Why is the nucleic acid test inaccurate for “Fuyang” patients who have recovered from new crown pneumonia?

This article is from the WeChat public account: Ice Glacier (ID: icereview) < span class = "text-remarks">, author: Zheng Shanhai (doctors), title figure from the visual China

The overall “epidemic” of the new championship is improving, and the dawn of victory is shining.

Everyone is working together and determined to completely wipe out new coronary pneumonia, but some negative information pops up from time to time to disturb people ’s confidence, and even casts some shadows on people ’s hearts, such as nucleic acid testing of discharged patients Questions that turn positive are such negative news.

01 How is the patient still recovering?

As early as February, it was reported that a patient in Chengdu was found to be cured and discharged 10 days later, and the nucleic acid turned positive after a review. At that time, many people thought this was an example.

</ iframe> </ p></p> <p> </ p></p> <p> But recently it has been reported that 14% of discharged patients in Guangdong have been tested positive for nucleic acid, and 26 of 44 discharged patients in a hospital in Wuhan have tested positive for nucleic acid. The problem appears to be serious. </ p></p> <p> </ p></p> <p> <strong> Everyone knows that a positive accounting test is the “gold standard” for the diagnosis of new coronary pneumonia. Whether a person has clinical symptoms or not, the diagnosis of new coronary pneumonia can be confirmed with this result. </ strong> A person who has just decided to recover, heyWhat about a well-documented patient? </ p></p> <p> </ p></p> <p> Since the outbreak of the “New Epidemic”, various medical institutions have made very strict judgments on discharged patients. In addition to the patient’s temperature returning to normal, respiratory symptoms improving, and pulmonary imaging showing obvious absorption of acute inflammation, they must also <Span class = "text-remarks" label = "Remarks"> (sampling interval at least 1 day) </ span> Negative nucleic acid test for respiratory pathogens is required before the patient can be discharged. </ p></p> <p> </ p></p> <p> Why can’t such standards stop “positive” patients? This is really not good news for us to complete the virus eradication war. </ p></p> <p> </ p></p> <p label = "大 Title" class = "text-big-title"> 02 Why is nucleic acid detection inaccurate? </ p></p> <p> </ p></p> <p> Although the reason for the nucleic acid reexamination of discharged patients is still inconclusive. However, medicine has its own common sense and experience. As far as virus infection is concerned, there is no cure in the strict sense. The ones who recover are self-healing and rely on autoantibodies. </ p></p> <p> </ p></p> <p> Since the body can already resist this virus, it is very difficult to re-infect it in the short term. <strong> So Academician Zhong Nanshan pointed out with certainty that the possibility of reinfection in Fuyang patients is very small, and the reason can only be found from the accuracy of nucleic acid detection. </ strong> </ p></p> <p> </ p></p> <p class = "img-center-box"> <img class = "lazyImg" _src = "https://img.huxiucdn.com/article/content/202003/09/175043981031.jpg?imageView2/2/w/ 1000 / format / jpg / interlace / 1 / q / 85 "data-w =" 1080 "data-h =" 601 "> </ p></p> <p label = "picture note" class = "text-img-note"> Zhong Nanshan (picture / web) <br label="picture note" class="text-img-note"> </ p></p> <p> </ p></p> <p> Virus is the simplest living body, mainly composed of genetic material and protein, and genetic material is composed of one or more nucleic acid molecules. Each virus has different genetic material and different nucleic acid characteristics. Therefore, nucleic acid is the core and most accurate marker of the virus. </ p></p> <p> </ p></p> <p> <strong> If a nucleic acid corresponding to a certain virus is detected in a person ’s body, that provesThis person is infected. </ strong> </ p></p> <p> </ p></p> <p> However, in the case of neocoronary pneumonia, the invasion site is mainly in the lower respiratory tract. Therefore, it is best to take specimens from the posterior pharyngeal wall or deeper. The location of the virus invasion may cause the specimen to be free of virus. </ p></p> <p> </ p></p> <p> Furthermore, the removed specimens need to be further processed. In this process, the virus may be inactivated. In addition, the test kit may also cause deviations, leading to patients who have been infected with the virus. However, the specimen test shows that A negative result, that is, no new coronavirus nucleic acid was found. </ p></p> <p> </ p></p> <p> This phenomenon is clinically called false negative, which means false negative results. <strong> Some investigations have shown that the false-negative rate of nucleic acid testing for neo-coronary pneumonia is even more than 50%. </ strong> This is also the reason for the diagnosis and treatment of new coronary pneumonia. Despite multiple revisions, the prerequisite for lifting the diagnosis of new coronary pneumonia is that the nucleic acid test must be negative more than twice. </ p></p> <p> </ p></p> <p label = "大 Title" class = "text-big-title"> 03 Viral toxicity will be reduced in recoverers </ p></p> <p> </ p></p> <p> But the increase in the number of tests can only reduce the cumulative probability of false negatives, and can’t really avoid false negatives. Therefore, it is not surprising that patients who have been screened for nucleic acid negatives are later detected positive. </ p></p> <p> </ p></p> <p> This is indeed a problem for the prevention and control of new coronary pneumonia, and high vigilance should be maintained, but it seems that it is not necessary to emphasize the unreliability of nucleic acid testing completely. </ p></p> <p> </ p></p> <p> Shanghai Medical Treatment Team Leader and Infectious Diseases expert Zhang Wenhong is very clear about this, <strong> Why do n’t you have to worry about nucleic acid detection in discharged patients? </ strong> The problem that should be paid attention to is that such patients will not It can be transmitted to other people, but as far as the various information released so far, no cases of infection caused by discharged patients have been found. </ p></p> <p> </ p></p> <p class = "img-center-box"> <img class = "lazyImg" _src = "https://img.huxiucdn.com/article/content/202003/09/175043778120.jpg?imageView2/2/w/ 1000 / format / jpg / interlace / 1 / q / 85 "data-w =" 680 "data-h =" 443 "> </ p></p> <p label = "picture note" class = "text-img-note "> Official cancellation of multiple cabins in Wuhan (Picture / Internet) <br label="Picture Note" class="text-img-note"> </ p></p> <p> </ p></p> <p> This is also in line with the characteristics of virus transmission. Because the virus leaves the host very difficult to survive or has a short survival period, the highly toxic virus loses its chance of transmission due to severe host symptoms or rapid death. </ p></p> <p> </ p></p> <p> Those viruses that have a longer incubation period in the human body are more insidious. Because they have been surrounded by the immune system in the human body, although they survive, the toxicity is generally weakened. When transmitted to the next generation host, the toxicity will be There is a certain decline. <strong> Therefore, the virus-induced epidemic situation will show the characteristics of increasingly weak virus toxicity. </ strong> </ p></p> <p> </ p></p> <p> For those patients whose symptoms are reduced after infection with the virus, even if there is still a viral load in the body, the virus’s toxicity must have been greatly weakened, so the ability of the virus to cause others to contract disease has been greatly reduced. </ p></p> <p> </ p></p> <p> In addition, people’s awareness of prevention is very strong and effective protection can be achieved. This ensures that the falsely cured patients with improved symptoms do not cause new infections. </ p></p> <p> </ p></p> <p label = "大 Title" class = "text-big-title"> 04 The question of Fuyang cannot be ignored and ignored </ p></p> <p> </ p></p> <p> Of course, in theory, as long as the virus can still be detected in the body, there may be contagiousness, so you must not ignore the problem of Fuyang discharged from the hospital. </ p></p> <p> </ p></p> <p> So, in the newly updated 7th edition of the New Coronary Pneumonia diagnosis and treatment specifications, the post-discharge <strong> “should continue to carry out 14-day self-health test” to “should continue to carry out 14-day isolation management and health monitoring </ strong> The level of isolation and management of discharged patients has been improved, which is another guarantee for ensuring everyone’s safety. </ p></p> <p> </ p></p> <p class = "img-center-box"> <img class = "lazyImg" _src = "https://img.huxiucdn.com/article/content/202003/09/175043094527.jpg?imageView2/2/w/ 1000 / format / jpg / interlace / 1 / q / 85 "data-w =" 1080 "data-h =" 719 "> </ p></p> <p label = "Picture note" class = "text-img-note"> Patient recovered and discharged (Figure / Internet) <br label = "Picture Note" class = "text-img-note"> </ p></p> <p> </ p></p> <p> Now, some hospitals in Wuhan have further tightened discharge standards and increased the detection of serum antibodies IgM and IgG, which is equivalent to opening a window for detection in addition to nucleic acids. </ p></p> <p> </ p></p> <p> These two antibodies are immune responses produced by the body after the infection. The former produces early, low affinity, and gradually subsides as the virus is cleared. Time, <strong> By comparing the relationship between the two, you can roughly determine the stage where the infection is roughly. It has a certain reference function for more accurately judging the rehabilitation of patients. </ strong> </ p></p> <p> </ p></p> <p> So, although the new crown virus is cunning, it is a virus in the end. If you deal with it according to the general attributes of the virus, you can always find out its spleen. Practice has shown that as long as it follows the rules, the virus will eventually be defeated by us. </ p></p> <p> </ p></p> <p> I heard that in some places, the approach of closing the entire unit to discharged Fuyang patients is still being taken. Caution should be taken, but the scope is too wide and worth exploring. </ p></p> <p> </ p></p> <p> <span class = "text-remarks" label = "Remarks"> This article is from WeChat public account: </ span> <a href = "https://mp.weixin.qq.com/s/Tv-EDlJLje0yoSXeFsVing "target =" _ blank "rel =" nofollow "style =" text-decoration: none; "> <span class =" text-remarks "> Ice Glacier (ID: icereview) </ span> </a> < span class = "text-remarks">, author: Zheng Shanhai (physician) </ span> </ p></p> </div> <p class="post-tags"></p> </article> <script src='//unpkg.com/valine/dist/Valine.min.js'></script> <div id="vcomments"></div> <script> new Valine({ el: '#vcomments', appId: 'nFXLD31mFjDHlrEDx3OQWstS-gzGzoHsz', appKey: 'GhTuxYTHv3w2aqSJ0urXJov5', }) </script> <style> #veditor { background-image: url(https://image.bestzuo.cn/images/20200708160947.gif!getwebp); background-size: contain; background-repeat: no-repeat; background-position: right; background-color: rgba(255, 255, 255, 0); resize: vertical } img.vimg { transition: all 1s /* 旋转时间为 1s */ } img.vimg:hover { transform: rotate(360deg); -webkit-transform: rotate(360deg); -moz-transform: rotate(360deg); -o-transform: rotate(360deg); -ms-transform: rotate(360deg); } #vcomments .vcards .vcard { padding: 15px 20px 0 20px; border-radius: 10px; margin-bottom: 15px; box-shadow: 0 0 4px 1px rgba(0, 0, 0, .12); transition: all .3s } #vcomments .vcards .vcard:hover { box-shadow: 0 0 8px 3px rgba(0, 0, 0, .12) } #vcomments .vcards .vcard .vh .vcard { border: none; box-shadow: none; } </style> </main>  <aside class="sidebar col-md-3 col-sm-4 col-xs-12" style="float:right"> <aside id="polylang-2" class="widget widget_polylang"><ul> <li class="lang-item lang-item-17 lang-item-zh no-translation lang-item-first"><a lang="zh-CN" hreflang="zh-CN" href="https://www.ww01.net/"><img src="data:image/png;base64,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" title="中文 (中国) (zh_CN)" alt="中文 (中国)" width="16" height="11" style="width: 16px; height: 11px;" /><span style="margin-left:0.3em;">中文 (中国)</span></a></li> <li class="lang-item lang-item-29 lang-item-en current-lang"><a lang="en-AU" hreflang="en-AU" href="https://www.ww01.net/en/archives/50640"><img src="data:image/png;base64,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" title="English (en_AU)" alt="English" width="16" height="11" style="width: 16px; height: 11px;" /><span style="margin-left:0.3em;">English</span></a></li> </ul> </aside><aside id="custom_html-2" class="widget_text widget widget_custom_html"><div class="textwidget custom-html-widget"><script async src="https://pagead2.googlesyndication.com/pagead/js/adsbygoogle.js"></script>  <ins class="adsbygoogle" style="display:block" data-ad-client="ca-pub-1204574674466407" data-ad-slot="3371268877" data-ad-format="auto" data-full-width-responsive="true"></ins> <script> (adsbygoogle = window.adsbygoogle || []).push({}); </script>  <script src="https://libs.baidu.com/jquery/2.0.0/jquery.min.js"></script> <script> $(function () { $(".search-form").submit(function(e){ e.preventDefault(); window.open("https://www.google.com/search?q=site:ww01.net%20"+$(".search-field").val()); }); }) </script></div></aside> <aside id="recent-posts-4" class="widget widget_recent_entries"> <h3 class="widget-title">Recent Posts</h3> <ul> <li> <a href="https://www.ww01.net/en/archives/174760">CISA plans to establish an iron ore Working Committee: strengthen the research on major issues related to iron ore</a> <span class="post-date">2022年8月1日</span> </li> <li> <a href="https://www.ww01.net/en/archives/174752">Hangzhou: when a family with three children purchases their first home, the first loan limit of the provident fund can be increased by up to 20%</a> <span class="post-date">2022年8月1日</span> </li> <li> <a href="https://www.ww01.net/en/archives/174747">COMAC announced that the domestic large aircraft C919 has completed its certification test flight</a> <span class="post-date">2022年8月1日</span> </li> <li> <a href="https://www.ww01.net/en/archives/174745">Investigation ｜ long term rent in hotels: it is a “new consumption trend”, but also an industry self-help</a> <span class="post-date">2022年8月1日</span> </li> <li> <a href="https://www.ww01.net/en/archives/174743">Liquidity outlook in August: can the overnight capital interest rate of about 1% continue</a> <span class="post-date">2022年8月1日</span> </li> </ul> </aside><aside id="text-8" class="widget widget_text"><h3 class="widget-title">contact us</h3> <div class="textwidget"><p>email：sparrww@vip.163.com</p> </div> </aside> </aside> </div>  </div>   <footer> <div class="footer-top"> <div class="container"> <div class="row"> <div class="col-sm-4"> <aside id="linkcat-6" class="widget widget_links"><h3 class="widget-title">Links</h3> <ul class='xoxo blogroll'> <li><a href="http://www.domeet.net/" rel="me noopener" target="_blank">domeet</a></li> <li><a href="https://www.kevinbobo.top/" rel="noopener" target="_blank">kevinBobo</a></li> <li><a href="https://www.yvyong.com/" rel="noopener" target="_blank">yvyong BLOG</a></li> </ul> </aside> </div> <div class="col-sm-4 md-footer-cl"> </div> <div class="col-sm-4"> </div> </div> </div> </div> <div class="blog-footer blog-footer-widgets"> <div class="container"> <p class="site-credits">© 2022 - Powered by <a href="https://jumpstarter.io/frenchtastic/coeur">Coeur</a></p> <p class="back-to-top"><a href="#"><i class="fa fa-angle-up"></i> Back to top<a></p> </div> </div> </footer> </div>  <script id="imwpf-this-page"> var g_this_page = { "type": "post", "id": 50640, "terms": [{"id":37,"tax":"category"},{"id":29,"tax":"language"}] };console.log(g_this_page); </script><div class="imwpcache_status_ok"></div><div style="display:none"> <script src="https://s5.cnzz.com/z_stat.php?id=1275404939&web_id=1275404939" language="JavaScript"></script> <script> (function(){ var src = "https://jspassport.ssl.qhimg.com/11.0.1.js?d182b3f28525f2db83acfaaf6e696dba"; document.write('<script src="' + src + '" id="sozz"><\/script>'); })(); </script> </div> <script>console.log('命中缓存\n缓存页加载耗时: 0.0041s\n缓存页生成时间: 2022-08-08 11:29:18')</script></body> </html>

domeet webmaster