新冠疫情流行阶段和平均病毒载量变化的影响：对 SARS-CoV-2 检测策略的启示。
The impact of COVID-19 epidemic phase and changes in mean viral loads: implications for SARS-CoV-2 testing strategies.
机构信息
Faculty of Medicine, The University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia; Pathology Queensland Central Laboratory, Brisbane, Queensland, Australia.
Pathology Queensland Central Laboratory, Brisbane, Queensland, Australia; Centre for Children's Health Research, Children's Health Queensland, Brisbane, Queensland, Australia.
出版信息
Diagn Microbiol Infect Dis. 2022 Mar;102(3):115598. doi: 10.1016/j.diagmicrobio.2021.115598. Epub 2021 Nov 19.
The sensitivity of SARS-CoV-2 diagnostic tests is inherently linked to viral load. We explored whether average viral loads changed at a population level in Queensland, Australia during the early phase of the pandemic. RT-PCR threshold cycle (C) values, a crude marker for viral load, were compared for samples collected in February/March-2020 to those collected in April/May-2020, noting that the major public health interventions began in late-March 2020. Positive detections peaked mid-March, which coincided with the highest detection numbers and lowest C values. However, this changed from April where the later C samples (C > 30) predominated. Overall, in February/March 29% (267/922) of samples had C values >30 cycles compared to 88% (559/636) in April/May. Our study shows that SARS-CoV-2 viral loads in patients may vary at a population level over time. This needs considering when assessing suitability of diagnostic methods, particularly when methods in question are known to have reduced sensitivity.
SARS-CoV-2 诊断检测的灵敏度本质上与病毒载量有关。我们探讨了在澳大利亚昆士兰州大流行早期，人群中平均病毒载量是否发生了变化。我们比较了 2020 年 2 月/3 月和 2020 年 4 月/5 月采集的样本的 RT-PCR 阈值循环 (C) 值，C 值是病毒载量的一个粗略指标，注意到主要的公共卫生干预措施始于 2020 年 3 月底。阳性检出率在 3 月中旬达到峰值，这与检测数量最高和 C 值最低的时期相吻合。然而，这一情况从 4 月开始发生变化，当时 C 值较高（C > 30）的样本占主导地位。总体而言，在 2 月/3 月，922 个样本中有 29%（267 个）的 C 值>30 循环，而在 4 月/5 月，这一比例为 88%（559 个）。我们的研究表明，患者的 SARS-CoV-2 病毒载量可能会随时间在人群中发生变化。在评估诊断方法的适用性时，特别是当所讨论的方法已知灵敏度降低时，需要考虑到这一点。
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