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Lancet Infect Dis:"钻石公主"号游轮新冠肺炎患者病毒脱落及血清抗体反应特征研究

2020-06-15 MedSci原创 MedSci原创

COVID-19患者可发展为无症状的肺部感染并伴有病毒脱落,而那些在影像学上有肺炎迹象的患者往往抗体反应增强。

在游轮这种封闭环境中,传染性疾病具有极高的传播风险,近日研究人员就2020年2月 "钻石公主"号游轮上的严重急性呼吸综合征冠状病毒2(SARS-CoV-2)确诊患者的病毒脱落模式和症状出现前后抗体反应情况进行了考察。
 
研究人员招募了来自香港的成年乘客(≥18岁),他们是2020年2月在日本横滨停泊的钻石公主游轮上的乘客。所有受试者在登陆前4天病毒核酸检测呈阴性,在进一步隔离过程中,采用定量RT-PCR(RT-qPCR)对鼻咽和咽拭子样本进行检测,在基线(进入检疫时)和检疫第4、8和12天对SARS-CoV-2的内部核蛋白和表面尖峰受体结合蛋白(RBD)进行血清IgG和IgM的检测。
 
215名成人参与者,其中9名(4%)通过RT-qPCR或血清学检测呈SARS-CoV-2阳性,并住院治疗。在这9名患者中,8名患者(89%)在基线检查时鼻咽拭子RT-qPCR呈阳性。到第8天,9名患者抗RBD-IgG均呈阳性。鼻咽拭子RT-PCR和抗RBD-IgG同时阳性8例(89%,)。1例抗RBD-IgG阳性,核酸检测为阴性的患者在高分辨率CT上出现多灶性外周毛玻璃改变,为COVID-19的典型表现。5例(56%)在高分辨率CT上有毛玻璃改变的患者在第8天和第12天的抗核蛋白IgG-OD值和第12天的抗RBD-IgG-OD值均高于无毛玻璃改变的患者。在14天的隔离期内,6名(67%)无症状患者始终未出现症状。
 
COVID-19患者可发展为无症状的肺部感染并伴有病毒脱落,而那些在影像学上有肺炎迹象的患者往往抗体反应增强。在有症状和无症状的患者中,IgG或IgM阳性证实了COVID-19的感染。应结合RT-PCR和血清学进行病例发现和接触追踪,以便于早期诊断、及时隔离和治疗。
 
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  2. [GetPortalCommentsPageByObjectIdResponse(id=2013398, encodeId=f14b20133981a, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Sun Jan 24 18:18:25 CST 2021, time=2021-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1830691, encodeId=fe96183069120, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Apr 27 12:18:25 CST 2021, time=2021-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1028185, encodeId=bf1e102818530, content=新冠肺炎,疫情何时才能消失, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=公卫新人, createdTime=Mon Jun 15 21:18:25 CST 2020, time=2020-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1033835, encodeId=067e1033835c9, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Mon Jun 15 21:18:25 CST 2020, time=2020-06-15, status=1, ipAttribution=)]
    2021-04-27 howi
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    2020-06-15 公卫新人

    新冠肺炎,疫情何时才能消失

    0

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    2020-06-15 goodbing

    顶刊就是不一样,质量很高,内容精彩!学到很多

    0

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