Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
J Infect Dis. 2022 Nov 1;226(9):1577-1587. doi: 10.1093/infdis/jiac225.
Detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is essential for diagnosis, treatment, and infection control. Polymerase chain reaction (PCR) fails to distinguish acute from resolved infections, as RNA is frequently detected after infectiousness. We hypothesized that nucleocapsid in blood marks acute infection with the potential to enhance isolation and treatment strategies. In a retrospective serosurvey of inpatient and outpatient encounters, we categorized samples along an infection timeline using timing of SARS-CoV-2 testing and symptomatology. Among 1860 specimens from 1607 patients, the highest levels and frequency of antigenemia were observed in samples from acute SARS-CoV-2 infection. Antigenemia was higher in seronegative individuals and in those with severe disease. In our analysis, antigenemia exhibited 85.8% sensitivity and 98.6% specificity as a biomarker for acute coronavirus disease 2019 (COVID-19). Thus, antigenemia sensitively and specifically marks acute SARS-CoV-2 infection. Further study is warranted to determine whether antigenemia may aid individualized assessment of active COVID-19.
检测严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染对于诊断、治疗和感染控制至关重要。聚合酶链反应（PCR）无法区分急性感染和已解决的感染，因为在传染性之后经常检测到 RNA。我们假设血液中的核衣壳蛋白标记急性感染，并有可能增强隔离和治疗策略。在对住院和门诊患者的回顾性血清学调查中，我们根据 SARS-CoV-2 检测时间和症状学将样本沿感染时间线进行分类。在来自 1607 名患者的 1860 个样本中，在急性 SARS-CoV-2 感染的样本中观察到最高水平和最高频率的抗原血症。在血清阴性个体和患有严重疾病的个体中，抗原血症更高。在我们的分析中，抗原血症作为急性 2019 冠状病毒病（COVID-19）的生物标志物表现出 85.8%的敏感性和 98.6%的特异性。因此，抗原血症灵敏且特异性地标记 SARS-CoV-2 急性感染。需要进一步研究以确定抗原血症是否可以帮助对 COVID-19 进行个体化评估。
