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新冠病毒再次感染:相关可能性及未来展望

COVID-19 reinfection: Linked Possibilities and future outlook.

作者信息

Krishna Ekta, Pathak Vineet Kumar, Prasad Reshma, Jose Hannah, Kumar M Mohan

机构信息

Department of Community and Family Medicine, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India.

出版信息

J Family Med Prim Care. 2020 Nov 30;9(11):5445-5449. doi: 10.4103/jfmpc.jfmpc_1672_20. eCollection 2020 Nov.

Abstract

SARS-CoV-2 is the third major coronavirus epidemic to affect humans. There had been multiple instances of patients turning positive after recovering from SARS-2-CoV infection. Though many different theories emerge, false positive RT-PCR is logically the foremost cause and there is a general consensus that during quarantine re-infection from outside seems unlikely when strictly adhered to. As many new strains emerge worldwide during the course of on-going pandemic, the chances of re-infection cannot be ignored as it may contribute to false negative RT-PCR test results. SARS-2-CoV though a novel virus, is phylogenetically similar to SARS-like CoV with around 79% similarity. Studies on immunological response to these infections suggest that antibodies formed after infection confers immunity only for a short period of time before it starts to wane. Also studies on SARS-CoV-2 suggest that antibody formation and longevity of immunity in an individual is dependent on the strain of coronavirus, its severity and age of the person infected. All these considerations demand reviewing the treatment duration, discharge criteria, appropriate use of imaging techniques and importance of risk communication and health education to those recovered.

摘要

严重急性呼吸综合征冠状病毒2(SARS-CoV-2)是影响人类的第三次重大冠状病毒疫情。有多个病例显示,患者在从SARS-2-CoV感染中康复后检测结果转为阳性。尽管出现了许多不同的理论,但从逻辑上讲,逆转录聚合酶链反应(RT-PCR)出现假阳性是首要原因,并且人们普遍认为,在严格遵守隔离规定的情况下,从外部再次感染的可能性似乎不大。在当前大流行期间,全球出现了许多新毒株,再次感染的可能性不容忽视,因为这可能导致RT-PCR检测结果出现假阴性。SARS-2-CoV虽然是一种新型病毒,但在系统发育上与类SARS冠状病毒相似,相似度约为79%。对这些感染的免疫反应研究表明,感染后形成的抗体仅在短时间内具有免疫力,之后就会开始减弱。此外,对SARS-CoV-2的研究表明,个体中抗体的形成和免疫的持续时间取决于冠状病毒的毒株、其严重程度以及感染者的年龄。所有这些因素都要求重新审视治疗持续时间、出院标准、成像技术的合理使用以及对康复者进行风险沟通和健康教育的重要性。

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