Persistence ofSARS-CoV-2 nasopharyngeal swabPCRpositivity inCOVID-19 convalescent plasma donors
Persistence ofSARS-CoV-2 nasopharyngeal swabPCRpositivity inCOVID-19 convalescent plasma donors
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DOI：
10.1111/trf.16015
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发表时间：
2020-08-24
期刊：
影响因子：
2.9
通讯作者：
Gniadek, Thomas J.
中科院分区：
文献类型：
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作者：
Ikegami, Sachie;Benirschke, Robert;Gniadek, Thomas J.
背景 在许多病毒感染的症状消除和感染性之后，核酸通过核酸片段、非感染性颗粒或传染性病毒的延迟清除而持续存在。对于 2019 冠状病毒病 (COVID-19)，鼻咽 (NP) 拭子阳性、针对 COVID-19 的抗体的产生以及临床病史之间的关系尚不清楚。研究设计和方法 通过 NP 拭子 PCR 对从 COVID-19 中康复并自愿捐献恢复期血浆 (CP) 的个人进行筛查，回答问卷，并进行抗 COVID-19 抗体检测。结果 在活动性疾病症状消失超过 14 天后，有 11.8% 的人通过 NP 拭子 PCR 检测呈 SARS-CoV-2 阳性，其中包括一名无症状疾病的捐献者，并在初次诊断后 41 天通过 NP 拭子检测呈阳性。临床病史并未显示与 NP 拭子阳性持续存在显着相关性。此外，症状缓解后 14 天以上的 NP 拭子阳性与抗 COVID-19 血清学结果无关。使用两种不同的检测方法，IgG 抗 SARS-CoV-2 尖峰抗体强度与 COVID-19 住院相关。总抗 SARS-CoV-2 核衣壳抗体强度与从症状缓解到样本采集的时间以及症状持续时间相关。结论 在很大一部分先前诊断的个体中，在症状消退后很长时间内仍可检测到 SARS-CoV-2 核酸，这在解释 PCR 拭子结果时需要考虑到这一点。 PCR 阳性持续存在与抗体强度或 COVID-19 症状无关。如果使用抗尖峰抗体来评估 CP 效力，患有严重 COVID-19 疾病症状的个体可能代表更好的捐赠者。
Background Nucleic acid persists after symptom resolution and infectivity for many viral infections via delayed clearance of nucleic acid fragments, non-infectious particles, or transmissible virus. For Coronavirus Disease 2019 (COVID-19), the relationship between nasopharyngeal (NP) swab positivity, the development of antibodies against COVID-19, and clinical history are unclear. Study design and methods Individuals who recovered from COVID-19 and volunteered to donate convalescent plasma (CP) were screened by NP swab PCR, responded to a questionnaire, and were tested for anti-COVID-19 antibodies. Results A proportion of 11.8% of individuals tested positive for SARS-CoV-2 by NP swab PCR greater than 14 days after the resolution of symptoms of active disease, including one donor who had asymptomatic disease and tested positive by NP swab 41 days after her initial diagnosis. Clinical history did not show a significant correlation with persistence of NP swab positivity. Also, NP swab positivity >14 days from symptom resolution did not correlate with anti-COVID-19 serology results. IgG anti-SARS-CoV-2 spike antibody strength correlated with hospitalization for COVID-19 using two different assays. Total anti-SARS-CoV-2 nucleocapsid antibody strength correlated with time from symptom resolution to sample collection and symptom duration. Conclusions SARS-CoV-2 nucleic acid is detectable long after the resolution of symptoms in a significant percentage of previously diagnosed individuals, which is important to consider when interpreting PCR swab results. Persistence of PCR positivity does not correlate with antibody strength or symptoms of COVID-19. If anti-spike antibody is used to assess CP potency, individuals who suffered severe COVID-19 disease symptoms may represent better donors.