ABSTRACT
Objective To analyze the detection rate and clinical value of SARS-CoV-2 nucleic acid in anal swab specimen from the convalescent patients with novel coronavirus infection (COVID-19). Methods SARS-CoV-2 nucleic acid samples were detected in convalescent patients with COVID-19 including sputum, pharyngeal swabs and anal swabs specimens. The nucleic acid positive rates of three types of specimens were analyzed. Meanwhile, the nucleic acid detection rates of sputum and pharyngeal swab specimens were analyzed in patients with the positive nucleic acid of anal swab virus. Results A total of 156 samples were collected from 50 patients with COVID 19. The positive for SARS-CoV-2 nucleic acid was 8 (19.5%) in 41 sputum samples. The positive for SARS-CoV-2 nucleic acid was 6 (10.9%) in 55 throat swab samples. The positive for SARS-CoV-2 nucleic acid was 11 (18.3%) in 60 anal swab specimen. Among the 50 convalescent patients with COVID-19, sputum, pharyngeal swabs and anal swab samples were 8 cases (19.5%), 6 cases (12.0%) and 10 cases (20.0%), respectively. In 10 patients with positive anal swab detection, 9 cases were found negative in the respiratory tract specimens. Conclusion The positive detection rate of SARS-CoV-2 nucleic acid is higher in anal swab specimen than that of laryngeal swabs and sputum specimens of the convalescent patients with COVID-19. When SARS-CoV-2 nucleic acid is negative in respiratory tract specimens, the anal swab specimen should be detected in the recovery period, which can be used as leaving hospital standard or isolation standard.
ABSTRACT
Novel coronavirus pneumonia (NCP) is an emerging, highly contagious community acquired pneumonia (CAP) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Highly efficient and accurate microbiological laboratory assay is essential to confirm the SARS-CoV-2 infection, rule out other pathogens that can cause CAP, and monitor secondary infections. Here, we enrolled and provide microbiological analysis for 129 suspected and 52 transferred confirmed NCP patients hospitalized in the First Affiliated Hospital of University of Science and Technology of China (USTC) from Jan 21 to Feb 29, 2020. By analyzing the dual swab samples (sputum and pharyngeal) from 129 suspected patients with realtime RT-PCR, we confirmed 33 SARS-CoV-2 infections, with two co-infection cases with adenovirus or rhinovirus. We also used multiplex PCR to detect 13 common respiratory tract pathogens in 96 non-NCP patients, and found that 30 patients (31.25%) were infected with at least one respiratory tract pathogen that may cause CAP. Further, we performed bacterial and fungal cultures as well as fungal serologic tests and found that there is no secondary bacterial/fungal infections in confirmed NCP patients. Our studies suggest that, during the epidemic of NCP in Anhui province, there was a certain proportion of infection and co-infection of other common pathogens of CAP, and the secondary bacterial and fungal infection is not detectable in NCP patients. In comparison with SARS-CoV-2 detection alone, this optimized strategy combining multiple pathogen detection for identification of NCP and other CAP patients as well as cultures and serologic tests for confirmed patients increases the diagnosis efficiency and facilitates the personalized medication.
Subject(s)
Coronavirus Infections , Coinfection , Infections , Mycoses , Pneumonia , Severe Acute Respiratory Syndrome , COVID-19ABSTRACT
The outbreak of the novel coronavirus disease 2019 (COVID-19) infection began in December 2019 in Wuhan, and rapidly spread to many provinces in China. The number of cases has increased markedly in Anhui, but information on the clinical characteristics of patients is limited. We reported 75 patients with COVID-19 in the First Affiliated Hospital of USTC from Jan 21 to Feb 16, 2020, Hefei, Anhui Province, China. COVID-19 infection was confirmed by real-time RT-PCR of respiratory nasopharyngeal swab samples. Epidemiological, clinical and laboratory data were collected and analyzed. Of the 75 patients with COVID-19, 61 (81.33%) had a direct or indirect exposure history to Wuhan. Common symptoms at onset included fever (66 [88.0%] of 75 patients) and dry cough (62 [82.67%]). Of the patients without fever, cough could be the only or primary symptom. The most prominent laboratory abnormalities were lymphopenia, decreased percentage of lymphocytes (LYM%), decreased CD4+ and CD8+ T cell counts, elevated C-reactive protein (CRP) and lactate dehydrogenase (LDH). Patients with elevated interleukin 6 (IL-6) showed significant decreases in the LYM%, CD4+ and CD8+ T cell counts. Besides, the percentage of neutrophils, CRP, LDH and Procalcitonin levels increased significantly. We concluded that COVID-19 could cause different degrees of hematological abnormalities and damage of internal organs. Hematological profiles including LYM, LDH, CRP and IL-6 could be indicators of diseases severity and evaluation of treatment effectiveness. Antiviral treatment requires a comprehensive and supportive approach. Further targeted therapy should be determined based on individual clinical manifestations and laboratory indicators.