Clinical features of COVID‐19 convalescent patients with re‐positive nucleic acid detection

Zhu, Haiyan; Fu, Liyun; Jin, Yinhua; Shao, Jiale; Zhang, Shun; Zheng, Naihang; Fan, Limin; Yu, Zhe; Ying, Jun; Hu, Yaoren; Chen, Tongen; Chen, Yanglingzi; Chen, Min; Chen, Mingjue; Xiong, Zi; Kang, Junfei; Jin, Jia-Chang; Cai, Ting; Ye, Honghua

doi:10.1002/jcla.23392

Cited by 58 publications

(78 citation statements)

References 14 publications

(20 reference statements)

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“…Chung et al 13 reported that 76% of the patients had bilateral lung affection, and also, 76% had their lower right lobe involved. Zhu et al 14 revealed that slow absorption of lung lesions in patients may be associated with persistent positive RT‐PCR test results. We found in Group S a higher proportion of bilateral lung lobe infections, which implies more serious infections in the lungs.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and factors affecting the duration of positive nucleic acid test for patients of COVID‐19 in XinYu, China

Yin

et al. 2020

Clinical Laboratory Analysis

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Background The outbreak of a new coronavirus, COVID‐19, which was earliest reported in Wuhan, China, is now transmitting throughout the world. The aim of this study was to articulate the clinical characteristics of COVID‐19 and to reveal possible factors that may affect the persistent time of positive SARS‐CoV‐2 nucleic acid test, so as to identify which patients may deteriorate or have poor prognoses as early as possible. Methods Retrospective cohort study was carried out on 47 patients with confirmed COVID‐19 infection admitted to XinYu People's Hospital of JiangXi Province. Epidemiological, demographic, clinical, laboratorial, management, treatment, and outcome data were also collected and analyzed. Results In this study, patients were divided into two groups based on whether their SARS‐CoV‐2 nucleic acid tests in respiratory specimens turn negative within (Group Rapid or Group R) or over (Group Slow or Group S) a week. There was no significant difference in age, sex, travel or exposure history, and smoking history between the two groups. Forty‐two patients had been observed with comorbidities. Similar clinical manifestations, for instance fever, cough, sputum, and fatigue, have been observed among patients in both groups, except that patients in Group S were obviously more likely to get fatigue than patients in Group R. Both groups had shown decrease in white blood cell or lymphocyte counts. Chest X‐ray or computed tomography scan showed unilateral or bilateral infiltrates. High proportion in both groups has used nasal cannula (89.47% vs. 85.71%) to inhale oxygen. 10.53% of Group S have applied high‐flow nasal cannula, while Group R used none. The current treatment is mainly antibiotics, antiviral, and traditional Chinese medicine, while a couple of patients has used methylprednisolone. Only 1 patient out of both groups got even worse despite this active treatment. Conclusion Clinical characteristics of COVID‐19 include the exposure history and typical systemic symptoms such as fever, cough, fatigue, decreased WBC and lymphocyte counts, and infiltration in both lower lobes on CT imaging. Among them, fatigue appears to be an important factor that affects the duration of positive SARS‐CoV‐2 nucleic acid test in respiratory specimens.

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Section: Discussionmentioning

confidence: 99%

Clinical characteristics and factors affecting the duration of positive nucleic acid test for patients of COVID‐19 in XinYu, China

Yin

et al. 2020

Clinical Laboratory Analysis

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“…Different countries may make slightly different discharge criteria based on their context. The chest CT of one case presented recurrent symptoms with blurred image in the upper lobe of both lungs, more prominent on the left side during the convalescent period, but the severity of image is less than that of late period of hospitalization [108][109][110][111][112][113][114].…”

Section: Discharge Managementmentioning

confidence: 92%

Chemoprophylaxis, diagnosis, treatments, and discharge management of COVID-19: An evidence-based clinical practice guideline (updated version)

et al. 2020

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The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of a rapidly spreading illness, coronavirus disease 2019 (COVID-19), affecting more than seventeen million people around the world. Diagnosis and treatment guidelines for clinicians caring for patients are needed. In the early stage, we have issued "A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version)"; now there are many direct evidences emerged and may change some of previous recommendations and it is ripe for develop an evidence-based guideline. We formed a working group of clinical experts and methodologists. The steering group members proposed 29 questions that are relevant to the

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“…Reinfections have been reported with other human coronaviruses, namely, 229E, NL63, OC43, all of which generally cause milder respiratory illness. Hitherto, multiple cases of clinical recurrence of COVID-19 and/or positive real time-polymerase chain reaction (RT-PCR) results after recovery have been reported [ [3] , [4] , [5] , [6] , [7] , [8] ]. Among 576 patients with COVID-19 discharged from hospital in Chongqing, China, 61 patients (10.6%) had positive RT-PCR test results [ 6 ].…”

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confidence: 99%

“…Zhou et al has reported that COVID-19 patients who “relapse” after discharge are usually elderly, have poor immune function, and have more comorbidities [ 36 ]. Accordingly, multiple cases of clinical recurrences of COVID-19 and/or re-positives of SARS-CoV-2 RT-PCR have been reported in patients with DM [ [3] , [4] , [5] , [6] , [7] , [8] ]. Amongst 61 patients who had turned re-positive after being discharged from the hospital, 5 had DM [ 6 ].…”

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Are people with uncontrolled diabetes mellitus at high risk of reinfections with COVID-19?

Pal

Banerjee

2021

Primary Care Diabetes

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Several cases of positive real time-polymerase chain reaction (RT-PCR) results (called "re-positives") after recovery from COVID-19 have emerged worldwide. These cases could represent patients experiencing a "turn positive" of nucleic acid detection attributed to the high false-negative rate of RT-PCR. On the contrary, in symptomatic patients, the possibility of reactivation or true reinfection remains. We hypothesize that people with uncontrolled diabetes mellitus might be at a high risk of reinfections with COVID-19 attributed to the impaired adaptive immune response. In fact, multiple cases of re-positives/re-infections in people with diabetes mellitus have hitherto been reported.

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Clinical features of COVID‐19 convalescent patients with re‐positive nucleic acid detection

Abstract: Hui and Fu contributed equally to the work.Ye and Cai contributed equally to the work.

Cited by 58 publications

References 14 publications

Clinical characteristics and factors affecting the duration of positive nucleic acid test for patients of COVID‐19 in XinYu, China

Clinical characteristics and factors affecting the duration of positive nucleic acid test for patients of COVID‐19 in XinYu, China

Chemoprophylaxis, diagnosis, treatments, and discharge management of COVID-19: An evidence-based clinical practice guideline (updated version)

Are people with uncontrolled diabetes mellitus at high risk of reinfections with COVID-19?

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