tetano
Editor, Senior Moderator
Clin Infect Dis. 2020 Apr 9. pii: ciaa351. doi: 10.1093/cid/ciaa351. [Epub ahead of print]
Factors associated with prolonged viral RNA shedding in patients with COVID-19.
Xu K[SUP]1[/SUP], Chen Y[SUP]1[/SUP], Yuan J[SUP]2[/SUP], Yi P[SUP]1[/SUP], Ding C[SUP]1[/SUP], Wu W[SUP]1[/SUP], Li Y[SUP]1[/SUP], Ni Q[SUP]1[/SUP], Zou R[SUP]2[/SUP], Li X[SUP]2[/SUP], Xu M[SUP]1[/SUP], Zhang Y[SUP]1[/SUP], Zhao H[SUP]1[/SUP], Zhang X[SUP]1[/SUP], Yu L[SUP]1[/SUP], Su J[SUP]1[/SUP], Lang G[SUP]1[/SUP], Liu J[SUP]1[/SUP], Wu X[SUP]1[/SUP], Guo Y[SUP]1[/SUP], Tao J[SUP]1[/SUP], Shi D[SUP]1[/SUP], Yu L[SUP]1[/SUP], Cao Q[SUP]1[/SUP], Ruan B[SUP]1[/SUP], Liu L[SUP]2[/SUP], Wang Z[SUP]2[/SUP], Xu Y[SUP]1[/SUP], Liu Y[SUP]2[/SUP], Sheng J[SUP]1[/SUP], Li L[SUP]1[/SUP].
Author information
Abstract
BACKGROUND:
An outbreak of coronavirus disease 2019 (COVID-19) is becoming a public health emergency. Data are limited on the duration and host factors related to viral shedding.
METHODS:
In this retrospective study, risk factors associated with severe acute respiratory coronavirus 2 (SARS-CoV-2) RNA shedding were evaluated in a cohort of 113 symptomatic patients from two hospitals outside Wuhan.
RESULTS:
The median duration of SARS-CoV-2 RNA detection was 17 days (Interquartile Range [IQR], 13-22 days) as measured from illness onset. When comparing patients with early (<15 days) and late viral RNA clearance (≥15 days after illness onset), prolonged SARS-CoV-2 RNA shedding was associated with male sex (p=0.009), old age (p=0.033), concomitated with hypertension (p=0.009), delayed admission to hospital after illness onset (p=0.001), severe illness at admission (p=0.049), invasive mechanical ventilation (p=0.006), and corticosteroid treatment (p=0.025). Patients with longer SARS-CoV-2 RNA shedding duration had slower recovery of body temperature (p<0.001) and focal absorption on radiograph images (p<0.001) than patients with early SARS-CoV-2 RNA clearance. Male sex (odds ratio [OR], 3.24 [95% CI, 1.31-8.02]), delayed hospital admission (OR, 1.30 [95% CI, 1.10-1.54]), and invasive mechanical ventilation (OR, 9.88 [95% CI, 1.11-88.02]) were independent risk factors for prolonged SARS-CoV-2 RNA shedding.
CONCLUSIONS:
Male sex, delayed admission to hospital after illness onset, and invasive mechanical ventilation were associated with prolonged SARS-CoV-2 RNA shedding. Hospital admission and general treatments should be started as soon as possible in symptomatic COVID-19 patients, especially male patients.
? The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America.
KEYWORDS:
COVID-19; Coronavirus; SARS-COV-2; risk factors; viral shedding
PMID:32271376DOI:10.1093/cid/ciaa351
Factors associated with prolonged viral RNA shedding in patients with COVID-19.
Xu K[SUP]1[/SUP], Chen Y[SUP]1[/SUP], Yuan J[SUP]2[/SUP], Yi P[SUP]1[/SUP], Ding C[SUP]1[/SUP], Wu W[SUP]1[/SUP], Li Y[SUP]1[/SUP], Ni Q[SUP]1[/SUP], Zou R[SUP]2[/SUP], Li X[SUP]2[/SUP], Xu M[SUP]1[/SUP], Zhang Y[SUP]1[/SUP], Zhao H[SUP]1[/SUP], Zhang X[SUP]1[/SUP], Yu L[SUP]1[/SUP], Su J[SUP]1[/SUP], Lang G[SUP]1[/SUP], Liu J[SUP]1[/SUP], Wu X[SUP]1[/SUP], Guo Y[SUP]1[/SUP], Tao J[SUP]1[/SUP], Shi D[SUP]1[/SUP], Yu L[SUP]1[/SUP], Cao Q[SUP]1[/SUP], Ruan B[SUP]1[/SUP], Liu L[SUP]2[/SUP], Wang Z[SUP]2[/SUP], Xu Y[SUP]1[/SUP], Liu Y[SUP]2[/SUP], Sheng J[SUP]1[/SUP], Li L[SUP]1[/SUP].
Author information
Abstract
BACKGROUND:
An outbreak of coronavirus disease 2019 (COVID-19) is becoming a public health emergency. Data are limited on the duration and host factors related to viral shedding.
METHODS:
In this retrospective study, risk factors associated with severe acute respiratory coronavirus 2 (SARS-CoV-2) RNA shedding were evaluated in a cohort of 113 symptomatic patients from two hospitals outside Wuhan.
RESULTS:
The median duration of SARS-CoV-2 RNA detection was 17 days (Interquartile Range [IQR], 13-22 days) as measured from illness onset. When comparing patients with early (<15 days) and late viral RNA clearance (≥15 days after illness onset), prolonged SARS-CoV-2 RNA shedding was associated with male sex (p=0.009), old age (p=0.033), concomitated with hypertension (p=0.009), delayed admission to hospital after illness onset (p=0.001), severe illness at admission (p=0.049), invasive mechanical ventilation (p=0.006), and corticosteroid treatment (p=0.025). Patients with longer SARS-CoV-2 RNA shedding duration had slower recovery of body temperature (p<0.001) and focal absorption on radiograph images (p<0.001) than patients with early SARS-CoV-2 RNA clearance. Male sex (odds ratio [OR], 3.24 [95% CI, 1.31-8.02]), delayed hospital admission (OR, 1.30 [95% CI, 1.10-1.54]), and invasive mechanical ventilation (OR, 9.88 [95% CI, 1.11-88.02]) were independent risk factors for prolonged SARS-CoV-2 RNA shedding.
CONCLUSIONS:
Male sex, delayed admission to hospital after illness onset, and invasive mechanical ventilation were associated with prolonged SARS-CoV-2 RNA shedding. Hospital admission and general treatments should be started as soon as possible in symptomatic COVID-19 patients, especially male patients.
? The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America.
KEYWORDS:
COVID-19; Coronavirus; SARS-COV-2; risk factors; viral shedding
PMID:32271376DOI:10.1093/cid/ciaa351