不仅是 COVID or not COVID ? 更有 CO-Infect 得注意- 大数跨境

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不仅是 COVID or not COVID ? 更有 CO-Infect 得注意

路明克斯

2020-04-16

导读：双管齐下, 共伴感染不错过！

出现了咳嗽, 打喷嚏的症状,

是感冒还是新冠肺炎?!

时值新型冠状病毒疫情持续蔓延之际, 中国的的疫情虽已有效遏制,然随着全球不断攀升的感染数与死亡病例, 令人一旦出现感冒症状,仍不免提心吊胆。

感染新冠肺炎的症状因为与感冒症状相近, 但是后续的疾病发展却可能大不相同[1,2], 及时并且准确地区分病原体, 对於临床医师的诊断治疗就至关重要。然而常见的呼吸道感染病原种类繁多,例如甲乙型流感病毒, 副流感病毒, 鼻病毒, 呼吸道合胞病毒等, 也因此许多的研究指出采用可以同时鉴别不同病原体的多重检测,可协助快速分流患者[3,4]。

感染新冠肺炎的症状因为与感冒症状相近, 但是后续的疾病发展却可能大不相同

凶手不止一个 ?!

所以, 感冒症状的元凶可能是新型冠状病毒感染或是一般呼吸道病原感染?

事情往往没有那么简单, 共伴感染 (同时被两种或两种以上的病原体感染) 虽不常见, 但依旧有一定的发生概率, 从呼吸道感染领域过去在成人以及儿童的研究中均发现, 与单一感染患者相比, 共伴感染的患者发生并发症以及重症的风险更高[5,6]。而此次的疫情中, 临床上也看到许多新冠病毒与其他呼吸道病原体共伴感染的情况[7-13]。

疫情爆发初期正值冬天, 恰好是流感的高发季节, 加上新型冠状病毒的传播特性与流感病毒相近, 种种迹象暗示著新型冠状病毒以及流感病毒共伴感染的可能性极高, 国内外的研究也揭示诸多流感病毒与新型冠状病毒共伴感染的病例[7,8,10,13]。除了流感病毒之外, 其他包括副流感病毒, 鼻病毒, 呼吸道合胞病毒, 人偏肺病毒, 冠状病毒 HKU1 等也被发现与新型冠状病毒发生共伴感染[11,12]。更惊人的是, 共伴感染的比率可能比大家预期的更高, 一篇国内的研究指出共伴感染比率约为 3.2%,在加州尚未发表的报告中提示, 共伴感染比率甚至高达 22.4%[12] (原文: ”a recentreport out of Stanford reported on a series of 562 SARS-CoV-2 tests performedin their emergency department. Of the 49 positive SARS-CoV-2 results, 22.4%(11) were positive for additional viruses, including Rhinovirus/ enterovirus,Metapneumovirus, and RSV. This information has not yet been peer reviewed andpublished, but is important and has been shared at the request of theCalifornia Department of Public Health.”)

如果直接排除常规呼吸道病原检测阳性的患者，可能错放 SARS-CoV-2 与其他呼吸道病原体共伴感染患者

病原猎手-- 路明克斯多重检测

在 Luminex 的 xMAP^® 平台上, 通过专利微球染色技术, 达成针对单份样本进行多项标的检测, 帮助实验室一网打尽呼吸道病原体。路明克斯的高致病性冠状病毒多重检测试剂盒 (NxTAG^® CoV) 可以同时检测 SARS-CoV,SARS-CoV-2, MERS-CoV; 另一款22 种多重呼吸道病原体检测试剂盒 (NxTAG^® RPP) 则覆盖了常见造成呼吸道感染的病毒 (包括流感病毒, 副流感病毒, 鼻病毒, 呼吸道合胞病毒, 人偏肺病毒, 人博卡病毒, 冠状病毒 229E,OC43, NL63, HKU1) 及细菌 (肺炎衣原体, 肺炎支原体, 嗜肺军团菌), 双管齐下, 协助临床准确检测感染病原, 辅助诊断治疗。

路明克斯给您完整的解决方案

除此之外, 由于 xMAP^®平台开放灵活的特性, 也有实验室已经成功创建他们自己的呼吸道六重病毒检测[14]以及九重下呼吸道感染的细菌检测[15]。

觉得还不够? 来 xMAP^®平台上打造最适合您的多重检测!

参考文献

[1] W. J. Guan, Z. Y. Ni, Y. Hu, W. H. Liang, C. Q. Ou, J. X. He, et al., "Clinical Characteristics of Coronavirus Disease 2019 in China," N Engl J Med, Feb 28 2020.

[2] C. Huang, Y. Wang, X. Li, L. Ren, J. Zhao, Y. Hu, et al., "Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China," Lancet, vol. 395, pp. 497-506, Feb 15 2020.

[3] K. E. Hanson and M. R. Couturier, "Multiplexed Molecular Diagnostics for Respiratory, Gastrointestinal, and Central Nervous System Infections," Clin Infect Dis, vol. 63, pp. 1361-1367, Nov 15 2016.

[4] M. Lotfi, W. H. Hsih, M. Y. Cheng, M. W. Ho, C. H. Chou, P. C. Lin, et al., "Featuring COVID-19 cases via screening symptomatic patients with epidemiologic link during flu season in a medical center of central Taiwan," J Microbiol Immunol Infect,Mar 13 2020.

[5] I. A. Echenique, P. A. Chan, K. C. Chapin, S. B. Andrea, J. L. Fava, and L. A. Mermel, "Clinical characteristics and outcomes in hospitalized patients with respiratory viral co-infection during the 2009 H1N1 influenza pandemic," PLoS One, vol. 8, p. e60845, 2013.

[6] A. K. Matsuno, T. B. Gagliardi, F. E. Paula, L. K. S. Luna, B. L. S. Jesus, R. T. Stein, et al., "Human coronavirus alone or in co-infection with rhinovirus C is a risk factor for severe respiratory disease and admission to the pediatric intensive care unit: A one-year study in Southeast Brazil," PLoS One, vol. 14, p. e0217744, 2019.

[7] K. Danis, O. Epaulard, T. Benet, A. Gaymard, S. Campoy, E. Bothelo-Nevers, et al., "Cluster of coronavirus disease 2019 (Covid-19) in the French Alps, 2020," Clin Infect Dis, Apr 11 2020.

[8] Q. Ding, P. Lu, Y. Fan, Y. Xia, and M. Liu, "The clinical characteristics of pneumonia patients coinfected with 2019 novel coronavirus and influenza virus in Wuhan, China," J Med Virol, Mar 20 2020.

[9] B. E. Fan, K. G. E. Lim, V. C. L. Chong, S. S. W. Chan, K. H. Ong, and P. Kuperan, "COVID-19 and mycoplasma pneumoniae coinfection," Am J Hematol, Mar 15 2020.

[10] Z. Khodamoradi and M. Moghadami, "Co-infection of Coronavirus Disease 2019 and Influenza A: A Report from Iran," Arch Iran Med, vol. 23, pp. 239-243, Apr 1 2020.

[11] D. Lin, L. Liu, M. Zhang, Y. Hu, Q. Yang, J. Guo, et al., "Co-infections of SARS-CoV-2 with multiple common respiratory pathogens in infected patients," Sci China Life Sci, Mar 5 2020.

[12] F. Touzard-Romo, C. Tape, and J. R. Lonks, "Co-infection with SARS-CoV-2 and Human Metapneumovirus," J Med Virol, vol. 103, pp. 75-76, Mar 19 2020.

[13] X. Wu, Y. Cai, X. Huang, X. Yu, L. Zhao, F. Wang, et al., "Co-infection with SARS-CoV-2 and Influenza A Virus in Patient with Pneumonia, China," Emerg Infect Dis, vol. 26, Mar 11 2020.

[14] Y. Yan, J. Y. Luo, Y. Chen, H. H. Wang, G. Y. Zhu, P. Y. He, et al., "A multiplex liquid-chip assay based on Luminex xMAP technology for simultaneous detection of six common respiratory viruses," Oncotarget, vol. 8, pp. 96913-96923, Nov 14 2017.

[15] L. Jiang, H. Ren, H. Zhou, T. Qin, and Y. Chen, "Simultaneous Detection of Nine Key Bacterial Respiratory Pathogens Using Luminex xTAG((R)) Technology," Int J Environ Res Public Health, vol. 14, Feb 23 2017.