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J Thorac Dis . Comparison of clinical characteristics between patients with coronavirus disease 2019 (COVID-19) who retested RT-PCR positive versus

tetano

Editor, Senior Moderator
J Thorac Dis


. 2020 Nov;12(11):6435-6445.
doi: 10.21037/jtd.2020.04.17.
Comparison of clinical characteristics between patients with coronavirus disease 2019 (COVID-19) who retested RT-PCR positive versus negative: a retrospective study of data from Nanjing


Yuan Liu[SUP] 1 [/SUP], Ning Ding[SUP] 2 [/SUP], Shixiang Zhou[SUP] 3 [/SUP], Chen Chen[SUP] 1 [/SUP], Shan Huang[SUP] 1 [/SUP], Yanling Lv[SUP] 4 [/SUP], Damin Jiao[SUP] 5 [/SUP], Yishan Zheng[SUP] 6 [/SUP], Zhiliang Hu[SUP] 1 [/SUP], Chuanjun Xu[SUP] 7 [/SUP], Wei Chen[SUP] 8 [/SUP], Hui Dai[SUP] 9 [/SUP], Wenkui Sun[SUP] 2 [/SUP], Cong Cheng[SUP] 1 [/SUP], Ru Lv[SUP] 1 [/SUP], Jian Cheng[SUP] 1 [/SUP], Zi Ye[SUP] 1 [/SUP], Zhengjie Li[SUP] 1 [/SUP], Yongxiang Yi[SUP] 10 [/SUP], Hongxia Wei[SUP] 1 [/SUP]



Affiliations

Abstract

Background: The epidemiological and clinical characteristics of patients with coronavirus disease 2019 (COVID-19) have been reported. However, the prevalence of retesting positive by RT-PCR for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and the associated patient characteristics, remain unclear.
Methods: We included 90 confirmed cases of COVID-19 treated in the Nanjing Public Health Center from January 20, 2020 to February 16, 2020 in this retrospective study. All patients completed treatment for COVID-19 and were retested by RT-PCR for SARS-CoV-2 4-20 days after completion of therapy. The clinical characteristics between patients with who retested positive versus negative by RT-PCR were compared, and the factors predictive of positive retesting were analyzed. Positive retesting was modeled with the area under the receiver operating characteristic curve (AUC).
Results: The age range of the study population was 0.8-97 years, and all patients were cured or showed improvement. A total of 10 (11%) patients retested positive by RT-PCR 4-20 days after completion of therapy. As compared with patients who retested negative, those who retested positive had a lower percentage of pre-admission fever, a higher percentage of post-admission fever, a lower percentage of bilateral lung infection, higher white blood cell (WBC) count and creatine phosphokinase, and lower hypersensitive c-reactive protein (hs-CRP), interleukin-6 and erythrocyte sedimentation rates (all P<0.05). Logistic regression analysis of the above eight key variables showed that lower hs-CRP and higher WBC were independently associated with positive retesting by RT-PCR. A combination of hs-CRP and WBC were predictive of positive retesting, with an AUC of 0.859.
Conclusions: Patients with COVID-19 who retested positive by RT-PCR for SARS-CoV-2 had mild symptoms and better blood testing results. A combination of hs-CRP and WBC may predict positive retesting by RT-PCR; however, the sensitivity and specificity should be studied further.

Keywords: Coronavirus disease 2019 (COVID-19); re-positive; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
 
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