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Quantitative Detection and Viral Load Analysis of SARS-CoV-2 in Infected Patients #MMPMID32221523
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
Clin Infect Dis 2020[Jul]; 71 (15): 793-798 PMID32221523show ga
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.
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Clin+Infect+Dis 2020 ; 71 (15): 793-798
