgM or IgG. IgM and IgG were monitored dynamically for 16 patients with COVID-19, the results showed that serological transformation of IgM was carried out simultaneously with IgG in seven patients, which was earlier than IgG in four patients and later than IgG in five patients.

CONCLUSION

The detection of SARS-CoV-2 IgM and IgG is very important to determine the course of COVID-19. Nucleic acid detection combined with serum antibody of SARS-CoV-2 may be the best laboratory indicator for the diagnosis of SARS-CoV-2 infection and the phrase and predication for prognosis of COVID-19.

摘要

目的

探讨血清 IgM 和 IgG 对 COVID-19 中 SARS-CoV-2 的临床价值。

方法

纳入 105 例 COVID-19 患者作为疾病组,197 例非 COVID-19 患者作为对照组。采用磁化学发光免疫分析(MCLIA)检测 IgM 和 IgG。

结果

SARS-CoV-2 IgM 的阳性率峰值比 IgG 早约 1 周,在 15-21 天内达到峰值,然后开始缓慢下降。IgG 的阳性率随病程增加而增加,在 22-39 天达到峰值。三种检测模式(IgM、IgG 和 IgM+IgG)的敏感性差异具有统计学意义。最大的病例组(发病 15-21 天)显示 IgG 的阳性率高于 IgM,且 IgM 联合 IgG 的敏感性高于 IgM 或 IgG。对 16 例 COVID-19 患者进行了动态 IgM 和 IgG 监测,结果显示 7 例患者同时进行了 IgM 血清学转化,4 例患者早于 IgG,5 例患者晚于 IgG。

结论

检测 SARS-CoV-2 IgM 和 IgG 对确定 COVID-19 病程非常重要。核酸检测结合 SARS-CoV-2 血清抗体可能是 SARS-CoV-2 感染诊断及 COVID-19 预后判断的最佳实验室指标。

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