Long-term positive severe acute respiratory syndrome coronavirus 2 ribonucleic acid and therapeutic effect of antivirals in patients with coronavirus disease: Case reports

Wei, Bo; Hang, Xiaofeng; Xie, Ying; Zhang, Yuanjing; Wang, Jianrong; Cao, Xinghao; Wu, Jinzi J.; Wang, Junxue

doi:10.1590/0037-8682-0372-2020

Cited by 8 publications

(6 citation statements)

References 13 publications

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“…However, some of the infected individuals showed persistent positive nucleic acid test result. A study from Shanghai, China, reported that four COVID-19 cases with persistent positive nucleic acid test had an average conversion time of 61 days from positive to negative nucleic acid test (20). In our study, the median conversion time from the rst positive to negative nucleic acid test was 24 days and 25 days in mild and severe patients, respectively, and the conversion time in one of the severe patients was up to 75 days.…”

Section: Discussionsupporting

confidence: 47%

“…Patients infected with SARA-CoV-2 are still shedding virus after six months of treatment, and this is called a chronic carrier state in the human body. The long-term positive viral RNA test result may be due to the damage of the immune system, immune tolerance and escape, or the mutation of the virus (20,22). Further studies are still needed to verify whether COVID-19 will form a chronic carrier state in humans.…”

Section: Discussionmentioning

confidence: 99%

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The value of early positive nucleic acid test and negative conversion time of SARS-CoV-2 RNA in the clinical outcome of COVID-19 patients

Zhai

Zang

Xiong

et al. 2021

Preprint

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Background The outbreak of coronavirus disease (COVID-19) poses a great threat to the global public health. At present, the number of new confirmed COVID-19 cases and new deaths is increasing worldwide. The strategy of comprehensive and scientific detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, the virus that causes COVID-19) through real-time reverse transcriptase polymerase chain reaction (RT-PCR) for special populations and environments provides great support for the prevention and control of this pandemic in China. Our study focused on determining the factors associated with the length of time from symptom onset to the first positive nucleic acid test of throat swabs in COVID-19 patients, evaluating the effect of early positive nucleic acid detection on the disease severity and its significance in prognosis, and predicting the factors associated with the time from positive SARS-CoV-2 RNA test to negative conversion in COVID-19 patients. Methods This study included 116 hospitalized patients with COVID-19 from January 30, 2020 to March 4, 2020 in Wuhan, China. Throat swabs samples were collected for real-time reverse transcriptase polymerase chain reaction (RT-PCR) test of SARS-CoV-2 RNA, and all patients included in this study were positive for this test. Results Multivariate Cox proportional hazards model showed that disease severity and the duration of disease before admission to hospitals were protective factors for the time from symptom onset to positive nucleic acid detection, and the time from positive nucleic acid test to negative conversion was a risk factor for the time from symptom onset to positive nucleic acid detection. Meanwhile, the time from symptom onset to positive nucleic acid detection was an independent risk factor for the prolonged negative conversion of SARS-CoV-2 virus. Conclusions Patients with more severe disease and longer duration of disease before admission to hospitals had a shorter time from symptom onset to positive nucleic acid test. Prolonged time from symptom onset to positive nucleic acid test was an independent risk factor for the prolonged negative conversion time of SARS-CoV-2 virus, and the severity of the disease had no correlation with negative conversion time of SARS-CoV-2 virus.

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Section: Discussionsupporting

confidence: 47%

Section: Discussionmentioning

confidence: 99%

The value of early positive nucleic acid test and negative conversion time of SARS-CoV-2 RNA in the clinical outcome of COVID-19 patients

Zhai

Zang

Xiong

et al. 2021

Preprint

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“…Since the beginning of the Covid-19 pandemic, due to several reports of persistent detection of viral RNA by RT-PCR in a nasopharyngeal or oropharyngeal swab, but without recurrence of symptoms, the possibility of SARS-CoV-2 reinfection has been suggested and investigated by different researchers around the world 5 , 6 , 10 , 11 .…”

Section: Discussionmentioning

confidence: 99%

Are SARS-CoV-2 reinfection and Covid-19 recurrence possible? a case report from Brazil

Bonifácio

Pereira

Araújo³

et al. 2020

Rev. Soc. Bras. Med. Trop.

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With the large number of individuals infected and recovered from Covid-19, there is intense discussion about the quality and duration of the immunity elicited by SARS-CoV-2 infection, including the possibility of disease recurrence. Here we report a case with strong clinical, epidemiological and laboratorial evidence of, not only reinfection by SARS-CoV-2, but also clinical recurrence of Covid-19.

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“…A patient with lymphoma who underwent autologous stem cell transplantation showed persistent SARS-CoV-2 viral shedding for 74 days, even with the administration of CP [77]. On the other hand, 1 study reported that 2 patients with long-term positive viral infection for 8 weeks showed substantial improvement after treatment with CP and ritonavir-boosted danoprevir [107]. Similarly, another study showed that CP therapy could rapidly reduce viral loads in more than half of 27 patients with prolonged positivity of SARS-CoV-2 for a median of 44 days after symptom onset [109].…”

Section: Discussionmentioning

confidence: 99%

Convalescent Plasma for the Prevention and Treatment of COVID-19: A Systematic Review and Quantitative Analysis

Peng¹,

Rhind²,

Beckett³

2021

JMIR Public Health Surveill

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Background The COVID-19 pandemic, caused by a novel coronavirus termed SARS-CoV-2, has spread quickly worldwide. Convalescent plasma (CP) obtained from patients following recovery from COVID-19 infection and development of antibodies against the virus is an attractive option for either prophylactic or therapeutic treatment, since antibodies may have direct or indirect antiviral activities and immunotherapy has proven effective in principle and in many clinical reports. Objective We seek to characterize the latest advances and evidence in the use of CP for COVID-19 through a systematic review and quantitative analysis, identify knowledge gaps in this setting, and offer recommendations and directives for future research. Methods PubMed, Web of Science, and Embase were continuously searched for studies assessing the use of CP for COVID-19, including clinical studies, commentaries, reviews, guidelines or protocols, and in vitro testing of CP antibodies. The screening process and data extraction were performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Quality appraisal of all clinical studies was conducted using a universal tool independent of study designs. A meta-analysis of case-control and randomized controlled trials (RCTs) was conducted using a random-effects model. Results Substantial literature has been published covering various aspects of CP therapy for COVID-19. Of the references included in this review, a total of 243 eligible studies including 64 clinical studies, 79 commentary articles, 46 reviews, 19 guidance and protocols, and 35 in vitro testing of CP antibodies matched the criteria. Positive results have been mostly observed so far when using CP for the treatment of COVID-19. There were remarkable heterogeneities in the CP therapy with respect to patient demographics, donor antibody titers, and time and dose of CP administration. The studies assessing the safety of CP treatment reported low incidence of adverse events. Most clinical studies, in particular case reports and case series, had poor quality. Only 1 RCT was of high quality. Randomized and nonrandomized data were found in 2 and 11 studies, respectively, and were included for meta-analysis, suggesting that CP could reduce mortality and increase viral clearance. Despite promising pilot studies, the benefits of CP treatment can only be clearly established through carefully designed RCTs. Conclusions There is developing support for CP therapy, particularly for patients who are critically ill or mechanically ventilated and resistant to antivirals and supportive care. These studies provide important lessons that should inform the planning of well-designed RCTs to generate more robust knowledge for the efficacy of CP in patients with COVID-19. Future research is necessary to fill the knowledge gap regarding prevention and treatment for patients with COVID-19 with CP while other therapeutics are being developed.

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Long-term positive severe acute respiratory syndrome coronavirus 2 ribonucleic acid and therapeutic effect of antivirals in patients with coronavirus disease: Case reports

Cited by 8 publications

References 13 publications

The value of early positive nucleic acid test and negative conversion time of SARS-CoV-2 RNA in the clinical outcome of COVID-19 patients

The value of early positive nucleic acid test and negative conversion time of SARS-CoV-2 RNA in the clinical outcome of COVID-19 patients

Are SARS-CoV-2 reinfection and Covid-19 recurrence possible? a case report from Brazil

Convalescent Plasma for the Prevention and Treatment of COVID-19: A Systematic Review and Quantitative Analysis

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