Jung Jiwon, Kim Jinyeong, Lim Joon Seo, Kim Eun Ok, Kim Mi-Na, Kim Sung-Han
Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea.
Division of Infectious Disease, Department of Internal Medicine, Hanyang University Guri Hospital, Guri 11923, Korea.
Viruses. 2021 Apr 30;13(5):804. doi: 10.3390/v13050804.
It is unclear whether universal PCR screening for SARS-CoV-2 in asymptomatic individuals prior to admission is useful. From April to December 2020, the positive rate of universal pre-admission screening was 0.005% (4/76,521) in a tertiary care hospital in Korea. The positive rates were not different between the periods (period 1 (daily new patients of <1 per million inhabitants) vs. period 2 (1-8.3 per million inhabitants) vs. period 3 (10.3 to 20 per million inhabitants); = 0.45). Universal pre-admission screening for SARS-CoV-2 had a lower positive rate than that of symptom-based screening (0.005% vs. 0.049% (53/109,257), < 0.001). In addition, seven patients with negative pre-admission test results had subsequent positive PCR during hospitalization, and four patients had secondary transmission. Universal pre-admission PCR screening may not be practical in settings of low prevalence of COVID-19, and negative PCR results at admission should not serve as a basis for underestimating the risk of nosocomial spread from asymptomatic patients.
入院前对无症状个体进行SARS-CoV-2的普遍PCR筛查是否有用尚不清楚。2020年4月至12月，韩国一家三级护理医院中普遍入院前筛查的阳性率为0.005%（4/76,521）。各时间段之间的阳性率没有差异（第1期（每百万居民中每日新增患者<1例）与第2期（每百万居民中1 - 8.3例）与第3期（每百万居民中10.3至20例）；P = 0.45）。SARS-CoV-2的普遍入院前筛查阳性率低于基于症状的筛查（0.005%对0.049%（53/109,257），P < 0.001）。此外，7例入院前检测结果为阴性的患者在住院期间随后PCR检测呈阳性，4例发生了二次传播。在COVID-19患病率较低的情况下，普遍入院前PCR筛查可能不实用，入院时PCR检测阴性结果不应作为低估无症状患者医院内传播风险的依据。
