Department of Laboratory Medicine, All India Institute of Medical Sciences, Delhi, India.
Preventive Oncology, NCI Jhajjar, All India Institute of Medical Sciences, Delhi, India.
Sci Rep. 2021 Aug 9;11(1):16131. doi: 10.1038/s41598-021-95329-4.
SARS-CoV-2 has posed an unprecedented challenge to the world. Pandemics have been caused previously by viruses of this family like Middle East Respiratory Corona Virus (MERS CoV), Severe Acute Respiratory Syndrome Corona Virus (SARS CoV). Although these viruses are primarily respiratory viruses, but they have been isolated from non-respiratory samples as well. Presently, the detection rate of SARS-CoV-2 RNA from different clinical specimens using Real Time Reverse Transcriptase Polymerized Chain Reaction (qRT-PCR) after onset of symptoms is not yet well established. Therefore, the aim of this systematic review was to establish the profile of detecting SARS-CoV-2, MERS CoV, SARS CoV from different types of clinical specimens other than the respiratory using a standard diagnostic test (qRT-PCR). A total of 3429 non-respiratory specimens were recorded: SARS CoV (total sample-802), MERS CoV (total sample-155), SARS CoV-2 (total sample-2347). Out of all the samples studied high positive rate was seen for saliva with 96.7% (14/14; 95% CI 87.6-100.0%) for SARS CoV and 57.5% (58/250; 95% CI - 1.2 to 116.2%) for SARS CoV-2, while low detection rate in urine samples for SARS CoV-2 with 2.2% (8/318; 95% CI 0.6-3.7%) and 9.6% (12/61; 95% CI - 0.9 to 20.1%) for SARS CoV but there was relatively higher positivity in urine samples for MERS CoV with detection rate of 32.4% (2/38; 95% CI - 37.3 to 102.1%). In Stool sample positivity was 54.9% (396/779; 95% CI 41.0-68.8%), 45.2% (180/430; 95% CI 28.1-62.3%) and 34.7% (4/38; 95% CI - 29.5 to 98.9%) for SARS CoV-2, MERS CoV, and SARS CoV, respectively. In blood sample the positivity was 33.3% (7/21; 95% CI 13.2-53.5%), 23.7% (42/277; 95% CI 10.5-36.9%) and 2.5% (2/81; 95% CI 0.00-5.8%) for MERS CoV, SARS CoV-2 and SARS CoV respectively. SARS-CoV-2 along with previous two pandemic causing viruses from this family, were highly detected stool and saliva. A low positive rate was recorded in blood samples. Viruses were also detected in fluids along with unusual samples like semen and vaginal secretions thus highlighting unique pathogenic potential of SARS-CoV-2.
SARS-CoV-2 对世界构成了前所未有的挑战。此前，该家族的病毒如中东呼吸综合征冠状病毒（MERS-CoV）和严重急性呼吸综合征冠状病毒（SARS-CoV）也曾引发过疫情。尽管这些病毒主要是呼吸道病毒，但它们也从非呼吸道样本中分离出来。目前，使用实时逆转录聚合酶链反应（qRT-PCR）在症状出现后从不同临床标本中检测 SARS-CoV-2 RNA 的检出率尚未得到很好的确定。因此，本系统评价的目的是建立使用标准诊断检测（qRT-PCR）从呼吸道以外的不同类型临床标本中检测 SARS-CoV-2、MERS-CoV 和 SARS-CoV 的方法。共记录了 3429 份非呼吸道标本：SARS-CoV（总样本 802 份）、MERS-CoV（总样本 155 份）、SARS-CoV-2（总样本 2347 份）。在所有研究的样本中，唾液的阳性率最高，SARS-CoV 为 96.7%（14/14；95%CI 87.6-100.0%），SARS-CoV-2 为 57.5%（58/250；95%CI-1.2-116.2%），而 SARS-CoV-2 的尿液样本检出率较低，为 2.2%（8/318；95%CI 0.6-3.7%）和 9.6%（12/61；95%CI 0.9-20.1%），SARS-CoV 的尿液样本阳性率相对较高，为 32.4%（2/38；95%CI-37.3-102.1%）。粪便样本的阳性率为 54.9%（396/779；95%CI 41.0-68.8%）、45.2%（180/430；95%CI 28.1-62.3%）和 34.7%（4/38；95%CI-29.5-98.9%），分别为 SARS-CoV-2、MERS-CoV 和 SARS-CoV。血液样本的阳性率分别为 33.3%（7/21；95%CI 13.2-53.5%）、23.7%（42/277；95%CI 10.5-36.9%）和 2.5%（2/81；95%CI 0.00-5.8%），分别为 MERS-CoV、SARS-CoV-2 和 SARS-CoV。SARS-CoV-2 与该家族之前引起两次大流行的两种病毒一样，可高度检测到粪便和唾液。血液样本的阳性率较低。还在精液和阴道分泌物等液体以及不寻常样本中检测到了病毒，这突出了 SARS-CoV-2 独特的致病潜力。
