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Quantitative Detection and Viral Load Analysis of SARS-CoV-2 in Infected Patients.
Clin Infect Dis. 2020 07 28; 71(15):793-798.CI

Abstract

BACKGROUND

Coronavirus disease 2019 (COVID-19) has become a public health emergency. The widely used reverse transcription-polymerase chain reaction (RT-PCR) method has limitations for clinical diagnosis and treatment.

METHODS

A total of 323 samples from 76 COVID-19-confirmed patients were analyzed by droplet digital PCR (ddPCR) and RT-PCR based 2 target genes (ORF1ab and N). Nasal swabs, throat swabs, sputum, blood, and urine were collected. Clinical and imaging data were obtained for clinical staging.

RESULTS

In 95 samples that tested positive by both methods, the cycle threshold (Ct) of RT-PCR was highly correlated with the copy number of ddPCR (ORF1ab gene, R2 = 0.83; N gene, R2 = 0.87). Four (4/161) negative and 41 (41/67) single-gene positive samples tested by RT-PCR were positive according to ddPCR with viral loads ranging from 11.1 to 123.2 copies/test. The viral load of respiratory samples was then compared and the average viral load in sputum (17 429 ± 6920 copies/test) was found to be significantly higher than in throat swabs (2552 ± 1965 copies/test, P < .001) and nasal swabs (651 ± 501 copies/test, P < .001). Furthermore, the viral loads in the early and progressive stages were significantly higher than that in the recovery stage (46 800 ± 17 272 vs 1252 ± 1027, P < .001) analyzed by sputum samples.

CONCLUSIONS

Quantitative monitoring of viral load in lower respiratory tract samples helps to evaluate disease progression, especially in cases of low viral load.

Authors+Show Affiliations

Beijing Ditan Hospital, Capital Medical University, Beijing, China. Clinical Center for HIV/AIDS, Capital Medical University, Beijing, China.Beijing Ditan Hospital, Capital Medical University, Beijing, China. Clinical Center for HIV/AIDS, Capital Medical University, Beijing, China.Human Genetic Resource Center, National Research Institute for Health and Family Planning, Beijing, China. Chinese Academy of Medical Sciences, Graduate School of Peking Union Medical College, Beijing, China.Beijing Ditan Hospital, Capital Medical University, Beijing, China. Clinical Center for HIV/AIDS, Capital Medical University, Beijing, China.Beijing Ditan Hospital, Capital Medical University, Beijing, China. Clinical Center for HIV/AIDS, Capital Medical University, Beijing, China.Beijing Ditan Hospital, Capital Medical University, Beijing, China. Clinical Center for HIV/AIDS, Capital Medical University, Beijing, China.Beijing Ditan Hospital, Capital Medical University, Beijing, China. Clinical Center for HIV/AIDS, Capital Medical University, Beijing, China.Beijing Ditan Hospital, Capital Medical University, Beijing, China. Clinical Center for HIV/AIDS, Capital Medical University, Beijing, China.Beijing Ditan Hospital, Capital Medical University, Beijing, China. Clinical Center for HIV/AIDS, Capital Medical University, Beijing, China.Beijing Ditan Hospital, Capital Medical University, Beijing, China. Clinical Center for HIV/AIDS, Capital Medical University, Beijing, China.Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China.Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China.Human Genetic Resource Center, National Research Institute for Health and Family Planning, Beijing, China.Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China.Beijing Ditan Hospital, Capital Medical University, Beijing, China. Clinical Center for HIV/AIDS, Capital Medical University, Beijing, China.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32221523

Citation

Yu, Fengting, et al. "Quantitative Detection and Viral Load Analysis of SARS-CoV-2 in Infected Patients." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 71, no. 15, 2020, pp. 793-798.
Yu F, Yan L, Wang N, et al. Quantitative Detection and Viral Load Analysis of SARS-CoV-2 in Infected Patients. Clin Infect Dis. 2020;71(15):793-798.
Yu, F., Yan, L., Wang, N., Yang, S., Wang, L., Tang, Y., Gao, G., Wang, S., Ma, C., Xie, R., Wang, F., Tan, C., Zhu, L., Guo, Y., & Zhang, F. (2020). Quantitative Detection and Viral Load Analysis of SARS-CoV-2 in Infected Patients. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 71(15), 793-798. https://doi.org/10.1093/cid/ciaa345
Yu F, et al. Quantitative Detection and Viral Load Analysis of SARS-CoV-2 in Infected Patients. Clin Infect Dis. 2020 07 28;71(15):793-798. PubMed PMID: 32221523.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Quantitative Detection and Viral Load Analysis of SARS-CoV-2 in Infected Patients. AU - Yu,Fengting, AU - Yan,Liting, AU - Wang,Nan, AU - Yang,Siyuan, AU - Wang,Linghang, AU - Tang,Yunxia, AU - Gao,Guiju, AU - Wang,Sa, AU - Ma,Chengjie, AU - Xie,Ruming, AU - Wang,Fang, AU - Tan,Chianru, AU - Zhu,Lingxiang, AU - Guo,Yong, AU - Zhang,Fujie, PY - 2020/03/13/received PY - 2020/03/27/accepted PY - 2020/3/30/pubmed PY - 2020/8/11/medline PY - 2020/3/30/entrez KW - COVID-19 KW - RT-PCR KW - SARS-CoV-2 KW - ddPCR KW - viral load SP - 793 EP - 798 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 71 IS - 15 N2 - BACKGROUND: Coronavirus disease 2019 (COVID-19) has become a public health emergency. The widely used reverse transcription-polymerase chain reaction (RT-PCR) method has limitations for clinical diagnosis and treatment. METHODS: A total of 323 samples from 76 COVID-19-confirmed patients were analyzed by droplet digital PCR (ddPCR) and RT-PCR based 2 target genes (ORF1ab and N). Nasal swabs, throat swabs, sputum, blood, and urine were collected. Clinical and imaging data were obtained for clinical staging. RESULTS: In 95 samples that tested positive by both methods, the cycle threshold (Ct) of RT-PCR was highly correlated with the copy number of ddPCR (ORF1ab gene, R2 = 0.83; N gene, R2 = 0.87). Four (4/161) negative and 41 (41/67) single-gene positive samples tested by RT-PCR were positive according to ddPCR with viral loads ranging from 11.1 to 123.2 copies/test. The viral load of respiratory samples was then compared and the average viral load in sputum (17 429 ± 6920 copies/test) was found to be significantly higher than in throat swabs (2552 ± 1965 copies/test, P < .001) and nasal swabs (651 ± 501 copies/test, P < .001). Furthermore, the viral loads in the early and progressive stages were significantly higher than that in the recovery stage (46 800 ± 17 272 vs 1252 ± 1027, P < .001) analyzed by sputum samples. CONCLUSIONS: Quantitative monitoring of viral load in lower respiratory tract samples helps to evaluate disease progression, especially in cases of low viral load. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/32221523/full_citation L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/ciaa345 DB - PRIME DP - Unbound Medicine ER -