如何预防新冠肺炎患者再次住院

Li Shi, Jie Chen, Jiqing He
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引用次数: 0

摘要

目的:探讨2019年新型冠状病毒(新冠肺炎)患者咽拭子逆转录聚合酶链反应(RT-PCR)的假阴性。方法:对260例患者的咽拭子样本进行新冠肺炎RT-PCR诊断。结果:胸部计算机断层扫描(CT)的阳性率为96.99%(252/260)。RT-PCR首次阳性率为87.70%,两次阳性率为92.30%,三次阳性率均为100%。多重RT-PCR检测结果显示RTPCR的阳性率很高。胸部CT扫描和RT-PCR联合检测,即使是首次检测,阳性率也达到100%,这有助于诊断新冠肺炎。两名新冠肺炎患者出院,口咽拭子RT-PCR结果为假阴性。在他们第二次入院期间,CT图像有显著进展,感染标志物增加,这表明炎症正在进行。选择完全康复的患者。症状得到缓解;消散在CT图像上几乎完全消失;感染标志物显著降低到正常水平,这表明炎症没有进展。淋巴细胞百分比(LYM)升高至正常水平。结论:连续随访胸部CT扫描对确诊2019-nCoV核酸RT-PCR阴性的新冠肺炎患者具有重要意义。结合2019-nCoV核酸的RT-PCR检测和其他检测方法,如CT成像,有助于诊断。提供了如何避免新冠肺炎患者再次住院的路线图。即使2019-nCoV核酸RT-PCR结果呈阴性,患者也不得出院。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
How to Prevent Rehospitalization in Patients with COVID-19
Aim: False-negativity of reverse-transcriptase–polymerase-chain-reaction (RT-PCR) for patients with 2019 Novel Coronavirus (COVID-19) via throat swab was discussed. Method: A total of 260 patients were diagnosed with COVID-19 RT-PCR for samples obtained via throat swab. Result: Positive rates of chest Computed tomography (CT) imaging were 96.99% (252/260). Positive rates of RT-PCR were 87.70% for the first time, 92.30% for two times, and 100% for three times. Multiple RT-PCR assay tests resulted in a high positive rate of RTPCR. Combined chest CT scans and RT-PCR lead to a positive rate of 100% even for the first testing, which is conducive to COVID-19 diagnosis. Two patients with COVID-19 were discharged from hospital with false-negative results of RT-PCR using the oropharyngeal swab. There was a significant progression on CT images and an increase in infective markers during their second admission to hospital, which indicated the progressing inflammation. Patients with complete recovery were selected. Symptoms were relieved; dissipation almost completely disappeared on CT image; and infective markers significantly decreased to normal levels, which indicated that the inflammation was not progressing. percent of lymphocyte percent (LYM) increased to normal level. Conclusion: Serial follow-up chest CT scans are quite important for confirming the patients with COVID-19 who resulted negative for RT-PCR of 2019-nCoV nucleic acid. A combination of the RT-PCR test for 2019-nCoV nucleic acid and other detective methods, such as CT imaging are conducive to diagnosis. The roadmap of how to avoid being rehospitalized for patients with COVID-19 was provided. Patients were not allowed to be discharged from hospital even with negative result of RT-PCR of 2019-nCoV nucleic acid.
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