ABSTRACT
OBJECTIVE: There were COVID-19 patients with SARS-COV-2 nucleic acid long-term positive. This article aims to understand the relevant factors that affect SARS-COV-2 clearance time. METHODS: The clinical data of 115 COVID-19 patients with SARS-COV-2 nucleic acid positive time exceeding 14 days were collected retrospectively, and the relationship between clinical characteristics, chest CT scans, blood cells, biochemical indicators, and the time of viral nucleic acid turning negative were analyzed. RESULTS: The time from symptom onsets to nucleic acid turning negative was (32.5 ± 8.7) days in this group of patients. The time of nucleic acid turning negative: no fever group was longer than fever group, diabetes group was longer than no comorbidity group, elevated levels of ALT (alanine aminotransferase), or GLU (fasting blood glucose) group, decreased levels of ALB (albumin) group or HDLC (high-density lipoprotein cholesterol) group was longer than it's normal group separately (P < 0.05). Cox multivariate regression analysis showed that ALT [odds ratio (OR): 2.164 (95% CI: 1.276-3.670), P = 0.004], GLU [OR: 2.064 (95% CI: 1.195-3.566), P = 0.009] and HDLC [OR: 0.527 (95% CI: 0.307-0.907), P = 0.021] were independent factors which affected the time of nucleic acid turning negative. CONCLUSIONS: ALT, GLU and HDLC were independent factors that influenced the time of nucleic acid turning negative. Although diabetes or hyperglycemia is a known risk factor, HDLC is the first to be identified, clinicians should be aware of dyslipidemia in covid-19 patients.
Subject(s)
COVID-19/blood , COVID-19/diagnosis , Cholesterol, HDL/blood , SARS-CoV-2/genetics , Aged , Alanine Transaminase/analysis , Blood Glucose/analysis , COVID-19/epidemiology , COVID-19/virology , Case-Control Studies , China/epidemiology , Comorbidity , Fasting/blood , Female , Humans , Hypoalbuminemia/blood , Male , Middle Aged , RNA, Viral/isolation & purification , Retrospective Studies , Risk Factors , SARS-CoV-2/growth & development , Severity of Illness Index , Time Factors , Virus Shedding/geneticsABSTRACT
OBJECTIVE: To compare the efficacy of 3/4-drugs' group with 1-drug's or 2-drugs' groups in coronavirus disease 2019 (COVID-19). METHODS: We included 207 patients confirmed with COVID-19. We compared the viral clearance rate and discharge rate at day 7, 14, 21 and 28, and median time of viral clearance and length of hospitalization in patients treated with 3/4, 1 or 2 drugs. RESULTS: The viral clearance rates of the 3/4-drugs group at day 7, 14 and 21 were significantly lower than those in the 1-drug's or 2-drugs' groups (P < 0.05). The median viral clearance days in 3/4-drugs group (13.5 days) were longer than 1-drug's or 2-drugs' groups (both were 9 days) (P < 0.001). The patients' discharge rates in the 3/4-drugs group at day 14 and 21 were significantly lower than that in the 1-drug's or 2 drugs' group (P < 0.05). The median length of hospitalization in the 3/4-drugs group was 17 days, which was significantly longer than 11 days in the 1-drug group and 13 days in the 2-drug group (P < 0.05). CONCLUSION: The efficacy of 1 or 2 antiviral drugs was similar in COVID-19, and 3/4-drug regimens were not associated with clinical improvement. Corticosteroid treatment and more serious disease were also risk factors for viral clearance and patients'discharge.