Department of Integrative Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
Department of Drug Clinical Trial, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
Biosci Trends. 2021 May 11;15(2):93-99. doi: 10.5582/bst.2021.01090. Epub 2021 Mar 26.
As the COVID-19 epidemic is still ongoing, a more rapid detection of SARS-CoV-2 infection such as viral antigen-detection needs to be evaluated for early diagnosis of COVID-19 disease. Here, we report the dynamic changes of SARS-CoV-2 viral antigens in nasopharyngeal swabs of COVID-19 patients and its association with the viral nucleic acid clearance and clinical outcomes. Eighty-five COVID-19 patients were enrolled for detection of SARS-CoV-2 viral antigens, including 57 anti-SARS-CoV-2 antibody negative cases and 28 antibody positive cases. The viral antigen could be detected in 52.63% (30/57) patients with SARS-CoV-2 antibody negative at the early stage of SARS-CoV-2 infection, especially in the first 5 days after disease onset (p = 0.0018) and disappeared in about 8 days after disease onset. Viral antigens were highly detectable in patients with low Ct value (less than 30) of SARS-CoV-2 nucleic acid RT-PCT assay, suggesting the expression of viral antigen was associated with high viral load. Furthermore, positive antigen detection indicated disease progression, nine cases with positive antigen (9/30, 30.0%), in contrast to two cases (2/27, 7.40%) (p = 0.0444) with negative antigen, which progressed into severe disease. Thus, the viral antigens were persistent in early stages of infection when virus was in highly replicating status, and viral antigen detection promises to rapidly screen positive patients in the early stage of SARS-CoV-2 infection.
由于 COVID-19 疫情仍在持续，需要评估更快速的 SARS-CoV-2 感染检测方法，如病毒抗原检测，以便对 COVID-19 疾病进行早期诊断。在这里，我们报告了 COVID-19 患者鼻咽拭子中 SARS-CoV-2 病毒抗原的动态变化及其与病毒核酸清除和临床结局的关系。我们纳入了 85 例 COVID-19 患者进行 SARS-CoV-2 病毒抗原检测，包括 57 例抗 SARS-CoV-2 抗体阴性病例和 28 例抗体阳性病例。在 SARS-CoV-2 感染早期，57 例抗 SARS-CoV-2 抗体阴性患者中有 30 例（52.63%）可检测到病毒抗原，尤其是在发病后 5 天内（p = 0.0018），并在发病后约 8 天内消失。病毒抗原在 SARS-CoV-2 核酸 RT-PCR 检测 Ct 值较低（<30）的患者中高度可检测，表明病毒抗原的表达与高病毒载量有关。此外，阳性抗原检测表明疾病进展，9 例抗原阳性（9/30，30.0%）的患者与 2 例抗原阴性（2/27，7.40%）的患者相比（p = 0.0444），抗原阳性患者更易进展为重症。因此，病毒抗原在病毒高度复制的感染早期持续存在，病毒抗原检测有望快速筛选 SARS-CoV-2 感染早期的阳性患者。
