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关于晚期循环阈值下 SARS-CoV-2 分子检测阳性结果解释的注意事项。

Considerations regarding Interpretation of Positive SARS-CoV-2 Molecular Results with Late Cycle Threshold Values.

机构信息

Medical Affairs, Cepheid, Sunnyvale, California, USA.

Scientific Affairs, Cepheid, Sunnyvale, California, USA.

出版信息

J Clin Microbiol. 2022 Sep 21;60(9):e0050122. doi: 10.1128/jcm.00501-22. Epub 2022 Jun 6.

Abstract

COVID-19 disease lies on a spectrum, ranging from completely asymptomatic to mild disease to severe and critical disease. Studies have shown that prolonged shedding or sporadic detection of SARS-CoV-2 RNA can occur long after symptom resolution. Adding to these clinical complexities is the demand for testing for SARS-CoV-2 at all stages of diseases, frequently driven by screening of asymptomatic persons, something that traditionally has not been performed for other viral respiratory diseases. This can lead to positive results from nucleic acid amplification tests (NAATs), such as RT-PCR, with late cycle threshold (CT) values near the test's limit of detection. In this commentary, we review unique attributes of COVID-19 and causes of NAAT late CT values. We provide interpretation considerations as well as strategies to aid in test interpretation.

摘要

新型冠状病毒疾病(COVID-19)存在于一个连续谱上,从完全无症状到轻症,再到重症和危重症。研究表明,在症状缓解后很长时间内,SARS-CoV-2 RNA 可能会持续排出或偶发检测到。除了这些临床复杂性之外,还需要在疾病的各个阶段进行 SARS-CoV-2 检测,这通常是由对无症状者的筛查驱动的,而这种做法在传统上从未用于其他病毒性呼吸道疾病。这可能导致核酸扩增检测(NAAT),如 RT-PCR 的阳性结果,其晚期循环阈值(CT)值接近检测的检出限。在这篇评论中,我们回顾了 COVID-19 的独特属性和导致 NAAT 晚期 CT 值的原因。我们提供了解释性考虑因素以及帮助解释测试的策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef1d/9491168/aaff45604e6e/jcm.00501-22-f001.jpg

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