Quantitative Detection and Viral Load Analysis of SARS-CoV-2 in Infected Patients

Author:

Yu Fengting12,Yan Liting12,Wang Nan34,Yang Siyuan12,Wang Linghang12,Tang Yunxia12,Gao Guiju12,Wang Sa12,Ma Chengjie12,Xie Ruming12,Wang Fang5,Tan Chianru5,Zhu Lingxiang3,Guo Yong5,Zhang Fujie12

Affiliation:

1. Beijing Ditan Hospital, Capital Medical University, Beijing, China

2. Clinical Center for HIV/AIDS, Capital Medical University, Beijing, China

3. Human Genetic Resource Center, National Research Institute for Health and Family Planning, Beijing, China

4. Chinese Academy of Medical Sciences, Graduate School of Peking Union Medical College, Beijing, China

5. Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China

Abstract

Abstract 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.

Funder

Capital Medical University

Beijing Key Laboratory of Emerging Infectious Diseases

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Microbiology (medical)

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