Qi Li1,2, Li Shuai3, Li Tan1,2, Lijun Song1,2, Chongyang Ou4,5, Xiaocheng Song4,5, Jian He6,7, Ming Gao7,8, Xinyu Hu1,2, Yang Liu9, Hui Chen10, Zui Zou2,9,11, Chao Yu4,5, Baodong Qin12, Wenyun Xu9. 1. Hebei North University Zhangjiakou 075000, Hebei, China. 2. School of Anesthesiology, Naval Medical University Shanghai 200433, China. 3. Department of Medical Service, No.905 Hospital of PLA Navy Shanghai 200050, China. 4. Department of Respiratory and Critical Care Medicine, Naval Hospital of Eastern Theater of PLA Zhoushan 316000, Zhejiang, China. 5. No.5 Department of Infectious Diseases, Guanggu District, The Maternal and Child Health Hospital of Hubei Wuhan 430070, Hubei, China. 6. Department of Information, The 967th Hospital of The Joint Logistic Support Force of PLA Dalian 116000, Liaoning, China. 7. Department of Information, Guanggu District, The Maternal and Child Health Hospital of Hubei Wuhan 430070, Hubei, China. 8. Department of Information, Hospital No. 968 of PLA Joint Support Force Jinzhou 121000, Liaoning, China. 9. Department of Anesthesiology, Changzheng Hospital, Second Affiliated Hospital of Naval Medical University Shanghai 200003, China. 10. Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine Shanghai 200434, China. 11. No.3 Department of Infectious Diseases, Guanggu District, The Maternal and Child Health Hospital of Hubei Wuhan 430070, Hubei, China. 12. Department of Medical Oncology, Changzheng Hospital, Second Affiliated Hospital of Naval Medical University Shanghai 200003, China.
Abstract
BACKGROUND: Previous studies have unveiled the occurrence of re-detectable positive (RP) RNA test result after hospital discharge among recovered COVID-19 patients, but the clinical characteristics of RP patients (RP patients) and the potential features affecting RP RNA test outcome remain unclear. METHODS: A total of 742 COVID-19 patients discharged between March 1st, 2020 and March 20th, 2020 were enrolled. All patients were followed-up for SARS-CoV-2 RNA test and RP patents were identified. The clinical characteristics between RP patients and NRP patients were compared, and the potential features affecting re-detectable RNA test outcome were further evaluated. RESULTS: Up to April 9th, 2020, 60 recovered patients (8.09%) had been re-detected to be SARS-CoV-2 RNA positive. Among those 60 RP patients, the median RP time was 12 days from the last negative result of SARS-CoV-2 RNA test or 10 days from hospital discharge. RP patients were prone to be older, having mild/moderate conditions, unilateral lung involvement and fatigue, chills, stuffy or runny nose, with high lymphocyte count. Multivariate logistic analysis and COX regression analysis demonstrated that age, lymphocyte count, urea nitrogen, stuffy or runny nose as well as lung involvement were independently associated with RP RNA test (P<0.05). CONCLUSIONS: Older patients accompanied with stuffy or runny nose, low urea nitrogen as well as unilateral lung involvement were more likely to develop RP RNA test result after hospital discharge. Therefore, we strongly suggest using broncho-alveolar lavage fluid for RNA detection, extending quarantine time, and conducting continual follow-up medical examination for those discharged patients. AJTR
BACKGROUND: Previous studies have unveiled the occurrence of re-detectable positive (RP) RNA test result after hospital discharge among recovered COVID-19 patients, but the clinical characteristics of RP patients (RP patients) and the potential features affecting RP RNA test outcome remain unclear. METHODS: A total of 742 COVID-19 patients discharged between March 1st, 2020 and March 20th, 2020 were enrolled. All patients were followed-up for SARS-CoV-2 RNA test and RP patents were identified. The clinical characteristics between RP patients and NRP patients were compared, and the potential features affecting re-detectable RNA test outcome were further evaluated. RESULTS: Up to April 9th, 2020, 60 recovered patients (8.09%) had been re-detected to be SARS-CoV-2 RNA positive. Among those 60 RP patients, the median RP time was 12 days from the last negative result of SARS-CoV-2 RNA test or 10 days from hospital discharge. RP patients were prone to be older, having mild/moderate conditions, unilateral lung involvement and fatigue, chills, stuffy or runny nose, with high lymphocyte count. Multivariate logistic analysis and COX regression analysis demonstrated that age, lymphocyte count, urea nitrogen, stuffy or runny nose as well as lung involvement were independently associated with RP RNA test (P<0.05). CONCLUSIONS: Older patients accompanied with stuffy or runny nose, low urea nitrogen as well as unilateral lung involvement were more likely to develop RP RNA test result after hospital discharge. Therefore, we strongly suggest using broncho-alveolar lavage fluid for RNA detection, extending quarantine time, and conducting continual follow-up medical examination for those discharged patients. AJTR
Authors: Roman Wölfel; Victor M Corman; Wolfgang Guggemos; Michael Seilmaier; Sabine Zange; Marcel A Müller; Daniela Niemeyer; Terry C Jones; Patrick Vollmar; Camilla Rothe; Michael Hoelscher; Tobias Bleicker; Sebastian Brünink; Julia Schneider; Rosina Ehmann; Katrin Zwirglmaier; Christian Drosten; Clemens Wendtner Journal: Nature Date: 2020-04-01 Impact factor: 49.962