About: Persistence and clearance of viral RNA in 2019 novel coronavirus disease rehabilitation patients

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An Entity of Type : schema:ScholarlyArticle, within Data Space : covidontheweb.inria.fr associated with source document(s)

Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Persistence and clearance of viral RNA in 2019 novel coronavirus disease rehabilitation patients
Creator	Tian, Di Dai, Fa-Hui Song, Zhi-Gang Wu, Fan Huang, Wei Chen, Jun Ling, Yun Zhang, Wen-Hong Wang, Sheng Zhu, Lei Lu, Hong-Zhou Hu, Bi-Jie Lin, Yi-Xiao Mao, En-Qiang Xu, Shui-Bao Zhu, Zhao-Qin
topic	covid:8b1a79b1896bdbbe3e5ffc68e2a45ee57058deca#this
Source	Medline; PMC
abstract	BACKGROUND: A patient's infectivity is determined by the presence of the virus in different body fluids, secretions, and excreta. The persistence and clearance of viral RNA from different specimens of patients with 2019 novel coronavirus disease (COVID-19) remain unclear. This study analyzed the clearance time and factors influencing 2019 novel coronavirus (2019-nCoV) RNA in different samples from patients with COVID-19, providing further evidence to improve the management of patients during convalescence. METHODS: The clinical data and laboratory test results of convalescent patients with COVID-19 who were admitted to from January 20, 2020 to February 10, 2020 were collected retrospectively. The reverse transcription polymerase chain reaction (RT-PCR) results for patients’ oropharyngeal swab, stool, urine, and serum samples were collected and analyzed. Convalescent patients refer to recovered non-febrile patients without respiratory symptoms who had two successive (minimum 24 h sampling interval) negative RT-PCR results for viral RNA from oropharyngeal swabs. The effects of cluster of differentiation 4 (CD4)+ T lymphocytes, inflammatory indicators, and glucocorticoid treatment on viral nucleic acid clearance were analyzed. RESULTS: In the 292 confirmed cases, 66 patients recovered after treatment and were included in our study. In total, 28 (42.4%) women and 38 men (57.6%) with a median age of 44.0 (34.0–62.0) years were analyzed. After in-hospital treatment, patients’ inflammatory indicators decreased with improved clinical condition. The median time from the onset of symptoms to first negative RT-PCR results for oropharyngeal swabs in convalescent patients was 9.5 (6.0–11.0) days. By February 10, 2020, 11 convalescent patients (16.7%) still tested positive for viral RNA from stool specimens and the other 55 patients’ stool specimens were negative for 2019-nCoV following a median duration of 11.0 (9.0–16.0) days after symptom onset. Among these 55 patients, 43 had a longer duration until stool specimens were negative for viral RNA than for throat swabs, with a median delay of 2.0 (1.0–4.0) days. Results for only four (6.9%) urine samples were positive for viral nucleic acid out of 58 cases; viral RNA was still present in three patients’ urine specimens after throat swabs were negative. Using a multiple linear regression model (F = 2.669, P = 0.044, and adjusted R(2) = 0.122), the analysis showed that the CD4+ T lymphocyte count may help predict the duration of viral RNA detection in patients’ stools (t = −2.699, P = 0.010). The duration of viral RNA detection from oropharyngeal swabs and fecal samples in the glucocorticoid treatment group was longer than that in the non-glucocorticoid treatment group (15 days vs. 8.0 days, respectively; t = 2.550, P = 0.013) and the duration of viral RNA detection in fecal samples in the glucocorticoid treatment group was longer than that in the non-glucocorticoid treatment group (20 days vs. 11 days, respectively; t = 4.631, P < 0.001). There was no statistically significant difference in inflammatory indicators between patients with positive fecal viral RNA test results and those with negative results (P > 0.05). CONCLUSIONS: In brief, as the clearance of viral RNA in patients’ stools was delayed compared to that in oropharyngeal swabs, it is important to identify viral RNA in feces during convalescence. Because of the delayed clearance of viral RNA in the glucocorticoid treatment group, glucocorticoids are not recommended in the treatment of COVID-19, especially for mild disease. The duration of RNA detection may relate to host cell immunity.
has issue date	2020-02-28(xsd:dateTime)
bibo:doi	10.1097/cm9.0000000000000774
bibo:pmid	32118639
has license	no-cc
sha1sum (hex)	8b1a79b1896bdbbe3e5ffc68e2a45ee57058deca
schema:url	https://doi.org/10.1097/cm9.0000000000000774
resource representing a document's title	Persistence and clearance of viral RNA in 2019 novel coronavirus disease rehabilitation patients
has PubMed Central identifier	PMC7147278
has PubMed identifier	32118639
schema:publication	Chin Med J (Engl)
resource representing a document's body	covid:8b1a79b1896bdbbe3e5ffc68e2a45ee57058deca#body_text
is http://vocab.deri.ie/void#inDataset of	https://covidontheweb.inria.fr:4443/about/id/http/ns.inria.fr/covid19/8b1a79b1896bdbbe3e5ffc68e2a45ee57058deca proxy:http/ns.inria.fr/covid19/8b1a79b1896bdbbe3e5ffc68e2a45ee57058deca
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