COVID-19患者早期咽拭子病毒载量与临床特征的关联分析  

Association of early virus nucleic acid in throat swabs and clinical characteristics in COVID-19 patients early in their illness

作　　者：王文龙[1] 许允[1] 庄思琪 戴钰丰 王―敏 项忠元[2] 胡敏[2] 蒋永芳[1] 唐玲丽[2] 唐浩能[2] Wang Wenlong;Xu Yun;Zhuang Siqi;Dai Yufeng;Wang Min;Xiang Zhongyuan;Hu Min;Jiang Yongfang;Tang Lingli;Tang Haoneng(Department of Infectious Diseases;Department of Laboratory Medicine,The Second Xiangya Hospital,Central South University)

机构地区：[1]中南大学湘雅二医院感染病科,长沙410011 [2]中南大学湘雅二医院检验科,长沙410011

出　　处：《重庆医科大学学报》2020年第7期925-928,共4页Journal of Chongqing Medical University

基　　金：湖南省自然科学基金资助项目(编号:2018JJ2559)。

摘　　要：目的:探讨新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)患者早期咽拭子病毒载量与临床症状及肺部影像学表现的关系。方法:回顾性分析2020年1月24日至2月9日在中南大学湘雅二医院确诊的30例COVID-19患者早期咽拭子病毒核酸载量与临床症状、肺部影像学特征的具体关联。结果:30例COVID-19患者就诊时,4例患者(13.33%)未出现临床症状,23例患者(76.67%)出现发热;20例患者(66.67%)出现COVID-19影像学改变,10例患者(33.33%)影像学无明显异常。COVID-19无症状患者的咽拭子病毒核酸Ct值与有症状患者相比差异无统计学意义;相比于影像学无异常的患者,出现肺炎影像学表现的患者咽拭子病毒核酸Ct值更大(P=0.001),体温更高(P=0.014);通过logistic回归模型校正性别和年龄后,咽拭子病毒核酸Ct值与出现肺炎影像学特征呈独立正相关(OR=1.34,95%CI=1.07~1.66,P=0.009)。结论:早期无临床症状的COVID-19患者与有症状患者的咽拭子病毒载量水平相当;COVID-19患者早期咽拭子病毒载量与肺部影像学特征呈负向关联。Objective:To investigate the relationship between early laboratory indexes and clinical manifestations and radiographic characteristics in coronavirus disease 2019(COVID-19).Methods:In this retrospective study,30 confirmed cases of COVID-19 in Second Xiangya Hospital(Changsha)from January 24th to February 9th,2020 were enrolled,viral loads in throat swabs of the patients and their correlation with clinical manifestations and imaging characteristics were analyzed.Results:On admission,4 out of 30 COVID-19 patients(13.33%)had no clinical symptoms,23 patients(76.67%)had fever.Imaging findings were observed in 20 patients(66.67%),while no obvious abnormalities were observed in 10 patients(33.33%).Ct value of viral nucleic acid in throat swabs of asymptomatic COVID-19 patientswas basically the same as in those patients with clinical symptoms.Compared with patients with no abnormality in imaging,patients with imaging manifestation of pneumonia had significantly increased Ct value(P=0.001)of viral nucleic acid and body temperature(P=0.014).After adjusted for gender and age by logistic regression model,Ct value of viral nucleic acid in throat swabs was positively correlated with the imaging characteristics of pneumonia(OR=1.34,95%CI=1.07-1.66,P=0.009).Conclusion:Asymptomatic COVID-19 patients had a similar level of viral load of throat swabs as symptomatic COVID-19 patients at an early stage.The viral load of throat swabs was negatively correlated with pulmonary imaging characteristics at an early stage of COVID-19 patients.

关 键 词：新型冠状病毒肺炎 咽拭子 病毒载量 临床特征 影像学特征 

分 类 号：R446[医药卫生—诊断学]