[Distribution and infectious characteristics of re-positive cases infected with SARS-CoV-2]

Zhonghua Liu Xing Bing Xue Za Zhi. 2021 Oct 10;42(10):1750-1756. doi: 10.3760/cma.j.cn112338-20210506-00367.
[Article in Chinese]

Abstract

Domestic and foreign literatures related to the persistence of SARS-CoV-2 and the re-positive cases infected with SARS-CoV-2 were reviewed, and the characteristics and infectivity of the re-positive cases were analyzed to provide scientific evidence for the improvement of case management and the development of measures to stop the spread of SARS-CoV-2. Existing studies have shown that re-positive rate of SARS-CoV-2 ranged from 2.4% to 19.8%, the median of interval between re-positive detection and discharge was 4-15 days. Following the second course of the disease, the anti-SARS-CoV-2 IgM, IgG and IgA positive rates of the cases were 11.11%-86.08%, 52.00%-100.00% and 61.54%-100.00% respectively, the total antibody and neutralizing antibody positive rates were 98.72% and 88.46%. The viral load of the re-positive cases was lower than that in the initial infection. At least 3 380 re-positive cases have been reported globally. SARS-CoV-2 strains were isolated from the samples of 3 re-positive cases (1 immunodeficiency case and 2 cases with abnormal pulmonary imaging). There were close contacts that were infected by an asymptomatic case taking immunosuppressive agents. In conclusion, the infectivity of re-positive cases infected with SARS-CoV-2 is generally very low. Rare re-positive cases infected with SARS-CoV-2 might cause further transmission. The management approach for the re-positive cases can be based on the assessment of the individual transmission risk according to the pathogen detection results.

针对国内外新型冠状病毒(新冠病毒)感染者排毒持久性以及复检核酸阳性者的相关研究文献进行综述,分析复检阳性者的特征与传染性,为完善病例管理与预防新冠病毒传播措施的制定提供科学依据。现有研究结果显示,新冠病毒复检阳性率范围在2.4%~19.8%之间,复检阳性时间中位数为出院后4~15 d。复检阳性后新冠病毒特异性IgM、IgG和IgA抗体血清阳性率分别为11.11%~86.08%、52.00%~100.00%、61.54%~100.00%;总抗体和中和抗体的血清阳性率分别为98.72%和88.46%。复检阳性后病毒载量低于初次感染时的病毒载量。目前,全球至少报告了3 380例复检阳性者,有3例复检阳性者(1例免疫缺陷病例和2例肺部影像学异常病例)的标本中分离到具有传染性的活病毒,有1例应用免疫抑制剂的无症状感染者引起密切接触者感染。复检阳性者具有传染性的风险总体很低,极个别复检阳性者不排除引起续发传播的可能。对于复检阳性者的管理时间和管理方式,可基于病原检测结果对个体传播风险评估后进行确定。.

MeSH terms

  • Antibodies, Neutralizing
  • Antibodies, Viral
  • COVID-19*
  • Humans
  • Immunoglobulin M
  • SARS-CoV-2*

Substances

  • Antibodies, Neutralizing
  • Antibodies, Viral
  • Immunoglobulin M