Ling Li1,2, Chianru Tan3, Jia Zeng4,5, Chen Luo1,2, Shi Hu6, Yanke Peng3, Wenjuan Li1,7, Zhixiong Xie5,8, Yueming Ling5,9, Xuejun Zhang1, E Deng1, Haixia Xu1,2, Jue Wang1,2, Yudi Xie1,2, Yaling Zhou1,2, Wei Zhang10,11, Yong Guo12, Zhong Liu13,14. 1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, 610052, Sichuan, People's Republic of China. 2. Key Laboratory of Transfusion Adverse Reactions, Chinese Academy of Medical Sciences, Chengdu, 610052, Sichuan, People's Republic of China. 3. Department of Biomedical Engineering, School of Medicine, Tsinghua University, 30 Shuangqing Road, Beijing, 100084, People's Republic of China. 4. Department of Aviation Disease, Naval Medical Center of PLA, Second Military Medical University, Shanghai, 200052, People's Republic of China. 5. The Maternal and Child Health Hospital of Hubei Province, Guanggu District, Wuhan, 430070, Hubei, People's Republic of China. 6. Department of Biophysics, College of Basic Medical Sciences, Second Military Medical University, Shanghai, 200433, People's Republic of China. 7. Anhui Medical University, Hefei, 230032, People's Republic of China. 8. Department of Clinical Laboratory Science of NO. 909 Hospital of PLA Joint Support Force, Zhangzhou, 363000, People's Republic of China. 9. Department of Clinical Laboratory Science of NO. 910 Hospital of PLA Joint Support Force, Quanzhou, 362000, People's Republic of China. 10. The Maternal and Child Health Hospital of Hubei Province, Guanggu District, Wuhan, 430070, Hubei, People's Republic of China. zhangweismmu@126.com. 11. Department of Respiratory and Critical Care Medicine, First Affiliated Hospital, Second Military Medical University, 168# Changhai Rd, Shanghai, 200433, People's Republic of China. zhangweismmu@126.com. 12. Department of Biomedical Engineering, School of Medicine, Tsinghua University, 30 Shuangqing Road, Beijing, 100084, People's Republic of China. yongguo@tsinghua.edu.cn. 13. Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, 610052, Sichuan, People's Republic of China. liuz@ibt.pumc.edu.cn. 14. Key Laboratory of Transfusion Adverse Reactions, Chinese Academy of Medical Sciences, Chengdu, 610052, Sichuan, People's Republic of China. liuz@ibt.pumc.edu.cn.
Abstract
BACKGROUND: COVID-19 has caused a global pandemic and the death toll is increasing. However, there is no definitive information regarding the type of clinical specimens that is the best for SARS-CoV-2 detection, the antibody levels in patients with different duration of disease, and the relationship between antibody level and viral load. METHODS: Nasopharyngeal swabs, anal swabs, saliva, blood, and urine specimens were collected from patients with a course of disease ranging from 7 to 69 days. Viral load in different specimen types was measured using droplet digital PCR (ddPCR). Meanwhile, anti-nucleocapsid protein (anti-N) IgM and IgG antibodies and anti-spike protein receptor-binding domain (anti-S-RBD) IgG antibody in all serum samples were tested using ELISA. RESULTS: The positive detection rate in nasopharyngeal swab was the highest (54.05%), followed by anal swab (24.32%), and the positive detection rate in saliva, blood, and urine was 16.22%, 10.81%, and 5.41%, respectively. However, some patients with negative nasopharyngeal swabs had other specimens tested positive. There was no significant correlation between antibody level and days after symptoms onset or viral load. CONCLUSIONS: Other specimens could be positive in patients with negative nasopharyngeal swabs, suggesting that for patients in the recovery period, specimens other than nasopharyngeal swabs should also be tested to avoid false negative results, and anal swabs are recommended. The antibody level had no correlation with days after symptoms onset or the viral load of nasopharyngeal swabs, suggesting that the antibody level may also be affected by other factors.
BACKGROUND:COVID-19 has caused a global pandemic and the death toll is increasing. However, there is no definitive information regarding the type of clinical specimens that is the best for SARS-CoV-2 detection, the antibody levels in patients with different duration of disease, and the relationship between antibody level and viral load. METHODS: Nasopharyngeal swabs, anal swabs, saliva, blood, and urine specimens were collected from patients with a course of disease ranging from 7 to 69 days. Viral load in different specimen types was measured using droplet digital PCR (ddPCR). Meanwhile, anti-nucleocapsid protein (anti-N) IgM and IgG antibodies and anti-spike protein receptor-binding domain (anti-S-RBD) IgG antibody in all serum samples were tested using ELISA. RESULTS: The positive detection rate in nasopharyngeal swab was the highest (54.05%), followed by anal swab (24.32%), and the positive detection rate in saliva, blood, and urine was 16.22%, 10.81%, and 5.41%, respectively. However, some patients with negative nasopharyngeal swabs had other specimens tested positive. There was no significant correlation between antibody level and days after symptoms onset or viral load. CONCLUSIONS: Other specimens could be positive in patients with negative nasopharyngeal swabs, suggesting that for patients in the recovery period, specimens other than nasopharyngeal swabs should also be tested to avoid false negative results, and anal swabs are recommended. The antibody level had no correlation with days after symptoms onset or the viral load of nasopharyngeal swabs, suggesting that the antibody level may also be affected by other factors.
Entities:
Keywords:
COVID-19; Droplet digital PCR; Nasopharyngeal swab; Viral load
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