Clinical characteristics and potential factors for recurrence of positive SARS-CoV-2 RNA in convalescent patients: a retrospective cohort study

作者全名："Ao, Zhi; Li, Yan; Wei, Jiawei; Jiang, Jinyue; Wang, Xiaohui; Zhang, Peng; Liu, Yuxin; Yu, Haiyan; Zhu, Linxiao; Wang, Xue; Hu, Qianfang; Duan, Jun; Hu, Wenhui; Zhang, Xianxiang; Wu, Guicheng; Guo, Shuliang"

作者地址："[Ao, Zhi; Wei, Jiawei; Jiang, Jinyue; Wang, Xiaohui; Zhu, Linxiao; Wang, Xue; Hu, Qianfang; Duan, Jun; Hu, Wenhui; Guo, Shuliang] Chongqing Med Univ, Dept Resp & Crit Care Med, Affiliated Hosp 1, Chongqing, Peoples R China; [Li, Yan; Zhang, Peng; Liu, Yuxin; Yu, Haiyan; Zhang, Xianxiang; Wu, Guicheng] Chongqing Univ, Gorges Hosp 3, Chongqing 404100, Peoples R China"

通信作者："Guo, SL (corresponding author), Chongqing Med Univ, Dept Resp & Crit Care Med, Affiliated Hosp 1, Chongqing, Peoples R China.; Zhang, XX; Wu, GC (corresponding author), Chongqing Univ, Gorges Hosp 3, Chongqing 404100, Peoples R China."

来源：CLINICAL AND EXPERIMENTAL MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000614654100001

JCR分区：Q2

影响因子：4.6

年份：2021

卷号：21

期号：3

开始页：361

结束页：367

文献类型：Article

关键词：Coronavirus disease 2019; RT-PCR; Viral shedding; Recurrent positive viral RNA

摘要："Background The recurrence of positive SARS-CoV-2 RT-PCR is frequently found in discharged COVID-19 patients but its clinical significance remains unclear. The potential cause, clinical characteristics and infectiousness of the recurrent positive RT-PCR patients need to be answered. Methods A single-centered, retrospective study of 51 discharged COVID-19 patients was carried out at a designated hospital for COVID-19. The demographic data, clinical records and laboratory findings of 25 patients with recurrent positive RT-PCR from hospitalization to follow-up were collected and compared to 26 patients with negative RT-PCR discharged regularly during the same period. Discharged patients' family members and close contacts were also interviewed by telephone to evaluate patients' potential infectiousness. Results The titer of both IgG and IgM antibodies was significantly lower (p = 0.027, p = 0.011) in patients with recurrent positive RT-PCR. Median duration of viral shedding significantly prolonged in patients with recurrent positive RT-PCR (36.0 days vs 9.0 days, p = 0.000). There was no significant difference in demographic features, clinical features, lymphocyte subsets count and inflammatory cytokines levels between the two groups of patients. No fatal case was noted in two groups. As of the last day of follow-up, none of the discharged patients' family members or close contact developed any symptoms of COVID-19. Conclusions Patients with low levels of IgG and IgM are more likely to have recurrent positive SARS-CoV-2 RT-PCR results and lead to a prolonged viral shedding. The recurrent positive of SARS-CoV-2 RT-PCR may not indicate the recurrence or aggravation of COVID-19. The detection of SARS-CoV-2 by RT-PCR in the patients recovered from COVID-19 is not necessarily correlated with the ability of transmission."

基金机构："New coronavirus infection and prevention emergency scientific research project, Chongqing Education Board [KYYJ202006]; Special Project for Emergency Research on 2019-nCoV Pneumonia, Chongqing Medical University (CQMU); fourth emergent science and technology special project on epidemic of novel coronavirus pneumonia, Chongqing Science and Technology Commission"

基金资助正文："This research was funded by New coronavirus infection and prevention emergency scientific research project, Chongqing Education Board (KYYJ202006), Special Project for Emergency Research on 2019-nCoV Pneumonia, Chongqing Medical University (CQMU), and the fourth emergent science and technology special project on epidemic of novel coronavirus pneumonia, Chongqing Science and Technology Commission."