tetano
Editor, Senior Moderator
Ann Transl Med
. 2021 Apr;9(8):665.
doi: 10.21037/atm-21-445.
Clinical features in coronavirus disease 2019 (COVID-19) patients with early clearance and prolonged shedding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA
Yan Zhou[SUP] 1 [/SUP], Fengming Ding[SUP] 1 [/SUP], Wuping Bao[SUP] 1 [/SUP], Yishu Xue[SUP] 1 [/SUP], Lei Han[SUP] 1 [/SUP], Xue Zhang[SUP] 1 [/SUP], Pengyu Zhang[SUP] 1 [/SUP], Yong Ji[SUP] 1 [/SUP], Dongning Yin[SUP] 1 [/SUP], Aihua Bao[SUP] 1 [/SUP], Shan Luo[SUP] 2 [/SUP], Zengchao Xu[SUP] 2 [/SUP], Jun Liu[SUP] 3 [/SUP], Min Zhang[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Since the outbreak of coronavirus disease 2019 (COVID-19), the pattern of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA shedding has not been well characterized.
Methods: In our study, 652 patients in Wuhan Designated Hospital were recruited, and their clinical and laboratory findings were extracted and analyzed.
Results: The median duration of SARS-CoV-2 RNA detection was 23 days [interquartile range (IQR), 18 days] from symptom onset. Compared to patients with early viral RNA clearance (<23 days after illness onset), we found that patients with late viral RNA clearance (?23 days) had a higher proportion of clinical features, as follows: symptoms, including fever, dry cough, and sputum production; comorbidities, including hypertension, chronic kidney disease, uremia, chronic liver disease, anemia, hyperlipidemia, and bilateral lung involvement; complications, such as liver injury; delayed admission to hospital; laboratory parameters at baseline, including higher eosinophils, uric acid, cholesterol, triglycerides, and lower hemoglobin; and less treatment with arbidol, chloroquine, or any antivirals. After generalized linear regression, prolonged SARS-CoV-2 RNA shedding was independently associated with younger age; delayed admission to hospital; symptoms including fever, shivering, and sputum production; comorbidities including hypertension, diabetes, cardiovascular disease, anemia, hyperlipidemia, uremia, and lung involvement; and higher alanine aminotransferase (ALT), uric acid, and cholesterol levels at baseline.
Conclusions: In conclusion, the factors mentioned above are associated with the negative conversion of SARS-CoV-2 RNA. A deeper insight into virological dynamics will be helpful for establishing patient discharge and quarantine release criteria.
Keywords: Coronavirus disease 2019 (COVID-19); negative conversion; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); viral RNA clearance; viral shedding.
. 2021 Apr;9(8):665.
doi: 10.21037/atm-21-445.
Clinical features in coronavirus disease 2019 (COVID-19) patients with early clearance and prolonged shedding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA
Yan Zhou[SUP] 1 [/SUP], Fengming Ding[SUP] 1 [/SUP], Wuping Bao[SUP] 1 [/SUP], Yishu Xue[SUP] 1 [/SUP], Lei Han[SUP] 1 [/SUP], Xue Zhang[SUP] 1 [/SUP], Pengyu Zhang[SUP] 1 [/SUP], Yong Ji[SUP] 1 [/SUP], Dongning Yin[SUP] 1 [/SUP], Aihua Bao[SUP] 1 [/SUP], Shan Luo[SUP] 2 [/SUP], Zengchao Xu[SUP] 2 [/SUP], Jun Liu[SUP] 3 [/SUP], Min Zhang[SUP] 1 [/SUP]
Affiliations
- PMID: 33987363
- PMCID: PMC8106067
- DOI: 10.21037/atm-21-445
Abstract
Background: Since the outbreak of coronavirus disease 2019 (COVID-19), the pattern of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA shedding has not been well characterized.
Methods: In our study, 652 patients in Wuhan Designated Hospital were recruited, and their clinical and laboratory findings were extracted and analyzed.
Results: The median duration of SARS-CoV-2 RNA detection was 23 days [interquartile range (IQR), 18 days] from symptom onset. Compared to patients with early viral RNA clearance (<23 days after illness onset), we found that patients with late viral RNA clearance (?23 days) had a higher proportion of clinical features, as follows: symptoms, including fever, dry cough, and sputum production; comorbidities, including hypertension, chronic kidney disease, uremia, chronic liver disease, anemia, hyperlipidemia, and bilateral lung involvement; complications, such as liver injury; delayed admission to hospital; laboratory parameters at baseline, including higher eosinophils, uric acid, cholesterol, triglycerides, and lower hemoglobin; and less treatment with arbidol, chloroquine, or any antivirals. After generalized linear regression, prolonged SARS-CoV-2 RNA shedding was independently associated with younger age; delayed admission to hospital; symptoms including fever, shivering, and sputum production; comorbidities including hypertension, diabetes, cardiovascular disease, anemia, hyperlipidemia, uremia, and lung involvement; and higher alanine aminotransferase (ALT), uric acid, and cholesterol levels at baseline.
Conclusions: In conclusion, the factors mentioned above are associated with the negative conversion of SARS-CoV-2 RNA. A deeper insight into virological dynamics will be helpful for establishing patient discharge and quarantine release criteria.
Keywords: Coronavirus disease 2019 (COVID-19); negative conversion; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); viral RNA clearance; viral shedding.