tetano
Editor, Senior Moderator
Am J Transl Res
. 2020 Oct 25;12(10):6954-6964.
eCollection 2020.
Clinical characteristics associated with long-term viral shedding in patients with coronavirus disease 2019
Miao Zhou[SUP] 1 [/SUP], Fei-Fei Yu[SUP] 2 [/SUP], Li Tan[SUP] 3 4 [/SUP], Yu-Dan Zhu[SUP] 5 6 [/SUP], Ning Ma[SUP] 7 8 [/SUP], Li-Jun Song[SUP] 3 4 [/SUP], Qi Li[SUP] 3 4 [/SUP], Yang Liu[SUP] 4 [/SUP], Zui Zou[SUP] 4 9 [/SUP], Tian-Ying Xu[SUP] 7 [/SUP], Chao Yu[SUP] 5 6 [/SUP]
Affiliations
Abstract
Background: To delineate the clinical characteristics associated with long-term viral shedding (>21 days) in patients with coronavirus disease 2019 (COVID-19).
Methods: In this retrospective study, factors associated with long-term (>21 days) severe acute respiratory coronavirus 2 (SARS-CoV-2) RNA shedding were evaluated in a conhort of 609 patients from two hospitals in Wuhan.
Results: The median duration of SARS-CoV-2 viral shedding was 19 days (interquartile range, 10-28 days) among all patients. There were 42% of patients having prolonged viral shedding time (>21 days), in which the longest viral shedding time was 58 days. When comparing patients with early (≤21 days) and late viral RNA clearance (>21 days), prolonged viral shedding was associated with age <65 (P=0.015), female sex (P=0.028), cough (P=0.025), fatigue (P=0.035), sore throat (P=0.013), aspartate aminotransferase (P=0.038), procalcitonin (P=0.010), albumin (P=0.003), D-dimer (P=0.011), lung involvement (P=0.014), reticular shadow (P<0.001) and lung consolidation (P=0.004). Age range (<65 years) (odds ratio [OR], 1.46 [95% CI, 1.05-2.03]) and female sex (odds ratio [OR], 1.40 [95% CI, 1.00-1.94]) were independent risk factors.
Conclusions: Long-term viral shedding (>21 days) is not a rare phenomenon among COVID-19 infectious patients. Age range (<65) and female sex are independent risk factors for long-term viral shedding. Early antiviral treatment should be considered for COVID-19 patients with such risk factors. Further study should be conducted to know the infectivity of patients with long-term viral shedding in order to develop reasonable control measures.
Keywords: COVID-19; Coronavirus; SARS-CoV-2; risk factors; viral shedding.
. 2020 Oct 25;12(10):6954-6964.
eCollection 2020.
Clinical characteristics associated with long-term viral shedding in patients with coronavirus disease 2019
Miao Zhou[SUP] 1 [/SUP], Fei-Fei Yu[SUP] 2 [/SUP], Li Tan[SUP] 3 4 [/SUP], Yu-Dan Zhu[SUP] 5 6 [/SUP], Ning Ma[SUP] 7 8 [/SUP], Li-Jun Song[SUP] 3 4 [/SUP], Qi Li[SUP] 3 4 [/SUP], Yang Liu[SUP] 4 [/SUP], Zui Zou[SUP] 4 9 [/SUP], Tian-Ying Xu[SUP] 7 [/SUP], Chao Yu[SUP] 5 6 [/SUP]
Affiliations
- PMID: 33194085
- PMCID: PMC7653593
Abstract
Background: To delineate the clinical characteristics associated with long-term viral shedding (>21 days) in patients with coronavirus disease 2019 (COVID-19).
Methods: In this retrospective study, factors associated with long-term (>21 days) severe acute respiratory coronavirus 2 (SARS-CoV-2) RNA shedding were evaluated in a conhort of 609 patients from two hospitals in Wuhan.
Results: The median duration of SARS-CoV-2 viral shedding was 19 days (interquartile range, 10-28 days) among all patients. There were 42% of patients having prolonged viral shedding time (>21 days), in which the longest viral shedding time was 58 days. When comparing patients with early (≤21 days) and late viral RNA clearance (>21 days), prolonged viral shedding was associated with age <65 (P=0.015), female sex (P=0.028), cough (P=0.025), fatigue (P=0.035), sore throat (P=0.013), aspartate aminotransferase (P=0.038), procalcitonin (P=0.010), albumin (P=0.003), D-dimer (P=0.011), lung involvement (P=0.014), reticular shadow (P<0.001) and lung consolidation (P=0.004). Age range (<65 years) (odds ratio [OR], 1.46 [95% CI, 1.05-2.03]) and female sex (odds ratio [OR], 1.40 [95% CI, 1.00-1.94]) were independent risk factors.
Conclusions: Long-term viral shedding (>21 days) is not a rare phenomenon among COVID-19 infectious patients. Age range (<65) and female sex are independent risk factors for long-term viral shedding. Early antiviral treatment should be considered for COVID-19 patients with such risk factors. Further study should be conducted to know the infectivity of patients with long-term viral shedding in order to develop reasonable control measures.
Keywords: COVID-19; Coronavirus; SARS-CoV-2; risk factors; viral shedding.