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Value of Viral Nucleic Acid in Sputum and Feces and Specific IgM/IgG in Serum for the Diagnosis of Coronavirus Disease 2019.

Author(s): He Y, Luo J, Yang J, Song J, Wei L, Ma W

Publication: Front Cell Infect Microbiol, 2020, Vol. 10, Page 445

PubMed ID: 32850506 PubMed Review Paper? No

Purpose of Paper

Conclusion of Paper

Studies

1. Study Purpose

   This study compared the detection of SARS-CoV-2 in matched nasal swab, oropharyngeal swab, feces, and sputum specimens using real-time qRT-PCR over the course of the patient’s hospitalization and detection of SARS-CoV-2 IgM/IgG antibodies in serum using immunochromatography. Specimens were collected from 20 hospitalized patients (median age=57.35 y; 14 males, 6 females) every day for a week and then every 2-3 days until patient discharge. Viral RNA was extracted from swab, sputum, and fecal specimens using a magnetic bead-based method (details for collection, processing, and storage not provided). The open reading frame (ORF1ab), nucleoprotein (N) gene regions of SARS-CoV-2 was detected by real-time qRT-PCR and specimens were determined positive if CT value was <40. Serum was separated from the blood specimen (tube type not specified) by centrifugation at 3,000 rpm for 15 min within 24 h after collection, inactivated at 56°C for 30 min, and stored at 4°C until analysis for SARS-CoV-2 IgM/IgG antibodies by immunochromatography.

   Summary of Findings:

   The detection rate of SARS-CoV-2 RNA was highest in sputum specimens (19/20), followed by nasal swabs (14/20), fecal specimens (11/20), and then oropharyngeal swabs (10/20). SARS-CoV-2 RNA was detected in sputum for a significantly longer average number of days compared to oropharyngeal swabs, nasal swabs, and feces (42.8 versus 32.0, 24.0, and 20.6 days, respectively; P<0.00017, P<0.00167, and P<0.00833, respectively). SARS-CoV-2 IgG and IgM antibodies were detected in serum of all 20 patients.

   Biospecimens

   • Cell - Nasal cavity
   • Cell - Oral Cavity
   • Bodily Fluid - Serum
   • Bodily Fluid - Sputum
   • Bodily Fluid - Feces
   • Bodily Fluid - Blood

   Preservative Types

   • None (Fresh)

   Diagnoses:

   • Pneumonia/Respiratory Infection

   Platform:

   Analyte	Technology Platform
   Protein	Immunoaffinity chromatography
   RNA	Real-time qRT-PCR

   Pre-analytical Factors:

   Classification	Pre-analytical Factor	Value(s)
   Real-time qRT-PCR Specific	Targeted nucleic acid	ORF1ab/N gene regions of SARS-CoV-2
   Biospecimen Acquisition	Biospecimen location	nasal swab oropharyngeal swab sputum feces serum

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