Objective　To analyze the correlation of COVID-19 nucleic acid antibody expression pattern with laboratory indicators and patients' basic diseases.Methods　A total of 95 patients diagnosed with COVID-19 in Hubei Provincial Hospital of Traditional Chinese and Western Medicine from January 28 to March 3, 2020 were collected and classified into 7 groups (group 1 to group 7) according to different expression patterns of nucleic acid and antibody results; the general information, basic disease history, and laboratory test results in each group were retrospectively analyzed and compared. Kruskal-Wallis rank sum test was used to compared the measurement data between the groups, and χ² test was used for the comparison of percentages. When P<0.05, there is a statistical difference.Results　The abnormal rates of serum interleukin 6 (IL-6) in the antibody and nucleic acid negative group (group 1) [62.5% (5/8)] and antibody negative and nucleic acid positive group (group 2) [100.0% (2/2)] were the highest. When the antibody pattern was the same under different staging modes, the abnormal rates of CD4⁺ T lymphocytes, CD8⁺ T lymphocytes, IL-6, serum amyloid protein A (SAA), and C-reactive protein (CRP) and the critical rate of the patients in the nucleic acid positive group were significantly higher than those in the nucleic acid negative group. The abnormal rates of SAA and CRP in all the patterns did not change much, and the specificities were not high. The group with double positive antibodies and positive nucleic acid (group 7) had the highest abnormal rate (94.44%, 17/18) of CD4⁺ T among all the test indicators. In the double-positive antibody groups, the probability of critically ill patients in the nucleic acid negative group was 2.36 times those in the first positive nucleic acid test group (group 5) and the subsequent positive nucleic acid test group (group 7). Compared with the double antibody positive and nucleic acid positive group (group 6), the patients with underlying diseases in group 5 were more likely to progress to critical type, especially the patients with abnormal glucose metabolism and cardiovascular diseases.Conclusions　For patients with double negative antibodies and negative nucleic acid many times, early abnormal IL-6 can be used as an early warning indicator when the nucleic acid of COVID-19 antibody is negative. The specificities of CRP and SAA as the monitoring indicators of disease progression are low. When the COVID-19 antibodies both are positive and if the decrease or continuous decrease of CD4⁺ T indicates that the patient is in a state of viral replication, the subsequent nucleic acid can become positive. When the antibody pattern of COVID-19 is the same, the nucleic acid detection rate is related to the patients' immune status. The higher the nucleic acid detection rate is, the higher the patients' severity is, indicating that the patients are in a state of poor prognosis. If the patients' COVID-19 antibodies both are positive, regardless of negative or positive nucleic acid test results, the patients with abnormal glucose metabolism are more likely to develop severe COVID-19 than the patients with other underlying diseases.

目的　分析新型冠状病毒肺炎（corona virus disease 2019，COVID-19）核酸抗体表达模式与实验室检测指标及患者基础性疾病的相关性。方法　收集2020年1月28日至3月3日在湖北省中西结合医院的95例COVID-19确诊患者，按照核酸和抗体结果的不同表达模式进行分型分组（分组1～分组7），分析比较各组患者一般资料、基础疾病病史和实验室检测结果。计量资料组间比较采用Kruskal-Wallis秩和检验，百分率的比较采用χ²检验，P<0.05为差异有统计学意义。结果　抗体和核酸全阴性组（分组1）、抗体全阴性且核酸阳性组（分组2）血清白细胞介素6（interleukin 6，IL-6）在所有检测指标中异常率最高，分别为62.5%（5/8）和100.0%（2/2）；不同分期模式下，抗体模式相同，与核酸阴性组比较，核酸阳性组CD4⁺ T淋巴细胞（CD4⁺ T）、CD8⁺ T淋巴细胞（CD8⁺ T）、IL-6、血清淀粉样蛋白A（SAA）、C反应蛋白（CRP）异常率和患者危重率明显升高。在所有分期模式中，SAA、CRP异常率无多大变化，特异性不高。抗体双阳性、核酸由阴转阳组（分组7）CD4⁺ T异常率（94.44%，17/18）在所有检测指标中最高。抗体双阳性组中，无论是首次核酸检测阳性组（分组5）还是后续检测阳性组（分组7）出现危重患者的概率为核酸阴性组的2.36倍。与双抗体阳性核酸阳性组（分组6）相比，分组5患有基础性疾病的患者更容易进展为危重型，尤其是糖代谢异常和心血管疾病患者。结论　COVID-19抗体双阴性并且多次核酸检测阴性的人群，IL-6早期异常可作为COVID-19抗体核酸阴性时早期预警指标。CRP、SAA作为病情进展的监控指标特异性较低；COVID-19抗体双阳性，若CD4⁺ T降低或持续降低提示患者体内病毒处于复制状态，后续核酸可转为阳性；COVID-19抗体模式相同，核酸检出率与患者的免疫状况相关，核酸检出率越高，患者的危重程度越高，也可说明患者处于一个预后不良的状态。COVID-19抗体双阳性，不管核酸检测结果阴性或者阳性，COVID-19合并糖代谢异常的患者较其他基础性患者更易发展成为重型患者。