新型冠状病毒肺炎临床实验室监测分析

目的 探讨5例新型冠状病毒肺炎(COVID-19)实验室检查的价值,为临床诊治和疫情防控提供参考。方法 选取2020年1月23日至2020年2月22日延安市第二人民医院收治的5例确诊COVID-19患者,采用RT-PCR检测不同部位采集的核酸标本及其它实验室数据进行统计学分析。结果 入院时5例患者外周血检查均有不同程度异常,其中3例淋巴细胞计数减少,3例CRP升高,3例有ESR加快;总共采集107份标本进行SARS-CoV-2核酸检测,其中咽拭子25份,阳性率44.0%(11/25),鼻拭子35份,阳性率25.7%(9/35),粪便(肛拭子)31份,阳性率77.4%(25/31),16份血标本核酸检测均阴性,5例患者符合出院标准时粪便核酸检测均阳性,截至2月27日对3例患者出院后追踪发现,出院2周或更长时间粪便SARS-CoV-2核酸仍阳性。结论 监测新冠肺炎外周血细胞计数变化有助于病情的及时判断,新冠肺炎的确诊鼻咽肛拭子组合送检是较好的策略,病毒有持续经粪便排泄现象,需对出院患者进行有效隔离和追踪随访,以避免粪-口及接触传播的风险和复发的可能。

Clinical laboratory monitoring and analysis of COVID-19

Objective To explore the value of laboratory tests of 5 cases of COVID-19,to provide a reference for clinical diagnosis and treatment and epidemic prevention and control.Methods Retrospective analysis of clinical data of 5 cases confirmed COVID-19 patients admitted to Second People's Hospital of Yan'an from January 23,2020 to February 22,2020.RT-PCR was used to detect nucleic acid samples collected from 5 different locations and other laboratory data for statistical analysis.Results At the time of admission,the peripheral blood tests of 5 patients were abnormal to varying degrees,of which 3 patients had reduced lymphocyte counts,3 had elevated CRP,and 3 had accelerated ESR,a total of 107 specimens were collected for SARS-CoV-2 nucleic acid detection,Among them,25 swabs were swallowed,and the positive rate was 44.0% (11/25),35 nasal swabs with a positive rate of 25.7% (9/35),31 stools (anal swabs) with a positive rate of 77.4% (25/31),Nucleic acid test was negative in 16 blood samples,the fecal nucleic acid test was positive when 5 patients met the discharge criteria.As of February 27,three patients have been discharged after discharge and found that fecal SARS-CoV-2 nucleic acid is still positive for 2 weeks or more after discharge.Conclusion Monitoring changes in peripheral blood cell counts of COVID-19 is helpful for timely judgment of disease deterioration,nasopharyngeal and Anal Swab Combination Diagnosis COVID-19 is a Better Strategy,COVID-19 has continuous fecal excretion,and patients must be effectively quarantined and followed up to avoid the risk of fecal-oral and contact transmission and the possibility of disease recurrence.