Viral Load Dynamics in Sputum and Nasopharyngeal Swab in Patients with COVID-19
Viral Load Dynamics in Sputum and Nasopharyngeal Swab in Patients with COVID-19
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COVID-19 患者痰液和鼻咽拭子中的病毒载量动态
DOI：
10.1177/0022034520946251
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发表时间：
2020-08-03
影响因子：
7.6
通讯作者：
Zhang, Y.
中科院分区：
文献类型：
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作者：
Liu, R.;Yi, S.;Zhang, Y.
2019年冠状病毒病(新冠肺炎)已造成一场与大量发病率和死亡率相关的全球大流行。鼻咽拭子和痰样本通常被收集用于呼吸道传染病的连续病毒载量筛查，但在新冠肺炎患者中，这些样本的时间分布并不完全清楚。我们在武汉大学人民医院进行了一项观察性队列研究，纳入31例确诊为新冠肺炎的患者，有无基础疾病。我们从每个患者身上获取样本，并通过实时定量聚合酶链式反应测量系列病毒载量。我们发现，在疾病出现时，痰中的病毒载量往往高于从鼻咽拭子中获得的样本。此外，随着疾病的发展，痰中的病毒载量随时间的推移比鼻咽组下降得更慢。有趣的是，即使鼻咽拭子中的样本转为阴性，人们通常也会观察到，患有基础疾病的患者，特别是高血压和糖尿病患者，新冠肺炎仍然呈阳性，而且需要更长的时间才能使痰样本转为阴性。这些综合发现强调了追踪痰样本的重要性，即使在鼻咽拭子检测为阴性的患者中也是如此，特别是对那些有潜在疾病的患者。总之，这项工作加强了痰样本对检测SARS-CoV-2的重要性，以将新冠肺炎在社区内的传播降至最低。
Coronavirus disease 2019 (COVID-19) has caused a global pandemic associated with substantial morbidity and mortality. Nasopharyngeal swabs and sputum samples are generally collected for serial viral load screening of respiratory contagions, but temporal profiles of these samples are not completely clear in patients with COVID-19. We performed an observational cohort study at Renmin Hospital of Wuhan University, which involved 31 patients with confirmed COVID-19 with or without underlying diseases. We obtained samples from each patient, and serial viral load was measured by real-time quantitative polymerase chain reaction. We found that the viral load in the sputum was inclined to be higher than samples obtained from the nasopharyngeal swab at disease presentation. Moreover, the viral load in the sputum decreased more slowly over time than in the nasopharyngeal group as the disease progressed. Interestingly, even when samples in the nasopharyngeal swab turned negative, it was commonly observed that patients with underlying diseases, especially hypertension and diabetes, remained positive for COVID-19 and required a longer period for the sputum samples to turn negative. These combined findings emphasize the importance of tracking sputum samples even in patients with negative tests from nasopharyngeal swabs, especially for those with underlying conditions. In conclusion, this work reinforces the importance of sputum samples for SARS-CoV-2 detection to minimize transmission of COVID-19 within the community.