中台灣區域教學醫院2020年使用不同新冠檢測平台的經驗

Experience of Differential COVID-19 Diagnostic Methods in a Metropolitan Hospital in Central Taiwan

根據WHO的最新統計數據，從2019年12月直至2021年8月中，全球多達2.16億人被診斷出新冠病毒（COVID-19），導致近450萬人死亡。COVID-19檢驗是防疫最重要的一個關卡。本研究使用之檢體為公費或自費檢驗COVID-19需求者。檢驗方法：1.指定檢驗機構檢驗方法（LDT）、2.瑞基新型冠狀病毒檢測。秀傳紀念醫院從2020年4月29日開始提供體系三院區COVID-19檢測服務，至2020年底，共執行3,381件的檢測。秀傳公費送驗檢體共1,793件，男性占比65.81%、女性占34.19%；本國籍佔62.41%、外國籍佔37.59%；主要送驗單位為急診及感染科。自費檢驗共1,147件，男性占72.10%、女性占27.90%；年齡主要分布在20–50歲的勞動年齡，自費受檢因素大多為工作需求。我們使用兩種檢測平台，其中以LDT方式的有2,325件，瑞基有1,056件；LDT有疑似無法判定的發生機率為1.8%；瑞基檢測無法判定的發生率為1.0%。目前因應COVID-19的篩選平台已經越來越多，每個平台各有其優缺點及適合的時機；LDT適合確診案例或檢體量多；而瑞基適合急件時篩檢。本研究統計2020年成立至年底兩個平台的使用經驗，供其他單位參考。

Globally, the World Health Organization (WHO) has reported 216 million confirmed cases of COVID-19, including 4.5 million deaths. Diagnosis of COVID-19 is the most effective method of preventing the epidemic. This study tests clinical samples for COVID-19 at Show Chwan Memorial Hospital from April 29, 2020 to December 31, 2020. Two detection platforms were used: LDT and POCKIT (ii RT-PCR). A total of 3,381 COVID-19 diagnostic tests were performed, of which 1,793 diagnostic tests were used to diagnose notifiable infectious diseases. Of the 3,381 tests, 72.1% were conducted on men and 27.9% on women, and 65.8% were performed on Taiwanese subjects and 34.2% on foreign subjects. Most of the patients came from the emergency and infection departments.
A total of 1,147 self-financed screenings were conducted, of which 72.1% were conducted on men and 27.9% on women. Most of the people who were tested were of working age (20–50 years) and most tests were conducted because of employment requirements. Of the 3,381 tests, 2,325 were conducted using LDT and 1,056 using POCKIT (ii RT-PCR). The rate of indeterminate results for LDT and POCKIT (ii RT-PCR) were 1.8% and 1.0%, respectively.
This study shows that each of the increasing number of screening platforms for COVID-19 has advantages and disadvantages. LDT is suitable for confirmed cases or large numbers of examinations and POCKIT (ii RT-PCR) is suitable for screening urgent cases. The prices of instruments and reagents also determine the selection of the testing method.