Differences of Severe Acute Respiratory Syndrome Coronavirus 2 Shedding Duration in Sputum and Nasopharyngeal Swab Specimens Among Adult Inpatients With Coronavirus Disease 2019
Copyright © 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved..
BACKGROUND: The viral shedding duration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has not been fully defined. Consecutive detection of SARS-CoV-2 RNA from respiratory tract specimens is essential for determining duration of virus shedding and providing evidence to optimize the clinical management of coronavirus disease 2019 (COVID-19).
RESEARCH QUESTION: What are the shedding durations of SARS-CoV-2 RNA in the upper and lower respiratory tract specimens? What are their associated risk factors?.
STUDY DESIGN AND METHODS: A total of 68 patients with COVID-19 admitted to Wuhan Taikang Tongji Hospital and Huoshenshan Hospital from February 10, 2020, to March 20, 2020, were recruited. Consecutive SARS-CoV-2 RNA detection from paired specimens of nasopharyngeal swab (NPS) and sputum were carried out. The clinical characteristics of patients were recorded for further analysis.
RESULTS: SARS-CoV-2 RNA was detected from NPSs in 48 patients (70.6%), and from sputum specimens in 30 patients (44.1%). The median duration of viral shedding from sputum specimens (34 days; interquartile range [IQR], 24-40) was significantly longer than from NPSs (19 days; IQR, 14-25; P < .001). Elderly age was an independent factor associated with prolonged virus shedding time of SARS-CoV-2 (hazard ratio, 1.71; 95% CI, 1.01-2.93). It was noteworthy that in 9 patients, the viral RNA was detected in sputum after NPS turned negative. Chronic lung disease and steroids were associated with virus detection in sputum, and diabetes mellitus was associated with virus detection in both NPS and sputum.
INTERPRETATION: These findings may impact a test based clearance discharge criteria given patients with COVID-19 may shed virus longer in their lower respiratory tracts, with potential implication for prolonged transmission risk. In addition, more attention should be given to elderly patients who might have prolonged viral shedding duration.
| Errataetall: |
CommentIn: Chest. 2020 Nov;158(5):1804-1805. - PMID 33160519 |
|---|---|
| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:158 |
|---|---|
| Enthalten in: |
Chest - 158(2020), 5 vom: 10. Nov., Seite 1876-1884 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Wang, Kun [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Adrenal Cortex Hormones |
|---|
| Anmerkungen: |
Date Completed 26.11.2020 Date Revised 11.11.2023 published: Print-Electronic CommentIn: Chest. 2020 Nov;158(5):1804-1805. - PMID 33160519 Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.chest.2020.06.015 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM311481957 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM311481957 | ||
| 003 | DE-627 | ||
| 005 | 20231225142340.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.chest.2020.06.015 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1038.xml |
| 035 | |a (DE-627)NLM311481957 | ||
| 035 | |a (NLM)32569635 | ||
| 035 | |a (PII)S0012-3692(20)31718-9 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Wang, Kun |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Differences of Severe Acute Respiratory Syndrome Coronavirus 2 Shedding Duration in Sputum and Nasopharyngeal Swab Specimens Among Adult Inpatients With Coronavirus Disease 2019 |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 26.11.2020 | ||
| 500 | |a Date Revised 11.11.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: Chest. 2020 Nov;158(5):1804-1805. - PMID 33160519 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: The viral shedding duration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has not been fully defined. Consecutive detection of SARS-CoV-2 RNA from respiratory tract specimens is essential for determining duration of virus shedding and providing evidence to optimize the clinical management of coronavirus disease 2019 (COVID-19) | ||
| 520 | |a RESEARCH QUESTION: What are the shedding durations of SARS-CoV-2 RNA in the upper and lower respiratory tract specimens? What are their associated risk factors? | ||
| 520 | |a STUDY DESIGN AND METHODS: A total of 68 patients with COVID-19 admitted to Wuhan Taikang Tongji Hospital and Huoshenshan Hospital from February 10, 2020, to March 20, 2020, were recruited. Consecutive SARS-CoV-2 RNA detection from paired specimens of nasopharyngeal swab (NPS) and sputum were carried out. The clinical characteristics of patients were recorded for further analysis | ||
| 520 | |a RESULTS: SARS-CoV-2 RNA was detected from NPSs in 48 patients (70.6%), and from sputum specimens in 30 patients (44.1%). The median duration of viral shedding from sputum specimens (34 days; interquartile range [IQR], 24-40) was significantly longer than from NPSs (19 days; IQR, 14-25; P < .001). Elderly age was an independent factor associated with prolonged virus shedding time of SARS-CoV-2 (hazard ratio, 1.71; 95% CI, 1.01-2.93). It was noteworthy that in 9 patients, the viral RNA was detected in sputum after NPS turned negative. Chronic lung disease and steroids were associated with virus detection in sputum, and diabetes mellitus was associated with virus detection in both NPS and sputum | ||
| 520 | |a INTERPRETATION: These findings may impact a test based clearance discharge criteria given patients with COVID-19 may shed virus longer in their lower respiratory tracts, with potential implication for prolonged transmission risk. In addition, more attention should be given to elderly patients who might have prolonged viral shedding duration | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a SARS-CoV-2 | |
| 650 | 4 | |a nasopharyngeal swab | |
| 650 | 4 | |a sputum | |
| 650 | 4 | |a virus shedding | |
| 650 | 7 | |a Adrenal Cortex Hormones |2 NLM | |
| 650 | 7 | |a Antibodies, Viral |2 NLM | |
| 650 | 7 | |a RNA, Viral |2 NLM | |
| 700 | 1 | |a Zhang, Xin |e verfasserin |4 aut | |
| 700 | 1 | |a Sun, Jiaxing |e verfasserin |4 aut | |
| 700 | 1 | |a Ye, Jia |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Feilong |e verfasserin |4 aut | |
| 700 | 1 | |a Hua, Jing |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Huayu |e verfasserin |4 aut | |
| 700 | 1 | |a Shi, Ting |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Qiang |e verfasserin |4 aut | |
| 700 | 1 | |a Wu, Xiaodong |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Chest |d 1970 |g 158(2020), 5 vom: 10. Nov., Seite 1876-1884 |w (DE-627)NLM000002720 |x 1931-3543 |7 nnns |
| 773 | 1 | 8 | |g volume:158 |g year:2020 |g number:5 |g day:10 |g month:11 |g pages:1876-1884 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.chest.2020.06.015 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 158 |j 2020 |e 5 |b 10 |c 11 |h 1876-1884 | ||