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    新型冠状病毒核酸检测与特异性IgM抗体检测的比较分析

    A comparative analysis of nucleic acid detection and specific IgM antibody detection in the diagnosis of novel coronavirus

    • 摘要: 目的 分别用实时荧光定量RT-PCR方法检测新型冠状病毒(SARS-CoV-2)核酸,用荧光免疫层析方法检测SARS-CoV-2特异性IgM抗体,对2种方法进行比较分析,为新型冠状病毒肺炎(COVID-19)的诊断提供参考。方法 选择82例COVID-19疑似患者,从出现临床症状当天至第21天,分别检测患者的鼻咽拭子样本SARS-CoV-2核酸阳性率和全血样本中SARS-CoV-2 IgM抗体阳性率。同时选取南通大学附属东台医院排除 COVID-19 的50例医务人员作为对照组。结果 COVID-19疑似患者组核酸检测方法检测出74例SARS-CoV-2阳性,阳性率为90.24%;对照组有1例样品一过性阳性,阳性率为2.00%。COVID-19疑似患者组IgM抗体检测方法检测出66例SARS-CoV-2阳性,阳性率为80.49%;对照组IgM抗体检测均为阴性。核酸检出时间为发病第1~18天,检出高峰期为第1~8天;IgM抗体检出时间为发病第3~19天,检出高峰期为第5~14天。结论 IgM抗体检测方法检测SARS-CoV-2阳性的高峰期比核酸检测方法滞后约1周,2种方法结合检测可实现互补,对排毒量低于核酸检测临界值的COVID-19确诊有重要意义。在临床诊断中将核酸检测方法和血清学检测方法相结合确诊COVID-19病例更为可靠。

       

      Abstract: Objective To compare real-time fluorescence quantitative RT-PCT and fluorescence immunochromatography for detection of the nucleic acid of novel coronavirus (SARS-CoV-2), so as to provide reference for the diagnosis of corona virus disease 2019 (COVID-19). Methods A total of 82 suspected COVID-19 patients were selected. Their positive rates of SARS-CoV-2 nucleic acid in nasopharyngeal swab samples and IgM antibody in whole blood samples were detected from the day when clinical symptoms appeared until 21 days later. Meanwhile, 50 medical staff without COVID-19 in Dongtan People's Hospital were selected as a control group. Results Based on nucleic acid detection method, 74 SARS-CoV-2 positive cases were found in the COVID-19 suspected patient group, with a positive rate of 90.24%, while there was one temporarily positive case in the control group, with a positive rate of 2.00%. Based on IgM antibody detection method, 66 SARS-CoV-2 cases were detected in the COVID-19 suspected patient group, with a positive rate of 80.49%, while all the samples were negative in the control group. The detection time of nucleic acid was from Days 1 to 18, reaching a peak from Days 1 to 8. The detection time of IgM antibody was from Days 3 to 19, reaching a peak from Days 5 to 14. Conclusions The peak period of IgM antibody detection is about one week behind the peak period of nucleic acid detection. Both methods are complementary, which is of importance to diagnose COVID-19 with a detoxification volume less than the nucleic acid concentration threshold. It is more reliable to use both nucleic acid and serological detection methods for COVID-19 diagnosis.

       

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