Associations of clinical characteristics and treatment regimens with the duration of viral RNA shedding in patients with COVID-19
Objective: The novel coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global pandemic, but the factors influencing viral RNA shedding, which would help inform optimal control strategies, remain unclear. Methods: The clinical course and viral RNA shedding pattern of 267 consecutive symptomatic COVID-19 patients admitted to the hospital from January 20, 2020 to March 15, 2020 were evaluated retrospectively. Results: The median duration of viral RNA shedding was 12 days (interquartile range 8–16 days) after the onset of illness. Of the 267 patients included in this study, 65.2% had viral RNA clearance within 14 days, 88.8% within 21 days, and 94.4% within 28 days. Older age (hazard ratio (HR) 0.99, 95% confidence interval (CI) 0.98–1.00; p = 0.04), time lag from illness onset to hospital admission (HR 0.91, 95% CI 0.88–0.94; p < 0.001), diarrhea (HR 0.59, 95% CI 0.36–0.96; p = 0.036), corticosteroid treatment (HR 0.60, 95% CI 0.39–0.94; p = 0.024), and lopinavir/ritonavir use (HR 0.70, 95% CI 0.52–0.94; p = 0.014) were significantly and independently associated with prolonged viral RNA shedding. Conclusions: Early detection and timely hospital admission may be warranted for symptomatic COVID-19 patients, especially for older patients and patients with diarrhea. Corticosteroid treatment is associated with prolonged viral RNA shedding and should be used with caution. Lopinavir/ritonavir use may be associated with prolonged viral RNA shedding in non-severe patients; further randomized controlled trials are needed to confirm this finding..
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:98 |
|---|---|
| Enthalten in: |
International Journal of Infectious Diseases - 98(2020), Seite 252-260 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Xudan Chen [VerfasserIn] |
|---|
| Links: |
doi.org [kostenfrei] |
|---|
| Themen: |
COVID-19 |
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| doi: |
10.1016/j.ijid.2020.06.091 |
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| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
DOAJ07425541X |
|---|
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| 520 | |a Objective: The novel coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global pandemic, but the factors influencing viral RNA shedding, which would help inform optimal control strategies, remain unclear. Methods: The clinical course and viral RNA shedding pattern of 267 consecutive symptomatic COVID-19 patients admitted to the hospital from January 20, 2020 to March 15, 2020 were evaluated retrospectively. Results: The median duration of viral RNA shedding was 12 days (interquartile range 8–16 days) after the onset of illness. Of the 267 patients included in this study, 65.2% had viral RNA clearance within 14 days, 88.8% within 21 days, and 94.4% within 28 days. Older age (hazard ratio (HR) 0.99, 95% confidence interval (CI) 0.98–1.00; p = 0.04), time lag from illness onset to hospital admission (HR 0.91, 95% CI 0.88–0.94; p < 0.001), diarrhea (HR 0.59, 95% CI 0.36–0.96; p = 0.036), corticosteroid treatment (HR 0.60, 95% CI 0.39–0.94; p = 0.024), and lopinavir/ritonavir use (HR 0.70, 95% CI 0.52–0.94; p = 0.014) were significantly and independently associated with prolonged viral RNA shedding. Conclusions: Early detection and timely hospital admission may be warranted for symptomatic COVID-19 patients, especially for older patients and patients with diarrhea. Corticosteroid treatment is associated with prolonged viral RNA shedding and should be used with caution. Lopinavir/ritonavir use may be associated with prolonged viral RNA shedding in non-severe patients; further randomized controlled trials are needed to confirm this finding. | ||
| 650 | 4 | |a Corticosteroid | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a Diarrhea | |
| 650 | 4 | |a Lopinavir/ritonavir | |
| 650 | 4 | |a Risk factors | |
| 650 | 4 | |a Viral RNA shedding | |
| 653 | 0 | |a Infectious and parasitic diseases | |
| 700 | 0 | |a Baoyi Zhu |e verfasserin |4 aut | |
| 700 | 0 | |a Wenxin Hong |e verfasserin |4 aut | |
| 700 | 0 | |a Jianwen Zeng |e verfasserin |4 aut | |
| 700 | 0 | |a Xi He |e verfasserin |4 aut | |
| 700 | 0 | |a Jingfeng Chen |e verfasserin |4 aut | |
| 700 | 0 | |a Haipeng Zheng |e verfasserin |4 aut | |
| 700 | 0 | |a Shuang Qiu |e verfasserin |4 aut | |
| 700 | 0 | |a Ying Deng |e verfasserin |4 aut | |
| 700 | 0 | |a Juliana C.N. Chan |e verfasserin |4 aut | |
| 700 | 0 | |a Jian Wang |e verfasserin |4 aut | |
| 700 | 0 | |a Yuying Zhang |e verfasserin |4 aut | |
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