Clinical, immunological and virological characterization of COVID-19 patients that test re-positive for SARS-CoV-2 by RT-PCR
Clinical, immunological and virological characterization of COVID-19 patients that test re-positive for SARS-CoV-2 by RT-PCR
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DOI：
10.1016/j.ebiom.2020.102960
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发表时间：
2020-09-01
期刊：
影响因子：
11.1
通讯作者：
Ke, Changwen
中科院分区：
文献类型：
--
作者：
Lu, Jing;Peng, Jinju;Ke, Changwen
背景资料：一些COVID-19病例在检测结果为阴性并出院后再次检测出SARS-CoV-2 RNA阳性，这引发了对病毒检测意义的质疑。方法：通过广东省COVID-19监测网络获得临床数据。使用微量中和试验测定中和抗体滴度。通过细胞接种评价临床样本的潜在感染性。结果：在619例出院的COVID-19病例中，87例在社会隔离的情况下重新检测为SARS-CoV-2阳性。所有再阳性病例在初次诊断时均具有轻度或中度症状，平均年龄为28岁。再阳性病例（n = 59）显示出与此处检测的其他COVID-19病例（n = 218）相似的中和抗体（NAbs）滴度分布。没有感染菌株可以通过培养和没有全长病毒基因组测序可以从re-positive cases.Interpretation：再阳性的SARS-CoV-2病例似乎并不是由主动再感染引起的，并确定在类似的14%的出院病例。在几乎所有再阳性病例中均检测到强NAb应答和潜在病毒基因组降解，表明传播风险显著降低，特别是通过呼吸道途径。(C)2020由Elsevier B. V.出版
Background: Some COVID-19 cases test positive again for SARS-CoV-2 RNA following negative test results and discharge, raising questions about the meaning of virus detection. Better characterization of re-positive cases is urgently needed.Methods: Clinical data were obtained through Guangdong's COVID-19 surveillance network. Neutralization antibody titre was determined using microneutralization assays. Potential infectivity of clinical samples was evaluated by cell inoculation. SARS-CoV-2 RNA was detected using three different RT-PCR kits and multiplex PCR with nanopore sequencing.Findings: Among 619 discharged COVID-19 cases, 87 re-tested as SARS-CoV-2 positive in circumstances of social isolation. All re-positive cases had mild or moderate symptoms at initial diagnosis and were younger on average (median, 28). Re-positive cases (n = 59) exhibited similar neutralization antibodies (NAbs) titre distributions to other COVID-19 cases (n = 218) tested here. No infectious strain could be obtained by culture and no full-length viral genomes could be sequenced from re-positive cases.Interpretation: Re-positive SARS-CoV-2 cases do not appear to be caused by active reinfection and were identified in similar to 14% of discharged cases. A robust NAb response and potential virus genome degradation were detected in almost all re-positive cases, suggesting a substantially lower transmission risk, especially through respiratory routes. (C) 2020 Published by Elsevier B.V.