Kev sim kuaj mob rau kev kuaj mob ntawm COVID-19 tam sim no nyob rau hauv kev xyaum raws li qhia los ntawm thoob ntiaj teb lub koom haum ntawm cov kws txawj raug tshuaj xyuas thiab soj ntsuam.
NKAUJ-19 kab mob, uas yog los ntawm Wuhan Tuam Tshoj, tau cuam tshuam ntau dua 208 lub teb chaws txog tam sim no. Cov zej zog kev tshawb fawb thoob plaws ntiaj teb tau teeb tsa nrog kev sib tw tseem ceeb hauv ob peb lub hlis dhau los, txhim kho kuaj mob rau Covid-19 Kev kuaj kab mob txhawm rau txhawm rau tshuaj xyuas cov neeg mob thiab cov neeg xav tias yuav tsum tswj hwm thiab tswj tus kabmob kis tau zoo.
Ua ntej peb ntsuas cov qauv thiab cov kev coj ua tam sim no siv los kuaj pom tus kab mob COVID-19, qhia rau peb ua ntej nkag siab tias qhov twg ua rau COVID-19 thiab ib qho yuav ua li cas los tsim cov kev kuaj mob los kuaj cov neeg mob rau tus kab mob no. Tus kab mob COVID-19 yog tshwm sim los ntawm RNA zoo tus kab mob no uas yog zoonotic, uas txhais tau hais tias lawv muaj peev xwm hla hom kab thaiv los ntawm cov tsiaj mus rau tib neeg, thiab tuaj yeem ua rau tib neeg, muaj mob xws li mob khaub thuas mus rau cov kab mob hnyav dua xws li MERS thiab SARS. Tus kab mob ua rau COVID-19 tam sim no tau muab lub npe hu ua SARS-CoV-2 los ntawm International Committee of Taxonomy of Viruses (ICTV), vim nws zoo ib yam li tus uas ua rau muaj tus kab mob SARS (SARS-CoVs). Kev kuaj mob rau tus kab mob COVID-19 tuaj yeem tsim muaj ntau txoj hauv kev.
Txoj kev nrov tshaj plaws thiab tam sim no tau txais kev pom zoo thoob ntiaj teb yog tsim cov kev kuaj mob uas tuaj yeem kuaj pom tus kab mob SARS-CoV-2 nws tus kheej. Qhov no xeem yog raws li kev kuaj pom tus kab mob genome hauv tus neeg mob tus qauv los ntawm RT-real time PCR (reverse transcriptase-real time Polymerase Chain Reaction). Qhov no suav nrog kev hloov pauv ntawm tus kab mob RNA mus rau DNA siv ib qho enzyme hu ua thim rov qab transcriptase thiab tom qab ntawd nthuav dav DNA siv cov txheej txheem tshwj xeeb thiab cov tshuaj fluorescent, uas khi rau ib cheeb tsam tshwj xeeb ntawm cov kab mob DNA, siv Taq polymerase thiab kuaj cov teeb liab fluorescent. Cov kev sim no raug xa mus rau NAATs (Nucleic Acid Amplification Tests). Cov txheej txheem no tuaj yeem muaj txiaj ntsig zoo rau kev tshawb pom ntxov heev ntawm kev muaj nucleic acid hauv cov qauv ntawm tus neeg mob, txawm tias cov neeg mob asymptomatic uas tsis pom cov tsos mob ntawm tus kab mob COVID-19 (tshwj xeeb tshaj yog nyob rau lub sijhawm incubation ntawm 14-28 hnub) thiab nyob rau tom qab. ib yam li thaum kab mob puv nkaus.
Ntau lub tuam txhab thoob ntiaj teb tau ua haujlwm hauv kev sib tw tawm tsam lub sijhawm ob peb lub hlis dhau los los tsim NAAT raws li kev kuaj mob rau kev kuaj pom ntawm SARS-CoV-2 raws li CDC (Centre for Disease Control), Atlanta, USA thiab WHO cov lus qhia ( 1, 2). Cov kws saib xyuas kev noj qab haus huv thoob plaws ntiaj teb tau pom zoo cov kev sim no rau kev siv thaum muaj xwm txheej ceev rau kev kuaj pom ntawm SARS-CoV-2. Cov kab mob kis tau tsom mus txog tam sim no suav nrog N, E, S thiab RdRP cov noob, nrog rau kev tswj hwm zoo thiab tsis zoo. Tus neeg mob cov qauv uas yuav tsum tau sau rau qhov kev sim no yog los ntawm cov kab mob ua pa sab saud (nasopharyngeal thiab oropharyngeal swab) thiab / lossis cov kab mob ua pa qis (sputum thiab / lossis endotracheal aspirate lossis bronchoalveolar lavage). Txawm li cas los xij, nws tseem tuaj yeem kuaj pom tus kab mob hauv lwm cov qauv, suav nrog cov quav thiab ntshav. Cov qauv yuav tsum tau muab khaws cia sai sai raws li qhov tsim nyog ua txhua yam kev tiv thaiv tsim nyog thiab ua raws li kev coj noj coj ua biosafety (raws li cov lus qhia tau teev tseg los ntawm WHO[1]), los ntawm cov neeg mob ntsib cov teeb meem xav tau txhais rau COVID-19, khaws cia thiab ntim nws. zoo yog tias nws yuav tsum tau thauj mus rau qhov chaw kuaj mob thiab tom qab ntawd ua tiav (extracting RNA nyob rau hauv lub txee biosafety hauv BSL-2 lossis qhov chaw sib npaug) swiftly nyob rau hauv ib tug yam ntxwv los xyuas kom meej cov qauv kev ncaj ncees. Tag nrho cov no yuav tsum tau ua raws li qhov tseem ceeb rau kev tswj hwm kev kho mob zoo dua thiab kev tiv thaiv kab mob.
Lub sijhawm kuaj pom rau ntau yam muaj NAAT raws li kev sim tsim los ntawm cov tuam txhab kuaj mob loj thoob ntiaj teb sib txawv ntawm 45 min mus rau 3.5 teev. Ntau yam kev txhim kho tau raug ua rau cov kev ntsuam xyuas no los hloov lawv mus rau qhov kev ntsuam xyuas kev saib xyuas thiab ua tiav cov txiaj ntsig xav tau hauv lub sijhawm tsawg dua li qhov ua tau yam tsis muaj kev cuam tshuam qhov tseeb ntawm qhov tshwm sim, txhawm rau nce cov kev ntsuas uas tuaj yeem ua tiav hauv ib hnub.
Lwm cov kev xaiv kuaj mob yog Kev kuaj mob ceev ceev (RDTs) uas yog kuaj pom tus kab mob antigens/proteins uas tau nthuav tawm nyob rau saum npoo ntawm SARS-CoV-2 cov kab mob raws li lawv rov ua dua hauv cov hlwb thiab ua rau muaj kab mob lossis cov tshuaj tiv thaiv kab mob hauv teb rau kev kis kab mob; Qhov kev sim no kuaj pom muaj cov tshuaj tiv thaiv kab mob hauv cov ntshav ntawm cov neeg ntseeg tias tau kis tus kab mob COVID-19 (3).
Qhov raug thiab rov tsim dua tshiab ntawm RDT txhawm rau kuaj cov kab mob antigens nyob ntawm ntau yam xws li lub sijhawm txij li pib muaj mob, qhov concentration ntawm tus kab mob hauv cov qauv, qhov zoo thiab kev ua cov qauv, thiab kev tsim cov tshuaj reagents tam sim no hauv cov khoom siv kuaj. Vim yog cov kev hloov pauv no, qhov rhiab heev ntawm cov kev ntsuam xyuas no yuav txawv ntawm 34% mus rau 80%. Ib qho teeb meem loj ntawm qhov kev xaiv no yog tias tus kab mob yuav tsum tau nyob rau hauv nws qhov kev rov ua dua thiab kis kab mob txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau kis tus kabmob.
Ib yam li ntawd, kev kuaj xyuas cov tshuaj tiv thaiv kab mob yog ua raws li lub zog ntawm cov tshuaj tiv thaiv kab mob uas nyob ntawm cov yam ntxwv xws li hnub nyoog, kev noj zaub mov zoo, qhov mob hnyav, thiab qee yam tshuaj lossis kab mob uas ua rau lub cev tsis muaj zog. Qhov teeb meem loj ntawm qhov kev xaiv no yog cov tshuaj tiv thaiv tau tsim nyob rau ntau hnub mus rau lub lis piam tom qab kis tus kab mob SARS-CoV-2 thiab ib tus yuav tsum tau tos ntev npaum li ntawd los ua qhov kev sim. Qhov no txhais tau hais tias kev kuaj pom tus kab mob COVID-19 raws li tus tswv tsev cov tshuaj tiv thaiv kab mob feem ntau tsuas yog ua tau nyob rau theem rov qab los, thaum muaj ntau txoj hauv kev rau kev cuam tshuam kev kho mob lossis kev tiv thaiv kab mob kis tau dhau los.
Tam sim no, RDTs tau hais los saum toj no tsuas yog tau pom zoo hauv qhov chaw tshawb fawb thiab tsis yog rau kev kuaj mob vim tsis muaj ntaub ntawv (3, 4). Raws li ntau thiab ntau cov ntaub ntawv sib kis tau dhau los muaj rau COVID-19, ntau RDTs yuav raug tsim thiab pom zoo raws li cov ntsiab lus ntawm kev kuaj mob hauv qhov chaw kho mob vim lawv tuaj yeem muab cov txiaj ntsig hauv 10-30 feeb uas tsis zoo li NAAT cov kev xeem uas nyob rau nruab nrab yuav siv sijhawm. ob peb teev kom kuaj tau tus kab mob.
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References:
1. WHO, 2020. Laboratory Test Strategy Recommendations for COVID-19. Kev taw qhia ib ntus. 21 Lub Peb Hlis 2020. Muaj nyob online ntawm https://apps.who.int/iris/bitstream/handle/10665/331509/WHO-COVID-19-lab_testing-2020.1-eng.pdf Tau txais los ntawm 09 Lub Plaub Hlis 2020
2. CDC 2020. Cov ntaub ntawv rau lub chaw soj nstuam. Kev taw qhia ib ntus rau Laboratories Muaj nyob online ntawm https://www.cdc.gov/coronavirus/2019-nCoV/lab/index.html Tau txais los ntawm 09 Plaub Hlis 2020.
3. WHO, 2020. Cov lus qhia txog kev siv Point of Care Tests. Kev piav qhia luv luv. 08 Lub Plaub Hlis 2020. Muaj nyob online ntawm https://www.who.int/news-room/commentaries/detail/advice-on-the-use-of-point-of-care-immunodiagnostic-tests-for-covid-19 Tau txais los ntawm 09 Plaub Hlis 2020.
4. ECDC, 2020. Ib qho Kev Tshaj Tawm ntawm Kev Ntsuas Kev Ntsuas nrawm rau kev kuaj mob COVID-19 hauv EU/EEA. 01 Lub Plaub Hlis 2020. European Center for disease Prevention and control. Muaj nyob online ntawm https://www.ecdc.europa.eu/en/publications-data/overview-rapid-test-situation-covid-19-diagnosis-eueea Tau txais los ntawm 09 Lub Plaub Hlis 2020
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