新型冠状病毒IgM/IgG抗体在病程监测中的临床意义

目的评价新型冠状病毒(SARS-CoV-2)IgM/IgG抗体检测(化学发光法)在新型冠状病毒肺炎(COVID-19)病程监测和转归方面的临床意义。方法回顾性研究。收集2020年1月20日至2020年3月1日在天津市疾病预防控制中心核酸检测阳性的COVID-19确诊患者88例(115例血清样本)作为疾病组,排除COVID-19(核酸检测阴性)的其他疾病患者245例(245例血清样本)作为对照组。用化学发光法检测SARS-CoV-2 IgM和IgG抗体。结果 SARS-CoV-2 IgM抗体检测的敏感性、特异性分别为90.91%、100%;SARS-CoV-2 IgG抗体检测的敏感性、特异性分别为88.64%、100%;IgM和IgG抗体联合检测敏感性显著提高至96.59%,特异性为100%,与核酸检测的总符合率高达99.10%。SARS-CoV-2 IgM抗体水平在COVID-19病程中呈现先升高后降低的趋势,IgG抗体水平随着病程的进展逐渐升高。结论 SARS-CoV-2 IgM和IgG抗体化学发光法联合检测敏感性高,可作为COVID-19一种有效的辅助诊断,在病程监测和转归方面有一定的意义。

Clinical significance of SARS-CoV-2 IgM/IgG antibodies in monitoring of COVID-19

Abstract: Objective: To evaluate the diagnostic value of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) IgM/IgG antibodies (chemiluminescence assay) in monitoring the prognosis of Corona Virus Disease 2019 (COVID-19). Methods: A retrospective study was performed. A total of 88 patients (115 serum samples) diagnosed as COVID-19 at Tianjin Center for Disease Control and Prevention from January 20, 2020 to March 1, 2020 were divided into disease group and 245 cases (245 serum samples) of the patients with other diseases excluding COVID-19 (negative nucleic acid test) were used as control group. SARS-CoV-2 IgM/IgG antibodies was detected by chemiluminescence immunoassay. Results: The sensitivity and specificity of SARS-CoV-2 IgM antibody detection were 90.91% and 100% and those of IgG antibody were 88.64% and 100%, respectively. The sensitivity of combined detection for IgM and IgG antibodies significantly improved the sensitivity to 96.59% and the specificity of 100%. The total coincidence rate of the detection IgM/IgG with nucleic acid detection was as high as 99.10%. The level of SARS-CoV-2 IgM antibody showed an increased trend firstly and then decreased during the course of COVID-19, but the level of IgG antibody increased gradually with the progression of the disease. Conclusion: The simultaneous detection of SARS-CoV-2 IgM and IgG antibody with chemiluminescence method displayed high sensitivity, so it could be used as an effective helpful diagnostic method of COVID-19 for monitoring prognosis of the disease.