tetano
Editor, Senior Moderator
Eur J Clin Microbiol Infect Dis
. 2020 Oct 29.
doi: 10.1007/s10096-020-04085-2. Online ahead of print.
Delayed hospital admission and high-dose corticosteroids potentially prolong SARS-CoV-2 RNA detection duration of patients with COVID-19
Zhigang Hu[SUP] 1 2 [/SUP], Sijia Li[SUP] 3 4 [/SUP], Ailan Yang[SUP] 5 [/SUP], Wenxin Li[SUP] 3 4 [/SUP], Xiaoqi Xiong[SUP] 3 4 [/SUP], Jianwu Hu[SUP] 6 [/SUP], Jun Jiang[SUP] 7 [/SUP], Xinyu Song[SUP] 8 9 [/SUP]
Affiliations
Abstract
Coronavirus disease 2019 (COVID-19) with the infection of SARS-CoV-2 has become a serious pandemic worldwide. However, only few studies focused on risk factors of prolonged SARS-CoV-2 RNA detection among patients with COVID-19. We included 206 adult patients with laboratory-confirmed COVID-19 from two hospitals between 23 Jan and 1 April 2020. Least absolute shrinkage and selection operator (LASSO) analysis was used to screen out independent risk factors of SARS-CoV-2 RNA detection. By multivariate binomial logistic regression analysis and Cox regression analysis, we further determined the associations between SARS-CoV-2 RNA detection and potential risk factors. All patients had two negative SARS-CoV-2 tests with 33 days of median duration of SARS-CoV-2 RNA detection (interquartile range: 25.2-39 days). LASSO and binomial logistic regression analyses suggested that delayed hospital admission (adjusted OR = 3.70, 95% CI: 1.82-7.50), hypokalemia, and subpleural lesion (adjusted OR = 4.32, 95% CI: 1.10-16.97) were associated with prolonged SARS-CoV-2 RNA detection. By LASSO and multivariate Cox regression analyses, we observed that delayed hospital admission, subpleural lesion, and high-dose corticosteroid use were independent risk factors of prolonged SARS-CoV-2 RNA detection. Early hospital admission shortened 5.73 days of mean duration of SARS-CoV-2 RNA detection than delayed hospital admission after adjusting confounding factors. Our study demonstrated that delayed hospital admission and subpleural lesion were associated with prolonged SARS-CoV-2 RNA detection among patients with COVID-19. The use of high-dose corticosteroids should be interpreted with extreme caution in treating COVID-19.
Keywords: COVID-19; Corticosteroids; Hospital admission; SARS-CoV-2.
. 2020 Oct 29.
doi: 10.1007/s10096-020-04085-2. Online ahead of print.
Delayed hospital admission and high-dose corticosteroids potentially prolong SARS-CoV-2 RNA detection duration of patients with COVID-19
Zhigang Hu[SUP] 1 2 [/SUP], Sijia Li[SUP] 3 4 [/SUP], Ailan Yang[SUP] 5 [/SUP], Wenxin Li[SUP] 3 4 [/SUP], Xiaoqi Xiong[SUP] 3 4 [/SUP], Jianwu Hu[SUP] 6 [/SUP], Jun Jiang[SUP] 7 [/SUP], Xinyu Song[SUP] 8 9 [/SUP]
Affiliations
- PMID: 33123934
- DOI: 10.1007/s10096-020-04085-2
Abstract
Coronavirus disease 2019 (COVID-19) with the infection of SARS-CoV-2 has become a serious pandemic worldwide. However, only few studies focused on risk factors of prolonged SARS-CoV-2 RNA detection among patients with COVID-19. We included 206 adult patients with laboratory-confirmed COVID-19 from two hospitals between 23 Jan and 1 April 2020. Least absolute shrinkage and selection operator (LASSO) analysis was used to screen out independent risk factors of SARS-CoV-2 RNA detection. By multivariate binomial logistic regression analysis and Cox regression analysis, we further determined the associations between SARS-CoV-2 RNA detection and potential risk factors. All patients had two negative SARS-CoV-2 tests with 33 days of median duration of SARS-CoV-2 RNA detection (interquartile range: 25.2-39 days). LASSO and binomial logistic regression analyses suggested that delayed hospital admission (adjusted OR = 3.70, 95% CI: 1.82-7.50), hypokalemia, and subpleural lesion (adjusted OR = 4.32, 95% CI: 1.10-16.97) were associated with prolonged SARS-CoV-2 RNA detection. By LASSO and multivariate Cox regression analyses, we observed that delayed hospital admission, subpleural lesion, and high-dose corticosteroid use were independent risk factors of prolonged SARS-CoV-2 RNA detection. Early hospital admission shortened 5.73 days of mean duration of SARS-CoV-2 RNA detection than delayed hospital admission after adjusting confounding factors. Our study demonstrated that delayed hospital admission and subpleural lesion were associated with prolonged SARS-CoV-2 RNA detection among patients with COVID-19. The use of high-dose corticosteroids should be interpreted with extreme caution in treating COVID-19.
Keywords: COVID-19; Corticosteroids; Hospital admission; SARS-CoV-2.