Connecting clusters of COVID-19: an epidemiological and serological investigation
Connecting clusters of COVID-19: an epidemiological and serological investigation
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DOI：
10.1016/s1473-3099(20)30273-5
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发表时间：
2020-07-01
影响因子：
56.3
通讯作者：
Lee, Vernon J. M.
中科院分区：
文献类型：
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作者：
Yong, Sarah Ee Fang;Anderson, Danielle Elizabeth;Lee, Vernon J. M.
背景明确新型冠状病毒病（COVID-19）的传播链和传染源是有效防控疫情的关键。我们描述了一项流行病学调查，该调查使用严重急性呼吸综合征冠状病毒2 （SARS-CoV-2）血清学分析，确定了三个COVID-19聚集性之间的联系。方法在新加坡，对所有COVID-19病例进行积极的病例发现和接触者追踪。经RT-PCR检测确诊为急性疾病。当流行病学信息表明人们可能是疾病传播的节点但已经从疾病中恢复时，使用SARS-CoV-2 IgG血清学检测来确定过去的感染情况。在新加坡发现了3例COVID-19聚集性病例，包括28例本地传播病例；这些人来自两个教堂（教堂A和教堂B）和一个家庭聚会。教堂A和教堂B的聚集性病例与教堂A （A2）的一名个人有关，该个人在2020年1月25日两人参加的家庭聚会上将SARS-CoV-2感染传播给了教堂B （F1）的主要病例。除A2外，所有病例均通过RT-PCR检测确诊，因为他们患有活动性疾病，A2在检测时已从疾病中康复，检测结果为阴性。该个体最终通过血清学检测诊断为既往感染。ELISA检测显示其光密度大于1？SARS-CoV-2核蛋白和受体结合域抗原的滴度高达1/400，并且在滴度高达1/320的情况下观察到病毒中和。血清学分析的开发和应用有助于在新加坡建立COVID-19聚集性之间的联系。血清学检测可在确定其他监测方法可能遗漏的恢复期病例或病情较轻的患者方面发挥关键作用。
Background Elucidation of the chain of disease transmission and identification of the source of coronavirus disease 2019 (COVID-19) infections are crucial for effective disease containment. We describe an epidemiological investigation that, with use of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serological assays, established links between three clusters of COVID-19.Methods In Singapore, active casefinding and contact tracing were undertaken for all COVID-19 cases. Diagnosis for acute disease was confirmed with RT-PCR testing. When epidemiological information suggested that people might have been nodes of disease transmission but had recovered from illness, SARS-CoV-2 IgG serology testing was used to establish past infection.Findings Three clusters of COVID-19, comprising 28 locally transmitted cases, were identified in Singapore; these clusters were from two churches (Church A and Church B) and a family gathering. The clusters in Church A and Church B were linked by an individual from Church A (A2), who transmitted SARS-CoV-2 infection to the primary case from Church B (F1) at a family gathering they both attended on Jan 25, 2020. All cases were confirmed by RT-PCR testing because they had active disease, except for A2, who at the time of testing had recovered from their illness and tested negative. This individual was eventually diagnosed with past infection by serological testing. ELISA assays showed an optical density of more than 1?4 for SARS-CoV-2 nucleoprotein and receptor binding domain antigens in titres up to 1/400, and viral neutralisation was noted in titres up to 1/320.Interpretation Development and application of a serological assay has helped to establish connections between COVID-19 clusters in Singapore. Serological testing can have a crucial role in identifying convalescent cases or people with milder disease who might have been missed by other surveillance methods.