基于抗原和聚合酶链式反应的组合策略对模拟社区内遏制COVID-19传播效果的定量分析

黄蔷如, 孙艳侠, 贾萌萌, 张婷, 陈方圆, 姜明月, 王晴, 冯录召, 杨维中

工程（英文） ›› 2023, Vol. 28 ›› Issue (9) : 234-242.

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工程（英文） ›› 2023, Vol. 28 ›› Issue (9) : 234-242. DOI: 10.1016/j.eng.2023.01.004
研究论文
Article

基于抗原和聚合酶链式反应的组合策略对模拟社区内遏制COVID-19传播效果的定量分析

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Quantitative Analysis of the Effectiveness of Antigen- and Polymerase Chain Reaction-Based Combination Strategies for Containing COVID-19 Transmission in a Simulated Community

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摘要

新型冠状病毒肺炎（coronavirus disease 2019, COVID-19）病例数量持续增加，这使得许多国家的医疗系统不堪重负并导致超额死亡。对感染人群进行检测仍然是遏制COVID-19疫情、延缓疾病的传播以及拉平疫情流行曲线的关键策略。本研究以奥密克戎突变株疫情为背景，旨在评估采用不同频率和组合的检测策略的有效性，分析与检测效果相关的影响因素，并基于这些影响因素进一步优化检测策略。我们开发了一个随机的、基于agent的、离散时间的易感者—潜隐者—感染者—康复者模型来模拟COVID-19在社区内的传播，评估了三个不同强度级别的检测策略与COVID-19传播之间的关联。研究结果表明抗原检测及其组合策略比聚合酶链式反应（polymerase chain reaction, PCR）相关策略更高效，更有助于降低医院床位和重症监护病房床位需求。相对于可检测的病毒载量阈值和检测时的接触风险，检测结果的返回时间这一因素对于检测策略的效果影响更大。较短的结果返回时间是抗原检测策略的主要优势所在，也是优化PCR策略的关键因素。优化调整检测结果返回时间后，低频次的检测策略的效果可以媲美每日连续检测策略的效果。检测策略的选择需要考虑防控目标、检测效力、社区患病率和经济等因素，本研究可以为后疫情时代的检测策略选择和优化提供证据，为优化医疗资源提供指导。

Abstract

The number of coronavirus disease 2019 (COVID-19) cases continues to surge, overwhelming healthcare systems and causing excess mortality in many countries. Testing of infectious populations remains a key strategy to contain the COVID-19 outbreak, delay the exponential spread of the disease, and flatten the epidemic curve. Using the Omicron variant outbreak as a background, this study aimed to evaluate the effectiveness of testing strategies with different test combinations and frequencies, analyze the factors associated with testing effectiveness, and optimize testing strategies based on these influencing factors. We developed a stochastic, agent-based, discrete-time susceptible-latent-infectious-recovered model simulating a community to estimate the association between three levels of testing strategies and COVID-19 transmission. Antigen testing and its combination strategies were more efficient than polymerase chain reaction (PCR)-related strategies. Antigen testing also showed better performance in reducing the demand for hospital beds and intensive care unit beds. The delay in the turnaround time of test results had a more significant impact on the efficiency of the testing strategy compared to the detection limit of viral load and detection-related contacts. The main advantage of antigen testing strategies is the short turnaround time, which is also a critical factor to be optimized to improve PCR strategies. After modifying the turnaround time, the strategies with less frequent testing were comparable to daily testing. The choice of testing strategy requires consideration of containment goals, test efficacy, community prevalence, and economic factors. This study provides evidence for the selection and optimization of testing strategies in the post-pandemic era and provides guidance for optimizing healthcare resources.

关键词

COVID-19 / 抗原检测 / PCR核酸检测 / 检测策略

Keywords

COVID-19 / Antigen testing / PCR testing / Testing strategies

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黄蔷如, 孙艳侠, 贾萌萌. 基于抗原和聚合酶链式反应的组合策略对模拟社区内遏制COVID-19传播效果的定量分析. Engineering. 2023, 28(9): 234-242 https://doi.org/10.1016/j.eng.2023.01.004

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