Positive result of Sars-Cov-2 in faeces and sputum from discharged patients with COVID-19 in Yiwu, China
Positive result of Sars-Cov-2 in faeces and sputum from discharged patients with COVID-19 in Yiwu, China
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DOI：
10.1002/jmv.25905
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发表时间：
2020-07-28
影响因子：
12.7
通讯作者：
Xu, Jian
中科院分区：
文献类型：
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作者：
Li, Youjiang;Hu, Yingying;Xu, Jian
背景随着中国对COVID-19的有效防控，治愈病例数量大幅增加。进一步监测病情预后，有效控制疫情“复发”，成为下一步工作重点。本研究通过监测COVID-19出院患者的SAR-CoV-2核酸状态，分析其临床预后，为医疗机构制定COVID-19患者出院标准和后续管理提供理论依据。方法我们纳入了13名出院的COVID-19患者，他们在家隔离了4周。记录患者每日临床体征，定期送检痰液和粪便标本进行SARS-CoV-2核酸检测。结果从首次出现症状到出院的时间为18 ~ 44 d，平均25 ± 6 d。两名患者的粪便样本在符合出院标准后仍呈阳性，四名患者的痰样本在出院后5至14天恢复阳性。呼吸系统标本中反复阳性率为31%（4/13）。结论在现行出院标准下，出院COVID-19患者的粪便和呼吸道样本中SARS-CoV-2核酸的高检出率提示潜在传染性。因此，我们建议将粪便病毒核酸检测作为COVID-19的常规监测指标，并在标准中增加阴性结果。同时，要加强对出院患者的定期随访，持续监测病毒核酸复发情况。
Background With the effective prevention and control of COVID-19 in China, the number of cured cases has increased significantly. Further monitoring of the disease prognosis and effective control of the "relapse" of the epidemic has become the next focus of work. This study analysed the clinical prognosis of discharged COVID-19 patients by monitoring their SAR-CoV-2 nucleic acid status, which provided a theoretical basis for medical institutions to formulate discharge standards and follow-up management for COVID-19 patients. Methods We included 13 discharged COVID-19 patients who were quarantined for 4 weeks at home. The patient's daily clinical signs were recorded and sputum and faecal specimens were regularly sent for detection of SARS-CoV-2 nucleic acid. Results The time between initial symptoms and meeting discharge criteria was 18 to 44 days with an average of 25 +/- 6 days. The faecal samples of two patients still tested positive after meeting the discharge criteria and the sputum samples of four patients returned positive 5 to 14 days after discharge. The rate of the recurring positive test result in samples from the respiratory system was 31% (4/13). Conclusion Under the present discharge criteria, the high presence of SARS-CoV-2 nucleic acid in faecal and respiratory samples of discharged COVID-19 patients indicates potential infectivity. Therefore, we suggest that faecal virus nucleic acid should be tested as a routine monitoring index for COVID-19 and a negative result be added to the criteria. Simultaneously, we should strengthen the regular follow-up of discharged patients with continuous monitoring of the recurrence of viral nucleic acid.