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Evaluating the accuracy of different respiratory specimens in the laboratory diagnosis and monitoring the viral shedding of 2019-nCoV infections.
Open accessAbstract
Background: The outbreak of novel coronavirus pneumonia (NCP) caused by 2019-nCoV spread rapidly, and elucidating the diagnostic accuracy of different respiratory specimens is crucial for the control and treatment of this disease. Methods: Respiratory samples including nasal swabs, throat swabs, sputum and bronchoalveolar lavage fluid (BALF) were collected from Guangdong CDC confirmed NCP patients, and viral RNAs were detected using a CFDA approved detection kit. Results were analyzed in combination with sample collection date and clinical information. Findings: Except for BALF, the sputum possessed the highest positive rate (74.4%∼88.9%), followed by nasal swabs (53.6%∼73.3%) for both severe and mild cases during the first 14 days after illness onset (d.a.o). For samples collected ≥ 15 d.a.o, sputum and nasal swabs still possessed a high positive rate ranging from 42.9%∼61.1%. The positive rate of throat swabs collected ≥ 8 d.a.o was low, especially in samples from mild cases. Viral RNAs could be detected in all the lower respiratory tract of severe cases, but not the mild cases. CT scan of cases 02, 07 and 13 showed typical viral pneumonia with ground-glass opacity, while no viral RNAs were detected in first three or all the upper respiratory samples. Interpretation: Sputum is most accurate for laboratory diagnosis of NCP, followed by nasal swabs. Detection of viral RNAs in BLAF is necessary for diagnosis and monitoring of viruses in severe cases. CT scan could serve as an important make up for the diagnosis of NCP. Funding: National Science and Technology Major Project, Sanming Project of Medicine and China Postdoctoral Science Foundation.
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“SARS-CoV-2 can be detected from different body fluids and the rate of positive test results vary depending on the sample size, days after illness onset, and severity of illness.”
From Oral Microbiome and SARS-CoV-2: Beware of Lung Co-infection (2020) · cites this paper as Yang et al., 2020
In the citing paper
“Sputum appeared to be a good clinical sample with a high positive rate (74.4∼88.9%), followed by nasal swabs (53.6∼73.3%) and throat swabs (50∼ 61.3%).”
From Oral Microbiome and SARS-CoV-2: Beware of Lung Co-infection (2020) · cites this paper as Yang et al., 2020
In the citing paper
“According to a study on 213 confirmed COVID-19 patients, viral RNA could be detected in all BALF samples of severe cases, but not from mild cases.”
From Oral Microbiome and SARS-CoV-2: Beware of Lung Co-infection (2020) · cites this paper as Yang et al., 2020
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“When the onset time was greater than 14 days, the positive rate of BALF, sputum, and nasal swabs showed similar results, and were still much higher than throat swabs (Yang et al., 2020).”
From Oral Microbiome and SARS-CoV-2: Beware of Lung Co-infection (2020) · cites this paper as Yang et al., 2020
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Metadata
- Authors
- Yang, Y., Yang, M., Shen, C., Wang, F., Yuan, J., Li, J., Zhang, M., Wang, Z., Xing, L., Wei, J., Peng, L., Wong, G., Zheng, H., Wu, W., Liao, M., Feng, K., Li, J., Yang, Q., Zhao, J., Zhang, Z., Liu, L., & Liu, Y.
- Affiliations
- Southern University of Science and Technology (CN)
- Chinese Academy of Sciences (CN)
- Corresponding author
- Zhang, Zheng
- ORCID
- Venue
- The Innovation
- Publisher
- openRxiv
- Published
- 2020-02-12
- Volume
- 1
- Issue
- 3
- Pages
- 100061-100061
- ISSN
- 2666-6758 (ISSN-L)
- PMC
- PMC7609236
- OpenAlex
- W3107529852
- Cited by
- 836
- References
- 36
- Citations by year
- 2026: 2 · 2025: 18 · 2024: 23 · 2023: 62 · 2022: 114 · 2021: 246 · 2020: 370
- FWCI
- 25.98
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- The Innovation (publishedVersion, cc-by-nc-nd)
- medRxiv (acceptedVersion)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Ministry of Science and Technology of the People's Republic of China (2020YFC0846300)
- China Postdoctoral Science Foundation (2019M660836, 2019T120147)
- National Science and Technology Major Project (2017ZX10204401, 2018ZX10711-001, 2017ZX10103011)
- Sanming Project of Medicine in Shenzhen (SZSM201512005, SZSM201412003)
- National Major Science and Technology Projects of China (2018ZX10711001, 2017ZX10103011)
- Topics
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 detection and testing
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Keywords
- SARS-CoV-2, COVID-19 pandemic, viral shedding, sputum, nasal swabs, bronchoalveolar lavage fluid, viral RNA detection, diagnostic accuracy, disease severity, ground-glass opacities
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