Clinical Course and Risk Factors for Recurrence of Positive SARS-CoV-2 RNA: A Retrospective Cohort Study from Wuhan, China

Chen, Jie; Xu, Xiaoping; Hu, Jing; Chen, Qiangda; Xu, Feifan; Liang, Hui; Liu, Nanmei; Zhu, Hengmei; Lan, Jinlong; Zhou, Lan; Xing, Jiajun; Pu, Ning; Cai, Zhigang

doi:10.2139/ssrn.3588539

Cited by 25 publications

(40 citation statements)

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“…The finding that the rate of readmission is higher for patients with hypertension as the underlying disease was also confirmed in a study in Spain [19]. In addition, a study on readmitted patients in Wuhan, China reported that patients with pulmonary fibrosis as the underlying disease had a higher risk of readmission [3]. In this study, it was found that the probability of readmission was 4.391 times higher in patients with a CCI score of 1 and 5.086 times higher in those with a CCI score of 2 or more, and the group that received chest X-ray/chest CT during the first admission had a higher rate of readmission.…”

Section: Discussionmentioning

confidence: 64%

“…Recently, with the number of cases of readmission increasing abroad, studies analyzing the clinical characteristics and risk factors of those patients have been carried out. According to a study by Jie Chen et al that analyzed the risk factors and clinical outcomes of readmitted COVID-19 patients among 1087 patients in Wuhan, China, 7.6% of the patients were readmitted after discharge [ 3 ]. In addition, Xian et al found that 27 out of 285 hospitalized COVID-19 patients in Guangdong, China tested positive again after recovering [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Analysis of Risk Factors on Readmission Cases of COVID-19 in the Republic of Korea: Using Nationwide Health Claims Data

Jeon

Seon

Park

et al. 2020

IJERPH

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In South Korea, 4.5% patients of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were readmitted to hospitals after discharge. However, there is insufficient research on risk factors for readmission and management of patients after discharge is poor. In this study, 7590 confirmed coronavirus disease (COVID-19) patients were defined as a target for analysis using nationwide medical claims data. The demographic characteristics, underlying diseases, and the use of medical resources were used to examine the association with readmission through the chi-square test and then logistic regression analysis was performed to analyze factors affecting readmission. Of the 7590 subjects analyzed, 328 patients were readmitted. The readmission rates of men, older age and patients with medical benefits showed a high risk of readmission. The Charlson Comorbidity Index score was also related to COVID-19 readmission. Concerning requiring medical attention, there was a higher risk of readmission for the patients with chest radiographs, computed tomography scans taken and lopinavir/ritonavir at the time of their first admission. Considering the risk factors presented in this study, classifying patients with a high risk of readmission and managing patients before and after discharge based on priority can make patient management and medical resource utilization more efficient. This study also indicates the importance of lifestyle management after discharge.

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Section: Discussionmentioning

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Analysis of Risk Factors on Readmission Cases of COVID-19 in the Republic of Korea: Using Nationwide Health Claims Data

Jeon

Seon

Park

et al. 2020

IJERPH

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“…We estimated that the interval between the onset of the initial episode of the disease and recurrent positivity was 35.4 days. The longest interval (50 days) was reported by Chen 12 . The time from the last negative PCR test result (used as a discharge criterion) to recurrent positivity was 9.8 days, with the longest interval (19 days) being reported by Huang 13 .…”

Section: Discussionmentioning

confidence: 92%

Recurrent SARS-CoV-2 RNA positivity after COVID-19: a systematic review and meta-analysis

Azam

Sulistiana

Ratnawati³

et al. 2020

Sci Rep

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Present study aimed to estimate the incidence of recurrent SARS-CoV-2 RNA positivity after recovery from COVID-19 and to determine the factors associated with recurrent positivity. We searched the PubMed, MedRxiv, BioRxiv, the Cochrane Library, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry for studies published to June 12, 2020. Studies were reviewed to determine the risk of bias. A random-effects model was used to pool results. Heterogeneity was assessed using I2. Fourteen studies of 2568 individuals were included. The incidence of recurrent SARS-CoV-2 positivity was 14.8% (95% confidence interval [CI] 11.44–18.19%). The pooled estimate of the interval from disease onset to recurrence was 35.4 days (95% CI 32.65–38.24 days), and from the last negative to the recurrent positive result was 9.8 days (95% CI 7.31–12.22 days). Patients with younger age and a longer initial illness were more likely to experience recurrent SARS-CoV-2 positivity, while patients with diabetes, severe disease, and a low lymphocyte count were less likely to experience. Present study concluded that the incidence of recurrent SARS-CoV-2 positivity was 14.8% suggesting further studies must be conducted to elucidate the possibility of infectious individuals with prolonged or recurrent RNA positivity.

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“…Furthermore, the nucleic acid test should be performed repeatedly for highly suspected patients to avoid misdiagnosis. The quarantine period should be prolonged for at least 50 days for recovered patients in order to avoid virus carrier transmission and identify patients that may pose a risk for the future outbreaks ( 7 ).…”

Section: Discussionmentioning

confidence: 99%

“…However, it could still take days for the immune system to completely eliminate the remaining virus in the body ( 8 ), leading to intermittent release of the virus for recurrence of positive results. Once the virus had replication and intermittent shedding, the RT-PCR results reverted to positive in the discharged patients ( 7 ). Continuous antiviral therapy should be considered especially for the patients with repeatedly positive results of SARS-CoV-2 ( 9 ).…”

Section: Discussionmentioning

confidence: 99%

Case Report: Recurrence of Positive SARS-CoV-2 Results in Patients Recovered From COVID-19

Zhang

Deng

et al. 2020

Front. Med.

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Background: Coronavirus disease 2019 (COVID-19) is spreading throughout the world. Limited data are available for recurrence of positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) results in patients with long duration of COVID-19.Methods: We reported four cases recovered from COVID-19 with recurrence of positive SARS-CoV-2 results during the long-term follow-up.Results: The four patients recovered from COVID-19 showed recurrence of positive SARS-CoV-2 results for more than 120 days with no symptoms and normal chest CT scan.Conclusions: The dynamic surveillance of SARS-CoV-2 by nucleic acid detection and serological assays is important for asymptomatic patients who might be potentially infectious.

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Clinical Course and Risk Factors for Recurrence of Positive SARS-CoV-2 RNA: A Retrospective Cohort Study from Wuhan, China

Cited by 25 publications

References 0 publications

Analysis of Risk Factors on Readmission Cases of COVID-19 in the Republic of Korea: Using Nationwide Health Claims Data

Analysis of Risk Factors on Readmission Cases of COVID-19 in the Republic of Korea: Using Nationwide Health Claims Data

Recurrent SARS-CoV-2 RNA positivity after COVID-19: a systematic review and meta-analysis

Case Report: Recurrence of Positive SARS-CoV-2 Results in Patients Recovered From COVID-19

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