文章摘要
李志丽,李昱,陈秋兰,杨孝坤,赵宏婷,姜欣丽,范思萌,李丹,秦颖,彭质斌,余建兴,毛乃颖,李中杰.复检核酸阳性的新型冠状病毒感染者流行分布及传染性特征分析[J].中华流行病学杂志,,():
复检核酸阳性的新型冠状病毒感染者流行分布及传染性特征分析
Distribution and infectious characteristics of re-positive cases infected with SARS-CoV-2
收稿日期:2021-05-06  出版日期:2021-08-13
DOI:10.3760/cma.j.cn112338-20210506-00367
中文关键词: 新型冠状病毒;复检阳性;传染性
英文关键词: SARS-CoV-2;Re-positive;Infectivity
基金项目:国家重点研发计划(2020YFC0846900,2020YFA0708100);国家自然科学基金(82041029);公共卫生应急反应机制运行项目(131031001000200001)
作者单位E-mail
李志丽 中国疾病预防控制中心传染病管理处, 北京 102206  
李昱 中国疾病预防控制中心传染病管理处, 北京 102206  
陈秋兰 中国疾病预防控制中心传染病管理处, 北京 102206  
杨孝坤 中国疾病预防控制中心传染病管理处, 北京 102206  
赵宏婷 中国疾病预防控制中心传染病管理处, 北京 102206  
姜欣丽 中国疾病预防控制中心传染病管理处, 北京 102206  
范思萌 中国疾病预防控制中心传染病管理处, 北京 102206  
李丹 中国疾病预防控制中心传染病管理处, 北京 102206  
秦颖 中国疾病预防控制中心传染病管理处, 北京 102206  
彭质斌 中国疾病预防控制中心传染病管理处, 北京 102206  
余建兴 中国疾病预防控制中心传染病预防控制所, 北京 102206  
毛乃颖 中国疾病预防控制中心病毒病所, 北京 102206  
李中杰 中国疾病预防控制中心传染病管理处, 北京 102206 lizj@chinacdc.cn 
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中文摘要:
      针对国内外新型冠状病毒(新冠病毒)感染者排毒持久性以及复检核酸阳性者的相关研究文献进行综述,分析复检阳性者的特征与传染性,为完善病例管理与预防新冠病毒传播措施的制定提供科学依据。现有研究结果显示,新冠病毒复检阳性率范围在2.4%~19.8%之间,复检阳性时间中位数为出院后4~15 d。复检阳性后新冠病毒特异性IgM、IgG和IgA抗体血清阳性率分别为11.11%~86.08%、52.00%~100.00%、61.54%~100.00%;总抗体和中和抗体的血清阳性率分别为98.72%和88.46%。复检阳性后病毒载量低于初次感染时的病毒载量。目前,全球至少报告了3 380例复检阳性者,有3例复检阳性者(1例免疫缺陷病例和2例肺部影像学异常病例)的标本中分离到具有传染性的活病毒,有1例应用免疫抑制剂的无症状感染者引起密切接触者感染。综上所述,复检阳性者具有传染性的风险总体很低,极个别复检阳性者不排除引起续发传播的可能。对于复检阳性者的管理时间和管理方式,可基于病原检测结果对个体传播风险评估后进行确定。
英文摘要:
      Domestic and foreign literatures related to the persistence of SARS-CoV-2 and the re-positive cases infected with SARS-CoV-2 were reviewed, and the characteristics and infectivity of the re-positive cases were analyzed to provide scientific evidence for the improvement of case management and the development of measures to stop the spread of SARS-CoV-2. Existing studies have shown that re-positive rate of SARS-CoV-2 ranged from 2.4% to 19.8%, the median of interval between re-positive detection and discharge was 4-15 days. Following the second course of the disease, the anti-SARS-CoV-2 IgM, IgG and IgA positive rates of the cases were 11.11%-86.08%, 52.00%-100.00% and 61.54%-100.00% respectively, the total antibody and neutralizing antibody positive rates were 98.72% and 88.46%. The viral load of the re-positive cases was lower than that of in the initial infection. At least 3380 re-positive cases have been reported globally. SARS-CoV-2 strains were isolated from the samples of 3 re-positive cases (1 immunodeficiency case and 2 cases with abnormal pulmonary imaging). There were close contacts that were infected by an asymptomatic case taking immunosuppressive agents. In conclusion, the infectivity of re-positive cases infected with SARS-CoV-2 is generally very low. Rare re-positive cases infected with SARS-CoV-2 might cause further transmission. The management approach for the re-positive cases can be based on the assessment of the individual transmission risk according to the pathogen detection results.
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