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SARS-CoV-2 IgG和IgM抗体在诊治新型冠状病毒肺炎的应用价值
Application value of SARS-CoV-2 IgG and IgM antibodies in diagnosis and treatment of new coronavirus pneumonia
- 第三军医大学学报 2020年42卷第15期 页码：1489-1494
- 作者机构：
1.400016 重庆, 重庆医科大学附属第一医院呼吸与危重症医学科
2.404000 重庆, 重庆市三峡中心医院检验科
- 作者简介：
[ 崔小平，E-mail:xiaoping1970@163.com CUI Xiaoping, E-mail:xiaoping1970@163.com
[ 郭述良，E-mail: Guosl999@sina.com GUO Shuliang, E-mail:Guosl999@sina.com
- 基金信息：重庆市“新型冠状病毒感染与防治”应急科研专项项目(KYYJ202006);重庆市科委“新冠肺炎疫情应急科技攻关专项”第四批项目(CSTC2020JSCX-FYZX0235)
DOI：10.16016/j.1000-5404.202003186
中图分类号： R373.1;R392.11;R563.1收稿：2020-03-15，
修回：2020-05-19，
纸质出版：2020-08-15
- 稿件说明：
移动端阅览
胡前芳, 王晓惠, 敖知, 等. SARS-CoV-2 IgG和IgM抗体在诊治新型冠状病毒肺炎的应用价值[J]. 第三军医大学学报, 2020,42(15):1489-1494.
Qianfang HU, Xiaohui WANG, Zhi AO, et al. Application value of SARS-CoV-2 IgG and IgM antibodies in diagnosis and treatment of new coronavirus pneumonia[J]. Journal of Third Military Medical University, 2020, 42(15): 1489-1494.
胡前芳, 王晓惠, 敖知, 等. SARS-CoV-2 IgG和IgM抗体在诊治新型冠状病毒肺炎的应用价值[J]. 第三军医大学学报, 2020,42(15):1489-1494. DOI： 10.16016/j.1000-5404.202003186.
Qianfang HU, Xiaohui WANG, Zhi AO, et al. Application value of SARS-CoV-2 IgG and IgM antibodies in diagnosis and treatment of new coronavirus pneumonia[J]. Journal of Third Military Medical University, 2020, 42(15): 1489-1494. DOI： 10.16016/j.1000-5404.202003186.
摘要
目的
2
探讨化学发光法检测SARS-CoV-2 IgM/IgG抗体在辅助诊疗新型冠状病毒肺炎(coronavirus disease 2019，COVID-19)中的应用价值。
方法
2
将203例COVID-19确诊患者作为确诊组，158例其他科室的非COVID-19患者和50例正常献血者共208例作为对照组，采用化学发光的方法进行检测。
结果
2
SARS-CoV-2 IgG抗体检测的临床灵敏度、特异性、阳性预测值、阴性预测值分别为85.7%、99.0%、98.8%、87.6%；SARS-CoV-2 IgM抗体检测的临床灵敏度、特异性、阳性预测值、阴性预测值分别为66.5%、98.0%、97.1%、75.0%；SARS-CoV-2 IgG和IgM抗体联合检测的临床灵敏度、特异性、阳性预测值、阴性预测值分别为89.6%、96.8%、97.3%、87.9%；SARS-CoV-2 IgG和IgM抗体在检出率无统计学差异的情况下，重症组距离发病日期的平均检测时间为10.8(10.8±4.1)d，早于轻症组的13.3(13.3±6.4)d，差异有统计学意义(
P
=0.017)；IgG阴性组的中位检测时间为发病后7.0(5.0~12.0)d，早于IgG阳性组的13.5(10.0~17.0)d，差异具有统计学意义(
P
=0.000 1)；IgM阴性组的中位检测时间为发病后11.0(6.0~16.0)d，早于IgM阳性组的14.0(10.0~17.0)d，差异具有统计学意义(
P
=0.016)。
结论
2
化学发光法检测新型冠状病毒IgM和IgG抗体的方法具有较好的特异性和敏感性，可辅助诊断COVID-19，弥补病毒核酸检测的不足；检测时间是影响抗体结果的主要因素，较早检出SARS-CoV-2 IgM/IgG抗体可能预示着病情更加严重。
Abstract
Objective
2
To explore the application value of chemiluminescence detection of SARS-CoV-2 IgM/IgG antibodies in the adjuvant diagnosis and treatment of coronavirus disease 2019 (COVID-19).
Methods
2
A total of 208 COVID-19-confirmed patients admitted in the Acute Pneumonia Section of Chongqing Three Gorges Central Hospital from January 23 to March 3
2020 were recruited and served as the confirmed group
and another 208 cases
including 158 non-COVID-19 patients from other departments and 50 health volunteers as blood donors were subjected as the control group. Chemiluminescence assay was used for detection of the antibodies.
Results
2
The results showed that the clinical sensitivity
specificity
positive predictive value
and negative predictive value for SARS-CoV-2 IgG antibody were 85.7%
99.0%
98.8%
and 87.6%
respectively. While the above values for SARS-CoV-2 IgM antibody were 66.5%
98.0%
97.1%
and 75.0%
respectively. And these values were 89.6%
96.8%
97.3%
and 87.9%
respectively
when the 2 antibodies combined together. There was no statistical difference in the detection rate of SARS-CoV-2 IgG and IgM antibodies. The average detection time from the date of onset was 10.8 (10.8±4.1) d in the severe group
statistically earlier than that in the mild group [13.3 (13.3±6.4) d
P
=0.017
]
. The median detection time of the IgG negative group was 7.0 (5.0~12.0) d after onset
earlier than 13.5 (10.0~17.0) d of the IgG positive group
with statistical difference (
P
=0.000 1); while
the median time of the IgM negative group was 11.0 (6.0~16.0) d after onset
earlier than 14.0 (10.0~17.0) d in the IgG positive group (
P
=0.016).
Conclusion
2
Chemiluminescence assay for detection of SARS-CoV-2 IgM and IgG antibodies has good specificity and sensitivity
and can help diagnose COVID-19
by making up the shortcomings of viral nucleic acid test. The detection time is the main factor affecting the results of antibody test
and early detection of SARS-CoV-2 IgM/IgG antibodies may indicate a more serious illness.
关键词
Keywords
references
ZHU N, ZHANG D Y, WANG W L, et al . A novel coronavirus from patients with pneumonia in China, 2019[J ] . N Engl J Med, 2020, 382(8): 727-733. DOI:10.1056/NEJMoa2001017.
LU H Z, STRATTON C W, TANG Y W. Outbreak of pneumonia of unknown etiology in Wuhan, China: The mystery and the miracle[J]. J Med Virol, 2020, 92(4): 401-402. DOI:10.1002/jmv.25678.
HUANG C L, WANG Y M, LI X W, et al . Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China[J ] . Lancet, 2020, 395(10223): 497-506. DOI:10.1016/S0140-6736(20)30183-5
[WHO. Coronavirus disease(COVID-19) pandemic[EB/OL ] .[2020-04-23 ] . https://www.who.int/emergencies/diseases/novel-coronavirus-2019 https://www.who.int/emergencies/diseases/novel-coronavirus-2019 .
[国家卫生健康委办公厅, 国家中医药管理局办公室.新型冠状病毒肺炎诊疗方案(试行第七版)[EB/OL ] .[2020-03-04 ] . https://so.m.sm.cn/c/s/m.vodjk.com/mip/a/1631009.shtml https://so.m.sm.cn/c/s/m.vodjk.com/mip/a/1631009.shtml .
[General Office of National Health Commission, Administration Office of National Administration of Traditional Chinese Medicine. Diagnosis and treatment plan of novel coronavirus pneumonia(7th Ed)[EB/OL ] .[2020-03-04 ] . https://so.m.sm.cn/c/s/m.vodjk.com/mip/a/1631009.shtml https://so.m.sm.cn/c/s/m.vodjk.com/mip/a/1631009.shtml .
CATHARINE I P, HILARY D M, ANTHONY S F. Coronavirus infections—more than just the common cold[J]. JAMA, 2020, 323(8):707-708. DOI:10.1001/jama.2020.0757.
CHEN D B, XU W X, LEI Z Y, et al . Recurrence of positive SARS-CoV-2 RNA in COVID-19: a case report[J ] . Int J Infect Dis, 2020, 93: 297-299. DOI:10.1016/j.ijid.2020.03.003.
徐万洲, 李娟, 何晓云, 等.血清2019新型冠状病毒IgM和IgG抗体联合检测在新型冠状病毒感染中的诊断价值[J].中华检验医学杂志, 2020, 43(3): 230-233. DOI: 10.3760/cma.j.issn.1009-9158.2020.03.007.
XU W Z, LI J, HE X Y, et al . Diagnostic value of combined detection of serum 2019 new coronavirus IgM and IgG antibodies in new coronavirus infection[J ] . Chin J Lab Med, 2020, 43(3): 230-233. DOI: 10.3760/cma.j.issn.1009-9158.2020.03.007.
LI G, CHEN X J, XU A L. Profile of specific antibodies to the SARS-associated coronavirus[J]. N Engl J Med, 2003, 349(5): 508-509. DOI:10.1056/NEJM200307313490520.
ZHOU P, YANG X L, WANG X G, et al . A pneumonia outbreak associated with a new coronavirus of probable bat origin[J ] . Nature, 2020, 579(7798): 270-273. DOI:10.1038/s41586-020-2012-7.
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