Comparison of nasopharyngeal and oropharyngeal swabs for SARS-CoV-2 detection in 353 patients received tests with both specimens simultaneously
Comparison of nasopharyngeal and oropharyngeal swabs for SARS-CoV-2 detection in 353 patients received tests with both specimens simultaneously
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DOI：
10.1016/j.ijid.2020.04.023
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发表时间：
2020-05-01
影响因子：
8.4
通讯作者：
Sun, Ziyong
中科院分区：
文献类型：
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作者：
Wang, Xiong;Tan, Li;Sun, Ziyong
背景：自2019年12月在武汉爆发冠状病毒病（COVID-19）以来，截至2020年3月10日，中国累计报告确诊病例80,932例。出院评估需要呼吸道标本连续两次RT-PCR检测结果呈阴性，口咽拭子是最常见的样本。然而，假阴性结果发生在住院后期，避免假阴性结果至关重要。 方法：我们回顾了同时接受两种标本检测的 353 名患者的病历，并比较了鼻咽拭子和口咽拭子的表现。 结果：在研究的 353 名患者（门诊患者 192 例；住院患者 161 例）中，中位年龄为 54 岁，中位年龄为 177 岁。 (50.1%) 是女性。鼻咽拭子的阳性率（阳性检测/总检测）高于口咽拭子，特别是在住院患者中。住院患者鼻咽拭子阳性率高于门诊患者。男性鼻咽拭子阳性率高于女性，尤其是门诊患者。两种标本检测的阳性率均比仅鼻咽拭子检测的阳性率略有提高。此外，鼻咽拭子和口咽拭子之间的一致性较差（Kappa = 0.308）。结论：总而言之，我们的研究表明，在COVID-19爆发的现阶段，鼻咽拭子可能比口咽拭子更合适。 (C) 2020 作者。由爱思唯尔有限公司代表国际传染病学会出版。
Background: Since the outbreak of coronavirus disease (COVID-19) in Wuhan in December 2019, by March 10, 2020, a total of 80,932 confirmed cases have been reported in China. Two consecutively negative RT-PCRtest results in respiratory tract specimens is required for the evaluation of discharge from hospital, and oropharyngeal swabs were the most common sample. However, false negative results occurred in the late stage of hospitalization, and avoiding false negative result is critical essential.Methods: We reviewed the medical record of 353 patients who received tests with both specimens simultaneously, and compared the performance between nasopharyngeal and oropharyngeal swabs.Results: Of the 353 patients (outpatients, 192; inpatients, 161) studied, the median age was 54 years, and 177 (50.1%) were women. Higher positive rate (positive tests/total tests) was observed in nasopharyngeal swabs than oropharyngeal swabs, especially in inpatients. Nasopharyngeal swabs from inpatients showed higher positive rate than outpatients. Nasopharyngeal swabs from male showed higher positive rate than female, especially in outpatients. Detection with both specimens slightly increased the positive rate than nasopharyngeal swab only. Moreover, the consistency between from nasopharyngeal and oropharyngeal swabs were poor (Kappa = 0.308).Conclusion: In conclusion, our study suggests that nasopharyngeal swabs may be more suitable than oropharyngeal swab at this stage of COVID-19 outbreak. (C) 2020 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.