Persistent viral RNA positivity during the recovery period of a patient with SARS‐CoV‐2 infection

Yang, Jian; Deng, Dao Ting; Wu, Nan; Yang, Bin; Li, Hong Juan; Pan, Xiao‐Ben

doi:10.1002/jmv.25940

Cited by 80 publications

(77 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In most reports (7 reports including 13 patients) the presence of COVID-19 in urine was detected in patients with moderate to severe disease. However, in three reports the virus has been isolated from urine of patients with mild disease (one neonate, one 7 year-old girl and a 44 year-old man) 21,23,25 .…”

Section: Resultsmentioning

confidence: 99%

Urinary viral shedding of COVID-19 and its clinical associations: A Systematic Review and Meta-analysis of Observational Studies

Kashi

Rosette

Amini

et al. 2020

Preprint

View full text Add to dashboard Cite

Purpose: To investigate the literature on the presence of COVID-19 virus in urine of infected patients and evaluate the attributes and clinical significance of COVID-19 in urine including probability of infection transmission through urine. Data sources: A systematic review of literature from December 2019 to 6 th May 2020 was conducted on Pubmed, google scholar, ovid, scopus and ISI web of science. Study eligibility criteria: Studies which investigated urinary viral shedding of COVID-19 in infected patients were included. Study appraisal and synthesis methods: Two reviewers selected relative studies and performed quality assessment of individual studies. Meta-analysis was performed the pooled case reports and case series. Fixed-effects model was used for analysis as no significant heterogeneity was observed between studies. Results: Thirty three studies were finally included in the systematic review including 12 case reports, 20 case series, and one cohort. Urinary samples from 430 patients were investigated. Ten studies reported the presence of COVID-19 in urinary samples from 16 patients. The rate of COVID-19 presence in urinary samples was 3.7%. Urinary viral load was low in most reports. The presence of virus in urine was not related to the disease course of the illness. Urinary COVID-19 was mostly detected from patients with moderate to severe disease (13 pts) but was also isolated from two children (one neonate and one 7 year-old girl) and one adult with mild disease. The pathogenicity of virus isolated from urine has been demonstrated in cell culture media in one study. Conclusions: This review highlights the low frequency of COVID-19 presence in urine of infected individuals and the potential of isolated virus for cytopathic effects. Therefore the probability of infection transmission through urine can be suggested. Caution must be exerted when dealing with urine of patients infected with COVID-19 including medical interventions like endoscopy and urethral catheterization. : medRxiv preprint ABSTRACT Purpose: To investigate the literature on the presence of COVID-19 virus in urine of infected patients and evaluate the attributes and clinical significance of COVID-19 in urine including probability of infection transmission through urine. Data sources: A systematic review of literature from December 2019 to 6 th May 2020 was conducted on Pubmed, google scholar, ovid, scopus and ISI web of science. Study eligibility criteria: Studies which investigated urinary viral shedding of COVID-19 in infected patients were included. Study appraisal and synthesis methods: Two reviewers selected relative studies and performed quality assessment of individual studies. Meta-analysis was performed the pooled case reports and case series. Fixed-effects model was used for analysis as no significant heterogeneity was observed between studies.Results: Thirty three studies were finally included in the systematic review including 12 case reports, 20 case series, and one cohort. Urinary samples from 430 patients were investigated...

show abstract

Section: Resultsmentioning

confidence: 99%

Urinary viral shedding of COVID-19 and its clinical associations: A Systematic Review and Meta-analysis of Observational Studies

Kashi

Rosette

Amini

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…One study showed 4 cases of healthcare professionals who tested positive after hospital discharge and discontinuation of quarantine, 8 whereas another study described a single-case patient who tested positive 70 days after the onset of COVID-19. 9 However, there is only 1 study indicating the rate of recovered patients testing positive again after the quarantine period. Mei et al 4 documented that 23 of 651 patients (3%) tested positive on a retest for SARS-CoV-2 by RT-PCR assay in a routine health check.…”

Section: Discussionmentioning

confidence: 99%

“…7 Nevertheless, data show that some patients are positive on nasopharyngeal swab after being declared recovered, and thus the appropriate timing of ending COVID-19 quarantine remains undetermined. 8,9 Overall, there is no information about signs and symptoms that can predict a new positive test in patients declared recovered from COVID-19. The fact that some patients could develop a potentially long-lasting viral presence highlights an important point of vigilance for controlling the pandemic both at the individual and collective level.…”

mentioning

confidence: 99%

Predictive Factors for a New Positive Nasopharyngeal Swab Among Patients Recovered From COVID-19

Landi

Carfì

Benvenuto

et al. 2021

American Journal of Preventive Medicine

View full text Add to dashboard Cite

on behalf of Gemelli Against COVID-19 Post-Acute Care Team Introduction: As an emerging infectious disease, the clinical and virologic course of COVID-19 requires better investigation. The aim of this study is to identify the potential risk factors associated with persistent positive nasopharyngeal swab real-time reverse transcription-polymerase chain reaction tests in a large sample of patients who recovered from COVID-19. Methods: After the acute phase of SARS-CoV-2 epidemic infection, the Fondazione Policlinico A. Gemelli IRCSS of Rome established a post-acute care service for patients discharged from the hospital and recovered from COVID-19. Between April 21 and May 21, 2020, a total of 137 individuals who officially recovered from COVID-19 were enrolled in this study. All patients were tested for the SARS-CoV-2 virus with nucleic acid RT-PCR tests. Analysis was conducted in June 2020. Results: Of the 131 patients who repeated the nasopharyngeal swab, 22 patients (16.7%) tested positive again. Some symptoms such as fatigue (51%), dyspnea (44%), and coughing (17%) were still present in a significant percentage of the patients, with no difference between patients with a negative test and those who tested positive. The likelihood of testing positive for SARS-CoV-2 infection was significantly higher among participants with persistent sore throat (prevalence ratio=6.50, 95% CI=1.38, 30.6) and symptoms of rhinitis (prevalence ratio=3.72, 95% CI=1.10, 12.5). Conclusions: This study is the first to provide a given rate of patients (16.7%) who test positive on RT-PCR test for SARS-CoV-2 nucleic acid after recovering from COVID-19. These findings suggest that a significant proportion of patients who have recovered from COVID-19 still could be potential carriers of the virus. In particular, if patients continue to have symptoms related to COVID-19, such as sore throat and rhinitis, it is reasonable to be cautious by avoiding close contact, wearing a face mask, and possibly repeating a nasopharyngeal swab.

show abstract

“…It is interesting to note that, with lower viremia, for the present case, 0.1 ≤ α ≤0.5 copies/ml, virus shedding events occur only when IIR= 0.1. The above provides an explanation for clinical observation related to positive RT-PCR results in patients who have recovered from COVID-19 22,23,24 . Following Li and collaborators 24 , the prolonged shedding of virus from recovered patients is obviously not an isolated phenomenon, but an integral component of the interaction dynamics between SARS-CoV-2 and the immune cells.…”

Section: Resultsmentioning

confidence: 82%

System Dynamics Modeling of Within-Host Viral Kinetics of Coronavirus (SARS CoV-2)

Burgos-Salcedo¹

2020

Preprint

View full text Add to dashboard Cite

Mathematical models are being used extensively in the study of SARS-CoV-2 transmission dynamics, becoming an essential tool for decision making concerning disease control. It is now required to understand the mechanisms involved in the interaction between the virus and the immune response effector cells, both innate and adaptive, in order to support lines of research related to the use of drugs, production of protective antibodies and of course, vaccines against SARS-CoV-2. The present study, using a system dynamic approach, hypothesizes over the conditions that characterize the fraction of the population which get infected by SARS-CoV-2 as the asymptomatic patients, the mild symptomatic, acute symptomatic, and also super-spreaders, in terms of innate immune response, the initial virus load, the virus burden with shedding events, and the cytokine levels.

show abstract

Persistent viral RNA positivity during the recovery period of a patient with SARS‐CoV‐2 infection

Cited by 80 publications

References 13 publications

Urinary viral shedding of COVID-19 and its clinical associations: A Systematic Review and Meta-analysis of Observational Studies

Urinary viral shedding of COVID-19 and its clinical associations: A Systematic Review and Meta-analysis of Observational Studies

Predictive Factors for a New Positive Nasopharyngeal Swab Among Patients Recovered From COVID-19

System Dynamics Modeling of Within-Host Viral Kinetics of Coronavirus (SARS CoV-2)

Contact Info

Product

Resources

About