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Viral RNA level, serum antibody responses, and transmission risk in recovered COVID-19 patients with recurrent positive SARS-CoV-2 RNA test results: a population-based observational cohort study.
Yang, Chao; Jiang, Min; Wang, Xiaohui; Tang, Xiujuan; Fang, Shisong; Li, Hao; Zuo, Le; Jiang, Yixiang; Zhong, Yifan; Chen, Qiongcheng; Zheng, Chenli; Wang, Lei; Wu, Shuang; Wu, Weihua; Liu, Hui; Yuan, Jing; Liao, Xuejiao; Zhang, Zhen; Shi, Xiaolu; Geng, Yijie; Zhang, Huan; Zheng, Huanying; Wan, Min; Lu, Linying; Ren, Xiaohu; Cui, Yujun; Zou, Xuan; Feng, Tiejian; Xia, Junjie; Yang, Ruifu; Liu, Yingxia; Mei, Shujiang; Li, Baisheng; Yang, Zhengrong; Hu, Qinghua.
  • Yang C; Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China.
  • Jiang M; Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China.
  • Wang X; Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China.
  • Tang X; Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China.
  • Fang S; Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China.
  • Li H; Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China.
  • Zuo L; Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China.
  • Jiang Y; Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China.
  • Zhong Y; Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China.
  • Chen Q; Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China.
  • Zheng C; Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China.
  • Wang L; Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China.
  • Wu S; Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China.
  • Wu W; Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China.
  • Liu H; Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China.
  • Yuan J; State Key Discipline of Infectious Disease, National Clinical Research Center for infectious disease, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, People's Republic of China.
  • Liao X; State Key Discipline of Infectious Disease, National Clinical Research Center for infectious disease, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, People's Republic of China.
  • Zhang Z; Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China.
  • Shi X; Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China.
  • Geng Y; Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China.
  • Zhang H; Guangdong Provincial Center for Disease Control and Prevention, Guangdong, People's Republic of China.
  • Zheng H; Guangdong Provincial Center for Disease Control and Prevention, Guangdong, People's Republic of China.
  • Wan M; Shenzhen LongHua District Maternity and Child Healthcare Hospital, Shenzhen, People's Republic of China.
  • Lu L; Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China.
  • Ren X; Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China.
  • Cui Y; State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China.
  • Zou X; Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China.
  • Feng T; Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China.
  • Xia J; Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China.
  • Yang R; State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China.
  • Liu Y; State Key Discipline of Infectious Disease, National Clinical Research Center for infectious disease, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, People's Republic of China.
  • Mei S; Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China.
  • Li B; Guangdong Provincial Center for Disease Control and Prevention, Guangdong, People's Republic of China.
  • Yang Z; Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China.
  • Hu Q; Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China.
Emerg Microbes Infect ; 9(1): 2368-2378, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-910382
ABSTRACT
Managing recovered COVID-19 patients with recurrent-positive SARS-CoV-2 RNA test results is challenging. We performed a population-based observational study to characterize the viral RNA level and serum antibody responses in recurrent-positive patients and evaluate their viral transmission risk. Of 479 recovered COVID-19 patients, 93 (19%) recurrent-positive patients were identified, characterized by younger age, with a median discharge-to-recurrent-positive length of 8 days. After readmission, recurrent-positive patients exhibited mild (28%) or absent (72%) symptoms, with no disease progression. The viral RNA level in recurrent-positive patients ranged from 1.8 to 5.7 log10 copies/mL (median 3.2), which was significantly lower than the corresponding values at disease onset. There are generally no significant differences in antibody levels between recurrent-positive and non-recurrent-positive patients, or in recurrent-positive patients over time (before, during, or after recurrent-positive detection). Virus isolation of nine representative specimens returned negative results. Whole genome sequencing of six specimens yielded only genomic fragments. 96 close contacts and 1,200 candidate contacts of 23 recurrent-positive patients showed no clinical symptoms; their viral RNA (1,296/1,296) and antibody (20/20) tests were negative. After full recovery (no longer/never recurrent-positive), 60% (98/162) patients had neutralizing antibody titers of ≥132. Our findings suggested that an intermittent, non-stable excretion of low-level viral RNA may result in recurrent-positive occurrence, rather than re-infection. Recurrent-positive patients pose a low transmission risk, a relatively relaxed management of recovered COVID-19 patients is recommended.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / RNA, Viral / Coronavirus Infections / Clinical Laboratory Techniques / Antibodies, Neutralizing / Betacoronavirus / Antibodies, Viral Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Female / Humans / Male / Middle aged / Young adult Language: English Journal: Emerg Microbes Infect Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / RNA, Viral / Coronavirus Infections / Clinical Laboratory Techniques / Antibodies, Neutralizing / Betacoronavirus / Antibodies, Viral Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Female / Humans / Male / Middle aged / Young adult Language: English Journal: Emerg Microbes Infect Year: 2020 Document Type: Article