ABSTRACT
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.
Subject(s)
COVID-19/diagnosis , Feces/virology , Patient Discharge , SARS-CoV-2/isolation & purification , Sputum/virology , Adult , Aged , China , Female , Humans , Infant , Male , Middle Aged , RNA, Viral/isolation & purification , Young AdultABSTRACT
Objective To annalyze the effect of launching blood virus nucleic acid test(NAT) centralization in Chongqing Municipal Blood Center.Methods The various links and key control points in the aspects of the transportation,detection and information system of 32 137 centralized test specimens submitted from 14 basic level local blood stations in Chongqing counties from January 2016 to June 2016 were analyzed.Results Among 32 137 centralized specimens from January to June 2016,55 specimens were rejected for various reasons,the NAT single reactive rate was 5.1‰(164/32 137),which in the Chongqing Municipal Blood Center was 2.3‰(129/55 859)during the same period.The identification detection rate in the basic level blood station was 1.8‰(57/32 137),while which in Chongqing Municipal Blood Center was only 0.6‰(35/55 859).Conclusion The effects of launching centralized NAT have already gradually emerged in Chongqing Municipal Blood Center.The detection ability and level have differences between the laboratory of basic level blood station and blood screening laboratory of blood center.Gradually increasing the centralized test degree conduces to comprehensive improvement of blood detection efficiency and blood saftey.
ABSTRACT
Rapid influenza antigen detection tests (RIADTs) using immunochromatography are the most readily available tools for the diagnosis and management of influenza. This study was designed to assess whether near point-of-care administration by primary care physicians of the RIADT and a fully automated respiratory virus nucleic acid test (Verigene Respiratory Virus Plus®; RV+) would contribute to improved patient management. When viral culture and RT-PCR/bi-directional sequencing were used as the gold standard, sensitivities and specificities for RIADT and RV+ were 58.3% and 90.9%, and 97.2% and 100%, respectively. Within 12 hours from onset of fever, sensitivities were 44.4% and 94.4%, respectively, for RIADT and RV+. In clinical situations where a higher-sensitivity test is needed, such as during pre-admission evaluations, for testing of hospital employees during the prodromal phase of infection, during the therapeutic decision-making process, and during outbreaks, we suggest that patients testing negative by the RIADT can be reassessed with the RV+ test to achieve maximal diagnostic accuracy.
