ABSTRACT
A novel coronavirus (COVID-19) pandemic threatens the world. Here, we first studied the dynamics profile of SARS-CoV-2 from 56 recovered patients with COVID-19. We found viral shedding occurred up to 6 weeks after onset of symptoms. A prolonged observation period is necessary for older patients.
Subject(s)
COVID-19/diagnosis , Reverse Transcriptase Polymerase Chain Reaction , Virus Shedding , Adult , Aged , Aged, 80 and over , Antibodies, Viral , COVID-19 Testing , Case-Control Studies , Female , Hospitalization/statistics & numerical data , Humans , Male , Middle Aged , Preliminary Data , RNA, Viral , SARS-CoV-2ABSTRACT
Since December 2019, Coronavirus Disease 2019 (COVID-19) has emerged as a global pandemic. We aimed to investigate the clinical characteristics and analyzed the risk factors for prolonged viral RNA shedding. We retrospectively collected data from 112 hospitalized COVID-19 patients in a single center in Wuhan, China. Factors associated with prolonged viral RNA shedding (≥28 days) were investigated. Forty-nine (43.8%) patients had prolonged viral RNA shedding. Patients with prolonged viral shedding were older and had a higher rate of hypertension. Proinflammatory cytokines, including interleukin-2R (IL-2R) and tumor necrosis factor-α (TNF-α), were significantly elevated in patients with prolonged viral shedding. Multivariate analysis revealed that hypertension, older age, lymphopenia and elevated serum IL-2R were independent risk factors for prolonged viral shedding. This comprehensive investigation revealed the distinct characteristics between patients with or without prolonged viral RNA shedding. Hypertension, older age, lymphopenia and high levels of proinflammatory cytokines may be correlated with prolonged viral shedding.
Subject(s)
COVID-19/virology , Cytokine Release Syndrome/virology , Diabetes Mellitus/virology , Hypertension/virology , Lymphopenia/virology , RNA, Viral/blood , SARS-CoV-2/pathogenicity , Adrenal Cortex Hormones/therapeutic use , Adult , Aged , Aged, 80 and over , COVID-19/diagnosis , COVID-19/immunology , China , Comorbidity , Cytokine Release Syndrome/diagnosis , Cytokine Release Syndrome/drug therapy , Cytokine Release Syndrome/immunology , Diabetes Mellitus/diagnosis , Diabetes Mellitus/drug therapy , Diabetes Mellitus/immunology , Drug Combinations , Female , Hospitalization , Humans , Hydroxychloroquine/therapeutic use , Hypertension/diagnosis , Hypertension/drug therapy , Hypertension/immunology , Interferons/therapeutic use , Lopinavir/therapeutic use , Lymphopenia/diagnosis , Lymphopenia/drug therapy , Lymphopenia/immunology , Male , Middle Aged , Receptors, Interleukin-2/biosynthesis , Retrospective Studies , Risk Factors , Ritonavir/therapeutic use , Severity of Illness Index , Tumor Necrosis Factor-alpha/biosynthesis , Virus Shedding , COVID-19 Drug TreatmentABSTRACT
BACKGROUND: With the spread of Coronavirus Disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection, its effect on society is amplified. We aimed to describe the viral detection results across different timepoints throughout the disease course. METHODS: A retrospective study of 301 confirmed COVID-19 patients hospitalized at Tongji Hospital in Wuhan, China, were included. Demographic characteristics of the patients were collected. Upper respiratory specimens (throat and/or nasal swabs) were obtained and analyzed by real-time RT-PCR for SARS-CoV-2 infection. Period of viral infection and the contagious stage were analyzed. RESULTS: Of 301 hospitalized COVID-19 patients, the median age was 58 years and 51.2 % were male. The median period between symptoms presence and positive SARS-CoV-2 RT-PCR results was 16 days (IQR, 10-23, Nâ¯=â¯301). The median period between symptoms presence and an effective negative SARS-CoV-2 RT-PCR result was 20 days (IQR, 17-24; Nâ¯=â¯216). Infected patient ≥65 years old stayed contagious longer (22 days vs 19 days, pâ¯=â¯0.015). Although two consecutive negative results were confirmed in 70 patients, 30 % of them had positive viral test results for the third time. Using specimens from nasal swabs to run the RT-PCR test showed a higher positive rate than using specimens from throat swabs. CONCLUSIONS: This large-scale investigation with 1113 RT-PCR test results from 301 COVID-19 patients showed that the average contagious period of SARS-CoV-2 infected patients was 20 days. Longer observation period and more than 2 series of negative viral test are necessary for patients ≥65 years.