Older age is associated with sustained detection of SARS-CoV-2 in nasopharyngeal swab samples

Hattori, Takeshi; Amishima, Masaru; Morinaga, Daisuke; Kamada, Keisuke; Nakakubo, Sho; Yamashita, Yu; Shichinohe, Yasuo; Fujisawa, Shinichi; Nishida, Mutsumi; Nasuhara, Yasuyuki; Teshima, Takanori; Konno, Satoshi

doi:10.1016/j.jinf.2020.06.046

Cited by 5 publications

(5 citation statements)

References 2 publications

(3 reference statements)

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“…There is also limited data on the time taken for SARS-CoV-2 clearance in infected patients and the factors that influence this duration. Hattori et al [8] reported that an older age is associated with a longer duration of SARS-CoV-2 RNA detection; however, this report lacked multivariate analysis and an evaluation of the differences based on age. Thus, little is known about the factors that influence the positive duration.…”

Section: Discussionmentioning

confidence: 88%

Factors associated with viral clearance periods from patients with COVID-19: A retrospective observational cohort study

Hirai

Nishioka

Sekine

et al. 2021

Journal of Infection and Chemotherapy

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Introduction: Knowledge is limited on the virologic course of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, particularly the time taken for viral clearance and the optimal time to discontinue isolation. This study aims to identify the clinical and demographic factors influencing the time taken for viral clearance in patients with COVID-19 to determine the optimal isolation period. Methods: This two-center retrospective observational cohort study was conducted between March 1 and June 31, 2020. Patients with COVID-19, which was confirmed by real-time reverse transcription polymerase chain reaction, were included. Data were extracted from medical records. The positive duration, which was defined as the period from the day of symptom onset to the negative conversion day, was assessed using a generalized linear model. Results: We included 63 patients. The mean positive duration was 20 days. The positive duration was significantly shorter for patients younger than 30 years of age and those between 30 and 60 years of age than for patients older than 60 years of age. We observed a more scattered distribution of the positive duration in older patients than in younger patients. Conclusions: Younger patients who recovered from COVID-19 took less time to clear SARS-CoV-2 than older patients; thus, a classification of the isolation periods based on age could be considered. A uniform viral clearance period for older patients may be difficult to determine because of biases such as underlying medical conditions. Further surveillance measures are recommended to determine the viral clearance time and the optimal isolation period.

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Section: Discussionmentioning

confidence: 88%

Factors associated with viral clearance periods from patients with COVID-19: A retrospective observational cohort study

Hirai

Nishioka

Sekine

et al. 2021

Journal of Infection and Chemotherapy

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“…Sensitivity of ICA markedly decreased over time after symptom onset, particularly in saliva. It is well documented that SARS-CoV-2 tends to persist longer in NPS than in saliva[12, 13]. It is thus reasonable to speculate that lower sensitivity of saliva ICA is due to late sampling rather than the difference in antigen load between saliva and NPS.…”

Section: Discussionmentioning

confidence: 98%

Performance of qualitative and quantitative antigen tests for SARS-CoV-2 in early symptomatic patients using saliva

Yokota

Sakurazawa

Sato

et al. 2020

Preprint

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BackgroundThe rapid detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an urgent need for the prevention and containment of disease outbreaks in communities. Although the gold standard is polymerase chain reaction (PCR), antigen tests such as immunochromatographic assay (ICA) and chemiluminescent enzyme immunoassay (CLEIA) that can yield results within 30 minutes.MethodsWe evaluated performance of ICA and CLEIA using 34 frozen PCR-positive specimens (17 saliva and 17 nasopharyngeal swab) and 307 PCR-negative samples.ResultsICA detected SARS-CoV-2 in only 14 (41%) samples, with positivity of 24% in saliva and 59% in NPS. Notably, ICA detected SARS-CoV-2 in 5 (83%) of 6 samples collected within 4 days after symptom onset. CLEIA detected SARS-CoV-2 in 31 (91%) samples, with positivity of 82% in saliva and 100% in NPS. CLEIA was negative in 3 samples with low viral load by PCR.ConclusionsThese results suggest that use of ICA should be limited to earlier time after symptom onset and CLEIA is more sensitive and can be used in situations where quick results are required.

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“…We excluded COVID-19 patients who showed a significant level of recovery and those who had severe complications. Some of the PCR test data from the patients with COVID-19 included in this manuscript have been presented in our previous papers [19][20][21].…”

Section: Patientsmentioning

confidence: 99%

Proposal of COVID-19 Clinical Risk Score for the management of suspected COVID-19 cases: a case control study

et al. 2020

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Background No clinical scoring system has yet been established to estimate the likelihood of coronavirus disease (COVID-19) and determine the suitability of diagnostic testing in suspected COVID-19 patients. Methods This was a single-center, retrospective, observational study of patients with suspected COVID-19 and confirmed COVID-19. Patient background, clinical course, laboratory and computed tomography (CT) findings, and the presence of alternative diagnoses were evaluated. Clinical risk scores were developed based on clinical differences between patients with and without COVID-19. Results Among 110 patients suspected of having COVID-19, 60.9% underwent polymerase chain reaction (PCR) testing based on the judgment of physicians. Two patients were found to have COVID-19. The clinical characteristics of 108 non-COVID-19 patients were compared with those of 23 confirmed COVID-19 patients. Patients with COVID-19 were more likely to have a history of high-risk exposures and an abnormal sense of taste and smell. The COVID-19 group had significantly higher rates of subnormal white blood cell counts, lower eosinophil counts, and lower procalcitonin levels than the non-COVID-19 group. When blood test results, CT findings, and the presence of alternative diagnoses were scored on an 11-point scale (i.e., “COVID-19 Clinical Risk Score”), the COVID-19 group scored significantly higher than the non-COVID-19 group, more than four points in the COVID-19 group. All non-COVID patients who did not undergo PCR had a score of 4 or less. Conclusions The COVID-19 Clinical Risk Score may enable the risk classification of patients suspected of having COVID-19 and can help in decision-making in clinical practice, including appropriateness of diagnostic testing. Further studies and prospective validation with an increased sample size are required.

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Older age is associated with sustained detection of SARS-CoV-2 in nasopharyngeal swab samples

Cited by 5 publications

References 2 publications

Factors associated with viral clearance periods from patients with COVID-19: A retrospective observational cohort study

Factors associated with viral clearance periods from patients with COVID-19: A retrospective observational cohort study

Performance of qualitative and quantitative antigen tests for SARS-CoV-2 in early symptomatic patients using saliva

Proposal of COVID-19 Clinical Risk Score for the management of suspected COVID-19 cases: a case control study

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