Characteristics of SARS-CoV-2 Delta variant-infected individuals with intermittently positive retest viral RNA after discharge

Li, Lu; Tang, Jingyan; Xie, Zhiwei; Gan, Qingxin; Tang, Guosheng; Huang, Zhongwei; Zeng, Huimin; Shi, Jingrong; Li, Jiaojiao; Li, Yan; Ke, Changwen; Kang, Min; Liang, Dan; Lu, Huan; Tong, Yuwei; Deng, Xilong; Liu, Jinxin; Lu, Hongzhou; Wang, Fuxiang; Hu, Fengyu; Li, Feng; Zhong, Nanshan; Tang, Xiaoping

doi:10.1093/nsr/nwac141

Cited by 8 publications

(15 citation statements)

References 8 publications

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“…The increase in discrimination and stigmatization may be due to individuals' fear of COVID-19 infection ( 50 ). Significantly, the latest research points out that the discharged patients with COVID-19 are safe in life and work ( 51 ). Thus, policymakers should intensify publicity of COVID-19-related information and encourage the public to better understand COVID-19.…”

Section: Discussionmentioning

confidence: 99%

“…The corona virus disease 2019 (COVID-19) pandemic has caused approximately 500 million infections and 6 million deaths worldwide by June 2022 (1), and the global pandemic is ongoing. As many countries have adopted the strategy of coexisting with the virus, COVID-19 constantly mutates, creating what has been termed the new normal characterized by dynamic changes and repeated invasion of COVID-19 (2). During the new normal, China has adopted a dynamic zero-COVID policy, which has achieved remarkable results.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence and influencing factors of pandemic fatigue among Chinese public in Xi'an city during COVID-19 new normal: a cross-sectional study

Xin

Wang

Xuan

et al. 2022

Front. Public Health

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ObjectiveThis study aimed to assess Chinese public pandemic fatigue and potential influencing factors using an appropriate tool and provide suggestions to relieve this fatigue.MethodsThis study used a stratified sampling method by age and region and conducted a cross-sectional questionnaire survey of citizens in Xi'an, China, from January to February 2022. A total of 1500 participants completed the questionnaire, which collected data on demographics, health status, coronavirus disease 2019 (COVID-19) stressors, pandemic fatigue, COVID-19 fear, COVID-19 anxiety, personal resiliency, social support, community resilience, and knowledge, attitude, and practice toward COVID-19. Ultimately, 1354 valid questionnaires were collected, with a response rate of 90.0%. A binary logistic regression model was used to examine associations between pandemic fatigue and various factors.ResultNearly half of the participants reported pandemic fatigue, the major manifestation of which was “being sick of hearing about COVID-19” (3.353 ± 1.954). The logistic regression model indicated that COVID-19 fear (OR = 2.392, 95% CI = 1.804–3.172), sex (OR = 1.377, 95% CI = 1.077–1.761), the pandemic's impact on employment (OR = 1.161, 95% CI = 1.016–1.327), and COVID-19 anxiety (OR = 1.030, 95% CI = 1.010–1.051) were positively associated with pandemic fatigue. Conversely, COVID-19 knowledge (OR = 0.894, 95% CI = 0.837–0.956), COVID-19 attitude (OR = 0.866, 95% CI = 0.827–0.907), COVID-19 practice (OR = 0.943, 95% CI = 0.914–0.972), community resiliency (OR = 0.978, 95% CI = 0.958–0.999), and health status (OR = 0.982, 95% CI = 0.971–0.992) were negatively associated with pandemic fatigue.ConclusionThe prevalence of pandemic fatigue among the Chinese public was prominent. COVID-19 fear and COVID-19 attitude were the strongest risk factors and protective factors, respectively. These results indicated that the government should carefully utilize multi-channel promotion of anti-pandemic policies and knowledge.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevalence and influencing factors of pandemic fatigue among Chinese public in Xi'an city during COVID-19 new normal: a cross-sectional study

Xin

Wang

Xuan

et al. 2022

Front. Public Health

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“…1 As a unique phenomenon, SARS‐CoV‐2 viral RNA becoming positive retest after discharge, the criteria of which is two consecutive viral RNA test negative at an interval of >24 h, was firstly reported at the very beginning of the SARS‐CoV‐2 pandemic 2 and was subsequently observed at a frequency from 3.3% to 7.3% 3 , 4 , 5 for ancestral SARS‐CoV‐2 infection. Recently, we reported that Delta infection resulted in a significantly higher frequency of viral RNA retest positive (approximately 60%), 6 suggestive of a correlation of more frequent occurrence of viral RNA retest positive with novel variants with higher viral titers. The status of viral RNA reoccurrence in Omicron infection is less reported.…”

Section: Introductionmentioning

confidence: 80%

“…We have reported that the SARS‐CoV‐2 viral RNA concentrations during the repositive stage are about 10e5–10e6 times lower than during the first hospitalization, and the alive virus, if any left, is barely infectious and unlikely to cause community transmission. 6 …”

Section: Introductionmentioning

confidence: 99%

High titers of neutralizing antibodies in the blood fail to eliminate SARS‐CoV‐2 viral RNA in the upper respiratory tract

Cui

Tang

et al. 2022

Journal of Medical Virology

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Retest‐positive severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) viral RNA, as a unique phenomenon among discharged individuals, has been demonstrated to be safe in the community. Still, the underlying mechanism of viral lingering is less investigated. In this study, first, we find that the frequency of viral RNA‐positive retesting differs among variants. Higher ratios of viral RNA‐positive retest were more frequently observed among Delta (61.41%, 514 of 837 cases) and Omicron (39.53%, 119 of 301 cases) infections than among ancestral viral infection (7.27%, 21 of 289 cases). Second, the tissues where viral RNA reoccurred were altered. Delta RNA reoccurred mainly in the upper respiratory tract (90%), but ancestral virus RNA reoccurred mainly in the gastrointestinal tract (71%). Third, vaccination did not reduce the frequency of viral RNA‐positive retests, despite high concentrations of viral‐specific antibodies in the blood. Finally, 37 of 55 (67.27%) Delta‐infected patients receiving neutralizing antibody therapy become viral RNA retest positive when high concentrations of neutralizing antibodies still patrol in the blood. Altogether, our findings suggest that the presentence of high titers of neutralizing antibodies in the blood is incompetent in clearing residual viral RNA in the upper respiratory tract.

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“…Therefore, the risk of transmission was extremely low. However, a recent study ( 7 ) on the Delta variant infected individuals showed a re-positivity rate of ~61.4% (514/837), which was significantly higher than that of the original strain, indicating that the combination of unvaccinated status, older age, and underlying disease could be a prognostic indicator in distinguishing patients with potentially high concentrations of viral RNA. Since the Delta variant has higher infectivity and viral load than the original strain ( 4 ), it may have a longer viral shedding time, leading to a significantly higher re-positive rate.…”

Section: Introductionmentioning

confidence: 90%

A comparative study of virus nucleic acid re-positive and non-re-positive patients infected with SARS-CoV-2 Delta variant strain in the Ningxia Hui Autonomous Region

Wang

Zhang

et al. 2022

Front. Public Health

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ObjectiveThis study aimed to provide a basis for epidemic prevention and control measures as well as the management of re-positive personnel by analyzing and summarizing the characteristics of re-positive patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant infections discharged from a hospital in the Ningxia Hui Autonomous Region in 2021.MethodsThis case-control study included a total of 45 patients with Delta variant infections diagnosed in the Fourth People's Hospital of the Ningxia Hui Autonomous Region between October 17 and November 28, 2021. Based on the nucleic acid test results post-discharge, the patients were dichotomized into re-positive and non-re-positive groups. Based on the time of the first re-positive test, the re-positive group was further divided into <7 and ≥7 days groups to compare their clinical characteristics and explore the possible influencing factors of this re-positivity.ResultsOf the 45 total patients, 16 were re-positive (re-positivity rate: 35.6%), including four patients who were re-positive after 2 weeks (re-positivity rate: 8.8%). The median time of the first re-positive after discharge was 7 days (IQR: 14-3). The re-positive group was younger than the non-re-positive group (35 vs. 53, P < 0.05), had a higher proportion of patients who were not receiving antiviral therapy (56.2 vs. 17.2%, P < 0.05). The median CT value of nucleic acid in the re-positive group was considerably greater than that at admission (36.7 vs. 22.6 P < 0.05). The findings demonstrated that neutralizing antibody treatment significantly raised the average IgG antibody level in patients, particularly in those who had not received COVID-19 vaccine (P < 0.05). The median lowest nucleic acid CT value of the ≥7 days group during the re-positive period and the immunoglobulin G (IgG) antibody level at discharge were lower than those in the <7 days group (P < 0.05). When compared to the non-positive group, patients in the ≥7 days group had a higher median virus nucleic acid CT value (27.1 vs. 19.2, P < 0.05) and absolute number of lymphocytes at admission (1,360 vs. 952, P < 0.05), and a lower IgG antibody level at discharge (P < 0.05).ConclusionsIn conclusion, this study found that: (1) The re-positivity rate of SARS-CoV-2 Delta variant infection in this group was 35.6%, while the re-positivity rate was the same as that of the original strain 2 weeks after discharge (8.0%). (2) Young people, patients who did not use antiviral therapy or had low IgG antibody levels at discharge were more likely to have re-positive. And the CT value of nucleic acid at the time of initial infection was higher in re-positive group. We speculated that the higher the CT value of nucleic acid at the time of initial infection, the longer the intermittent shedding time of the virus. (3) Re-positive patients were asymptomatic. The median CT value of nucleic acid was > 35 at the re-positive time, and the close contacts were not detected as positive. The overall transmission risk of re-positive patients is low.

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Characteristics of SARS-CoV-2 Delta variant-infected individuals with intermittently positive retest viral RNA after discharge

Cited by 8 publications

References 8 publications

Prevalence and influencing factors of pandemic fatigue among Chinese public in Xi'an city during COVID-19 new normal: a cross-sectional study

Prevalence and influencing factors of pandemic fatigue among Chinese public in Xi'an city during COVID-19 new normal: a cross-sectional study

High titers of neutralizing antibodies in the blood fail to eliminate SARS‐CoV‐2 viral RNA in the upper respiratory tract

A comparative study of virus nucleic acid re-positive and non-re-positive patients infected with SARS-CoV-2 Delta variant strain in the Ningxia Hui Autonomous Region

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