Yeyiphi eyona ndlela ilungileyo?
-Uvavanyo lwe-SARS-CoV-2 yoFundo loSulelo
Kwiimeko eziqinisekisiweyo ze-COVID-19, kuxelwe iimpawu zeklinikhi eziqhelekileyo ezibandakanya umkhuhlane, ukukhohlela, i-myalgia okanye ukudinwa.Ukanti ezi mpawu azizompawu ezizodwa ze-COVID-19 kuba ezi mpawu ziyafana nezo zezinye izifo ezosulelwe yintsholongwane ezifana nomkhuhlane.Okwangoku, i-virus nucleic acid Real-Time PCR (rt-PCR), i-CT imaging kunye nezinye iiparamitha ze-hematology zizixhobo eziphambili zokuxilongwa kwekliniki yosulelo.Uninzi lwezixhobo zovavanyo lwaselabhoratri ziye zaphuhliswa kwaye zisetyenziselwa ukuvavanya imizekelo yezigulana ze-COVID-19 yiCDC yaseTshayina.1, USCDC2kunye nezinye iinkampani zabucala.Uvavanyo lwe-IgG/IgM ye-antibody, indlela yovavanyo lwe-serological, nayo yongezwe njengendlela yokuxilonga kuguqulelo oluhlaziyiweyo lwaseTshayina loxilongo kunye nezikhokelo zonyango lwenoveli yesifo se-coronavirus (COVID-19), eyakhutshwa nge-3rd, Matshi.1.Uvavanyo lwentsholongwane ye-nucleic acid rt-PCR iseyeyona ndlela ikhoyo ngoku yokuxilongwa kwe-COVID-19.
Inyathelo elinamandla®Inoveli Coronavlrus (SARS-COV-2)Multiplex Real-Time PCR Kit(ukubona imizila emithathu yemfuza)
Kodwa ezi zixhobo zexesha lokwenyani ze-PCR zovavanyo, zijonga imathiriyeli yemfuza yentsholongwane, umzekelo kwimpumlo, ngomlomo, okanye kwi-swabs ezimpundu, zineengxaki ezininzi:
1) Ezi mvavanyo zinexesha elide lokujika kwaye zinzima ekusebenzeni;bathatha ngokubanzi ngaphezulu kweeyure ezi-2 ukuya kwezi-3 ukwenza iziphumo.
2) Iimvavanyo ze-PCR zifuna iilabhoratri eziqinisekisiweyo, izixhobo ezibiza kakhulu kunye namagcisa aqeqeshiweyo ukuze asebenze.
3) Kukho amanani athile okugxeka okungeyonyani kwe-rt-PCR ye-COVID-19.Isenokuba ngenxa yomthamo ophantsi we-SARS-CoV-2 wentsholongwane egazini kumzekelo weswab yokuphefumla ephezulu (iNoveli coronavirus yosulela iphecana lokuphefumla elisezantsi, elifana nepulmonary alveoli) kwaye uvavanyo alukwazi ukuchonga abantu abaye basulelwa, baphola, kwaye yasusa intsholongwane emizimbeni yabo.
Uphando nguLirong Zou et al4yafumanisa ukuba imithwalo ephezulu yentsholongwane egazini yabhaqwa kwakamsinyane emva kokuqalisa kweempawu, kunye nemithwalo ephezulu yentsholongwane egazini efunyenwe empumlweni kunasemqaleni kunye nentsholongwane ye-nucleic acid yokuphalaza ipateni yezigulana ezosulelwe yi-SARS-CoV-2 ifana neyezigulana ezinomkhuhlane.4kwaye ibonakala yahlukile kuleyo ibonwa kwizigulana ezosulelwe yi-SARS-CoV-2.
Yang Pan et al5yavavanya iisampulu ezilandelelanayo (i-swabs yomqala, isikhohlela, umchamo, kunye nesitulo) kwizigulana ezibini eBeijing kwaye yafumanisa ukuba umthamo wentsholongwane egazini kwiswabhu yomqala kunye neesampulu zesikhohlela ziye zanda malunga neentsuku ezi-5-6 emva kokuqalisa kweempawu, iisampuli zesikhohlela zibonise umthamo wentsholongwane egazini ngokubanzi kunomthamo wentsholongwane egazini. iisampulu zomqala.Akukho RNA yentsholongwane efunyenweyo kumchamo okanye iisampulu zesitulo kwezi zigulana zibini.
Uvavanyo lwe-PCR lunika iziphumo ezibonisa ukuba unayo kuphela xa intsholongwane isekhona.Uvavanyo alukwazi ukuchonga abantu abaye basulelwa, baphola, kwaye bayisusa intsholongwane emizimbeni yabo.Ngobuchule, malunga nama-30% ukuya kuma-50% kuphela ayenayo i-PCR kwizigulana ezinenyumoniya efunyenwe ekliniki.Uninzi lwezigulana zenyumoniya ze-coronavirus azikwazi ukufunyaniswa ngenxa yovavanyo olubi lwe-nucleic acid, ngoko ke abanakufumana unyango oluhambelanayo ngexesha.Ukususela kuhlelo lokuqala ukuya kweyesithandathu yezikhokelo, kuxhomekeke kuphela kwisiseko sokuxilongwa kweziphumo zovavanyo lwe-nucleic acid, okubangele ingxaki enkulu kwiiklinikhi.Oyena mntu wokuqala "umloli", uGqr. Li Wenliang, ugqirha wamehlo e-Wuhan Central Isibhedlele, ufile.Ngexesha lobomi bakhe, wayeneemvavanyo ezintathu ze-nucleic acid kwimeko yomkhuhlane kunye nokukhohlela, kwaye ixesha lokugqibela wafumana iziphumo ezilungileyo ze-PCR.
Emva kwengxoxo yeengcali, kwagqitywa ekubeni kwandiswe iindlela zokuvavanya i-serum njengenqobo entsha yokuxilonga.Ngelixa uvavanyo lwe-antibody, olukwabizwa ngokuba luvavanyo lwe-serological, olunokuqinisekisa ukuba umntu wosuleleke na nasemva kokuba amajoni akhe omzimba eyisusile intsholongwane ebangela i-COVID-19.
StrongStep® SARS-COV-2 IgG/IgM Antibody Rapid Test
Uvavanyo lwe-antibody lwe-IgG/IgM luya kunceda ukukhangela ngendlela esekwe kubemi ukuba ngubani osele enosulelo, kuba iimeko ezininzi zibonakala ngathi zisasazekile kwizigulana ezingenasifo zichongwe ngokulula.Isibini saseSingapore, umyeni wavavanywa ukuba une-PCR, iziphumo zovavanyo lwe-PCR yomfazi wakhe zazingenayo, kodwa iziphumo zovavanyo lwe-antibody zabonisa ukuba une-antibodies, njengoko wenzayo nomyeni wakhe.
Iimvavanyo ze-serological kufuneka ziqinisekiswe ngononophelo ukuze ziqinisekise ukuba zisabela ngokuthembekileyo, kodwa kuphela kwizilwa-buhlungu ezichasene nentsholongwane yenoveli.Enye inkxalabo yayikukuba ukufana phakathi kweentsholongwane ezibangela isifo esibukhali sokuphefumla kunye ne-COVID-19 kunokukhokelela ekusebenzeni kwakhona.I-IgG-IgM iphuhliswe nguXue Feng wang6kwakucatshangelwa ukuba iyakwazi ukusetyenziswa njengovavanyo lwe-point-of-care (POCT), njengoko lunokwenziwa kufuphi nebhedi ngegazi leminwe.Ikiti inobuntununtunu be-88.66% kunye ne-specicity ye-90.63%.Nangona kunjalo, kwakusekho iziphumo ezingezizo ezingalunganga nezingalunganga.
Kwinguqulelo ehlaziyiweyo yaseTshayina yoxilongo kunye nesikhokelo sonyango lwenoveli yesifo se-coronavirus (COVID-19)1, amatyala aqinisekisiweyo achazwa njengamatyala akrokrelekayo ahlangabezana nayo nayiphi na enye yezi ndlela zilandelayo:
(1)Iisampulu zendlela yokuphefumla, igazi okanye iisampulu zesitulo ezifunyaniswe zine-SARS-CoV-2 nucleic acid kusetyenziswa i-rt-PCR;
(2) Ulandelelwano lwemfuza lwentsholongwane oluphuma kumjelo wokuphefumla, igazi okanye iisampulu zesitulo zifana kakhulu ne-SARS-CoV-2 eyaziwayo;
(3)I-Serum inoveli ye-coronavirus ethile ye-antibody ye-IgM kunye ne-IgG yayilungile;
4
Uxilongo kunye nonyango lwe-COVID-19
| Izikhokelo | Ipapashiwe | Iikhrayitheriya zokuxilonga eziqinisekisiweyo |
| Inguqulelo yesi-7 | nge-3Mar.2020 | ❶ PCR ❷ NGS ❸ I-IgM+IgG |
| Inguqulelo yesi-6 | 18 Feb.2020 | ❶ PCR ❷ NGS |
Isalathiso
1. Izikhokelo zoxilongo kunye nonyango lwenoveli coronavirus inyumoniya (inguqulo yesi-7 yovavanyo, iKomishoni yezeMpilo yeSizwe yeRiphabhlikhi yaseTshayina, ekhutshwe nge-3.Mar.2020)
http://www.nhc.gov.cn/yzygj/s7652m/202003/a31191442e29474b98bfed5579d5af95.shtml
2. UPhando luSebenzisa kuphela iProtocol yeXesha lokwenyani ye-RT-PCR yokuchongwa kwe-2019-nCoV
https://www.cdc.gov/coronavirus/2019-ncov/lab/rt-pcr-detection-instructions.html
3. I-Singapore ibanga ukusetyenziswa okokuqala kovavanyo lwe-antibody ukulandelela usulelo lwe-coronavirus
https://www.sciencemag.org/news/2020/02/singapore-claims-first-use-antibody-test-track-coronavirus-infections
I-4.SARS-CoV-2 Umthwalo weNtsholongwane kwiMifanekiso ePhezulu yeZigulana ezosulelekileyo ngoFebruwari 19,2020 DOI: 10.1056/NEJMc2001737
5.Ii-Viralloads ze-SARS-CoV-2 kwiisampulu zeklinikhi iLancet Infect Dis 2020 iPapashwe kwi-Intanethi nge-24 kaFebruwari, 2020 (https://doi.org/10.1016/S1473-3099(20)30113-4)
6. Uphuhliso kunye nosetyenziso lweKlinikhi loVavanyo oluKhawulezayo lwe-IgM-IgG oluDityanisiweyo lwe-Antibody ye-SARS-CoV-2
Uxilongo lwe-Infection XueFeng Wang ORCID iD: 0000-0001-8854-275X
Ixesha lokuposa: Mar-17-2020
