SARS-CoV-2抗体检测在新型冠状病毒肺炎诊断中的应用价值

doi:10.3969/j.issn.1673-8640.2020.06.007

检验医学 ›› 2020, Vol. 35 ›› Issue (6): 546-550.DOI: 10.3969/j.issn.1673-8640.2020.06.007

SARS-CoV-2抗体检测在新型冠状病毒肺炎诊断中的应用价值

汪建茹¹, 杨进波¹, 张驰²()

1.湖北医药学院附属襄阳市第一人民医院检验科,湖北襄阳 441000
2.华中科技大学同济医学院附属同济医院检验科,湖北武汉 430030

收稿日期:2020-03-13 出版日期:2020-06-30 发布日期:2020-07-01
作者简介:null
作者简介：汪建茹,女,1987年生,硕士,主管技师,主要从事血液学检验相关研究。

Role of severe acute respiratory syndrome coronavirus 2 antibody detections in the diagnosis of corona virus disease 2019

WANG Jianru¹, YANG Jinbo¹, ZHANG Chi²()

1. Department of Clinical Laboratory,Xiangyang No.1 People's Hospital,Hubei University of Medicine,Xiangyang 441000,Hubei,China
2. Department of Clinical Laboratory,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Hubei,China

Received:2020-03-13 Online:2020-06-30 Published:2020-07-01

摘要/Abstract

摘要：

目的探讨血清严重急性呼吸综合征冠状病毒（SARS-CoV-2）IgM和IgG抗体检测在新型冠状病毒肺炎（COVID-19）诊断中的价值。方法选取COVID-19患者173例（COVID-19组）,其中140例SARS-CoV-2首次核酸检测阳性,33例多次检测后呈阳性。以101例排除COVID-19的患者作为对照组。采用胶体金免疫层析法（CGIA）检测SARS-CoV-2 IgM和IgG抗体,采用荧光定量聚合酶链反应（PCR）检测SARS-CoV-2核酸。以临床诊断为金标准,分析SARS-CoV-2 IgM和IgG抗体诊断COVID-19的效能。结果 SARS-CoV-2 IgM和IgG抗体的敏感性分别为76.9%、74.6%,特异性分别为94.0%、95.1%,临床总符合率分别为83.2%、82.1%,与临床诊断的一致性均较好（kappa值分别为0.663、0.644）。受试者工作特征（ROC）曲线分析结果显示,SARS-CoV-2 IgM和IgG抗体诊断COVID-19的曲线下面积（AUC）均为0.85。结论 SARS-CoV-2抗体检测具有较高的敏感性、特异性和临床总符合率,可用于COVID-19的辅助诊断。

关键词: 严重急性呼吸综合征冠状病毒2, 抗体, 新型冠状病毒肺炎

Abstract:

Objective To investigate the role of severe acute respiratory syndrome coronavirus 2（SARS-CoV-2） IgM and IgG antibody detections in the diagnosis of corona virus disease 2019（COVID-19）. Methods A total of 173 patients diagnosed with COVID-19 were enrolled. There were 140 cases of being positive for the first time of SARS-CoV-2 nucleic acid test and 33 cases of being eventually diagnosed for several times of SARS-CoV-2 nucleic acid test. Totally,101 patients without COVID-19 were enrolled as control group. Colloidal gold immunochromatography assay（CGIA） was used to detect SARS-CoV-2 IgM and IgG antibodies,and fluorescence quantitative polymerase chain reaction（PCR） was used to detect SARS-CoV-2 nucleic acid. Taking clinical diagnosis as gold standard,the efficiency of SARS-CoV-2 IgM and IgG antibody detections in the diagnosis of COVID-19 was analyzed. Results The sensitivities of SARS-CoV-2 IgM and IgG antibody detections were 76.9% and 74.6%,the specificities were 94.0% and 95.1%,and the consistency rates were 83.2% and 82.1%,which were well consistent with the clinical diagnosis（kappa values were 0.663 and 0.644）,respectively. Receiver operating characteristic（ROC） curve analysis showed that the areas under curves（AUC） of SARS-CoV-2 IgM and IgG antibody detections for the diagnosis of COVID-19 were 0.85. Conclusions The detections of SARS-CoV-2 antibodies have high sensitivities,specificities and consistency rates,which can be used for the auxiliary diagnosis of COVID-19.

Key words: Severe acute respiratory syndrome coronavirus 2, Antibody, Corona virus disease 2019

中图分类号:

R373.1

汪建茹, 杨进波, 张驰. SARS-CoV-2抗体检测在新型冠状病毒肺炎诊断中的应用价值[J]. 检验医学, 2020, 35(6): 546-550.

WANG Jianru, YANG Jinbo, ZHANG Chi. Role of severe acute respiratory syndrome coronavirus 2 antibody detections in the diagnosis of corona virus disease 2019[J]. Laboratory Medicine, 2020, 35(6): 546-550.

图/表 4

表1 SARS-CoV-2 IgM抗体与临床诊断的比较

SARS-CoV-2 IgM抗体	临床诊断		合计
SARS-CoV-2 IgM抗体	阳性	阴性	合计
阳性	133	6	139
阴性	40	95	135
合计	173	101	274

表2 SARS-CoV-2 IgG抗体与临床诊断的比较

SARS-CoV-2 IgG抗体	临床诊断		合计
SARS-CoV-2 IgG抗体	阳性	阴性	合计
阳性	129	5	134
阴性	44	96	140
合计	173	101	274

图1 SARS-CoV-2 IgM抗体和IgG抗体诊断COVID-19的ROC曲线注：——IgM抗体;------IgG抗体

图2 20例首次SARS-CoV-2核酸检测阴性患者血清SARS-CoV-2核酸、IgG抗体、IgM抗体阳性检出时间注：IgM抗体;IgG抗体;SARS-CoV-2核酸

参考文献 13

[1]	Naming the coronavirus disease（COVID-19） and the virus that causes it[EB/OL]. (2020-03-10)[2020-03-11].
[2]	国家卫生健康委员会. 新型冠状病毒肺炎诊疗方案（试行第七版）[EB/OL].(2020-03-03)[2020-03-10].
[3]	里进,叶光明,陈良君,等. 新型冠状病毒(2019-nCoV)核酸检测假阴性结果原因分析及对策[J/OL]. 中华检验医学杂志,2020,43. DOI:10.3760/cma.j.issn.1009-9158. 2010.0006.
[4]	莫茜,秦炜,傅启华,等. 正确认识新冠病毒核酸检测的影响因素[J/OL]. 中华检验医学杂志,2020,43. DOI:10.3760/cma.j.issn.1009-8158.2020.002.
[5]	HAMMITT L L,MURDOCH D R,SCOTT J A,et al.Specimen collection for the diagnosis of pediatric pneumonia[J]. Clin Infect Dis,2012,54(Suppl 2):S132-S139.
[6]	KIM Y G,YUN S G,KIM M Y,et al.Comparison between saliva and nasopharyngeal swab specimens for detection of respiratory viruses by multiplex reverse transcription-PCR[J]. J Clin Microbiol,2017,55(1):226-233.
[7]	LI L,CHEN Q Y,LI Y Y,et al.Comparison among nasopharyngeal swab,nasal wash,and oropharyngeal swab for respiratory virus detection in adults with acute pharyngitis[J]. BMC Infect Dis,2013,13:281.
[8]	ZHU N,ZHANG D,WANG W,et al.A novel coronavirus from patients with pneumonia in China,2019[J]. N Engl J Med,2020,382(8):727-733.
[9]	WHO Director-General's opening remarks at the media briefing on COVID-19[EB/OL]. (2020-03-06)[2020-03-10]. .
[10]	ZHANG W,DU R H,LI B,et al.Molecular and serological investigation of 2019-nCoV infected patients:implication of multiple shedding routes[J]. Emerg Microbes Infect,2020,9(1):386-389.
[11]	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.
[12]	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/OL]. 中华检验医学杂志,2020,43. DOI:10.3760/cma.j.cn114452-20200223-00109.
[13]	王强,杜琴,郭斌,等. 尿素解离法纠正2019新型冠状病毒IgM抗体检测结果假阳性的效果评价[J/OL]. 中华检验医学杂志,2020,43. DOI:10.3760/cma.j.cn114452-20200219-00091.

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SARS-CoV-2抗体检测在新型冠状病毒肺炎诊断中的应用价值

Role of severe acute respiratory syndrome coronavirus 2 antibody detections in the diagnosis of corona virus disease 2019

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