非侵入性SARS-CoV-2查测试的诊断准确性:国家前性分析
Thomas Althaus1, Alexandre Blake2, Alizée Costantini3
1Directorate of Health Affairs, 48 boulevard d'Italie, Monaco, 98000, Monaco. talthaus@gouv.mc.
BMC infectious diseases
|May 21, 2025
概括
口腔海绵唾液RT-PCR为所有成年人提供准确,非侵入性的SARS-CoV-2检测. 快速抗原测试仅对高病毒载量有用,包括Omicron亚型.
科学领域:
- 病毒学 病毒学
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 准确,非侵入性和负担得起的SARS-CoV-2检测对公共卫生至关重要.
- 唾液是一种可行的替代性鼻拭子,但方法各不相同.
- 需要标准化唾液采集和预分析程序.
研究的目的:
- 评估基于唾液的RT-PCR和用于检测SARS-CoV-2的快速抗原测试 (RAT) 的准确性.
- 为了比较不同的唾液采集方法 (口腔抽样与口腔海绵).
- 评估各种患者群体和SARS-CoV-2变异的测试性能.
主要方法:
- 从2021年2月到2023年2月对3488名症状和无症状的成年人进行前性研究.
- 通过口腔抹布或口腔海绵 (OS) 与鼻 (NP) RT-PCR一起收集的唾液.
- 使用RT-PCR和电化学发光免疫测试 (ECLIA) 快速抗原测试 (RAT) 分析唾液.
主要成果:
- 口腔海绵RT-PCR显示~95%的灵敏度和~95%的特异性,不受先前感染或接种疫苗的影响.
- 口腔抽样RT-PCR的灵敏度有所不同,但特异性接近100%.
- 鼠AT敏感度为66.9%-69.1%与RT-PCR相比,在高病毒载量 (Ct < 25) 时增加到71%-97%.
结论:
- 使用口腔海绵的唾液RT-PCR可在成年人中准确检测SARS-CoV-2,从而实现自我收集并简化预分析步骤.
- 这种方法对有症状和无症状的个体有效,包括识别负NP拭子.
- ECLIA RAT具有高通量,但最适合检测高病毒负载,包括最近的Omicron亚型 (BA.4&5,XBB系列).
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