| 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分布及传染性特征分析[J].Chinese journal of Epidemiology,2021,42(10):1750-1756 |
| 复检核酸阳性的新型冠状病毒感染者分布及传染性特征分析 |
| Distribution and infectious characteristics of re-positive cases infected with SARS-CoV-2 |
| 投稿时间：2021-05-06 |
| DOI：10.3760/cma.j.cn112338-20210506-00367 |
| KeyWord: 新型冠状病毒 复检阳性 传染性 |
| English Key Word: SARS-CoV-2 Re-positive Infectivity |
| FundProject: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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| ClickNum: 5167 |
| PDFClickNum: 1034 |
| Abstract: |
| 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。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。 |
| English Abstract: |
| 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 in the initial infection. At least 3 380 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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