Risk factors for cessation of viral RNA shedding in COVID-19 patients

ABSTRACT

Objectives: Our study aimed to evaluate the risk factors for the cessation of Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) RNA detection in a cohort of inpatients of laboratory-confirmed coronavirus disease 2019 (COVID-19) cases. Materials and Methods: This was a hospital-based, cross-sectional study. All COVID-19 patients positive on the reverse transcription polymerase chain reaction (RTPCR) test of nasopharyngeal samples who were admitted in this Dedicated COVID Hospital (DCH) from April to June 2020 were included in this study. The deceased patients were excluded.Cessation of Viral RNA Shedding (CVS) was considered to have been achieved on the date of the first negative SARS-CoV-2 RTPCR result out of the two consecutive negative SARS-CoV-2 PCR results on nasopharyngeal swabs taken 24 h apart. Results: Of the 4632 COVID-19 patients, 3307 (71.4%) patients achieved CVS. Patients had a median (IQR) time from positive to negative PCR of 16 (11-23) days. In multivariate cox regression analysis, age group 41 - 60 years (hazard ratio [HR], 0.76;95% confidence interval [CI], 0.63-0.91), age > 60 years (HR [CI] = 0.63 [0.53-0.78]), female sex (HR [CI] = 1.08 [1.01-1.16]), cancer (HR [CI] = 1.87 [1.03-3.41]) were the independent risk factors for cessation of viral shedding. Conclusion: Patients older than 40 years, male patients were shedding viral RNA for more duration and can be considered for the isolation for a longer duration.