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Clin Gastroenterol H:腹泻与COVID-19患者症状和病毒携带时间延长有关

2020-04-26 MedSci原创 MedSci原创

SARS-CoV-2肺炎患者中有31%患者出现腹泻。腹泻患者粪便中病毒RNA阳性的比例明显高于无腹泻患者。SARS-CoV-2从粪便中消除比从鼻子和喉咙中消除需要更长的时间。

近日,消化病领域权威杂志Clinical Gastroenterology and Hepatology发表了一篇研究文章,研究人员旨在比较伴有或不伴有腹泻的SARS-CoV-2感染(COVID-19)肺炎患者的临床、实验室检查、影像学和预后特征。

研究人员于2020年1月19日至2020年2月7日在中国武汉协和医院对84例SARS-CoV-2肺炎患者进行了回顾性、单中心分析。病例经实时逆转录PCR方法检测鼻和咽部拭子样本中SARS-CoV-2 RNA来确诊。分析血样中的白细胞计数、淋巴细胞计数、丙氨酸转氨酶、肌酸激酶、乳酸脱氢酶、D-二聚体、C反应蛋白,在某些病例中还分析免疫球蛋白、补体、淋巴细胞亚群和细胞因子。研究人员通过实时PCR检测粪便样品中的病毒RNA。

在84例SARS-CoV-2肺炎患者中,26例(31%)患者有腹泻。腹泻患者的发热和呼吸困难的持续时间明显长于无腹泻的患者(所有P<0.05)。与没有腹泻的患者(17%)相比,腹泻患者的粪便样本中检测出病毒RNA阳性的比例更高(69%)(P<0.001)。截至2月19日,在最近的一次SARS-CoV-2咽拭子试验中,腹泻患者阴性的比例(77%)低于无腹泻患者(97%)(P=0.010)。在住院期间最新的咽拭子测试结果为阴性的76例患者中,腹泻患者粪便SARS-CoV-2复检的阳性结果比例显著高于无腹​泻的患者(20%)(P=0.039)。

由此可见,在中国武汉这一单中心研究中,SARS-CoV-2肺炎患者中有31%患者出现腹泻。腹泻患者粪便中病毒RNA阳性的比例明显高于无腹泻患者。SARS-CoV-2从粪便中消除比从鼻子和喉咙中消除需要更长的时间。

原始出处:

Xiao-Shan Wei,et al.Diarrhea is associated with prolonged symptoms and viral carriage in COVID-19.Clinical gastroenterology and hepatology.2020. https://doi.org/10.1016/j.cgh.2020.04.030

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