Post discharge positive re-tests in COVID-19: common but clinically non-significant

Abdullah, Muhammad; Chong, Pui Lin; Asli, Rosmonaliza; Momin, Riamiza Natalie; Mani, Babu Ivan; Metussin, Dhiya; Chong, Vui Heng

doi:10.1080/23744235.2020.1780309

Cited by 10 publications

(7 citation statements)

References 8 publications

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“…Initial findings from earlier studies suggested that reinfection with SARS-CoV-2 was not rare [20][21][22][23], and this was worsened by sensational news reporting. However, a growing understanding of COVID-19 has allayed these initial fears as most of early cases were more likely to be due to either prolonged viral shedding or reactivation of an incompletely cleared virus, that may have been harbored in the nasal cavity, termed repositivity [24][25][26]. While repositive cases may not be as worrying as true reinfections, it is still important to understand how prevalent these cases are, and whether they are infective or not.…”

Section: Introductionmentioning

confidence: 99%

The prevalence of adaptive immunity to COVID-19 and reinfection after recovery – a comprehensive systematic review and meta-analysis

Chivese

Matizanadzo

Musa

et al. 2022

Pathogens and Global Health

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This study aims to estimate the prevalence and longevity of detectable SARS-CoV-2 antibodies and T and B memory cells after recovery. In addition, the prevalence of COVID-19 reinfection and the preventive efficacy of previous infection with SARS-CoV-2 were investigated. A synthesis of existing research was conducted. The Cochrane Library, the China Academic Journals Full Text Database, PubMed, and Scopus, and preprint servers were searched for studies conducted between 1 January 2020 to 1 April 2021. Included studies were assessed for methodological quality and pooled estimates of relevant outcomes were obtained in a meta-analysis using a bias adjusted synthesis method. Proportions were synthesized with the Freeman-Tukey double arcsine transformation and binary outcomes using the odds ratio (OR). Heterogeneity was assessed using the I 2 and Cochran's Q statistics and publication bias was assessed using Doi plots. Fifty-four studies from 18 countries, with around 12,000,000 individuals, followed up to 8 months after recovery, were included. At 6-8 months after recovery, the prevalence of SARS-CoV-2 specific immunological memory remained high; IgG -90.4% (95%CI 72.2-99.9, I 2 = 89.0%), CD4+ -91.7% (95%CI 78.2-97.1y), and memory B cells 80.6% (95%CI 65.0-90.2) and the pooled prevalence of reinfection was 0.2% (95%CI 0.0-0.7, I 2 = 98.8). Individuals previously infected with SARS-CoV-2 had an 81% reduction in odds of a reinfection (OR 0.19, 95% CI 0.1-0.3, I 2 = 90.5%). Around 90% of recovered individuals had evidence of immunological memory to SARS-CoV-2, at 6-8 months after recovery and had a low risk of reinfection.Registration PROSPERO: CRD42020201234

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Section: Introductionmentioning

confidence: 99%

The prevalence of adaptive immunity to COVID-19 and reinfection after recovery – a comprehensive systematic review and meta-analysis

Chivese

Matizanadzo

Musa

et al. 2022

Pathogens and Global Health

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“…A total of 9 706 records were identified from database searches and a final 54 studies (8-12, 16, 17, 24-26, 28-30, 44-84) from 18 countries were included after exclusion of ineligible studies (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

“…Using the Hoy risk of bias tool most of the studies (n=44) (8, 9, 12, 16, 17, 24-26, 30, 52, 54, 55, 58, 60, 61, 63-69, 71-75, 77-83, 87, 88, 90-95) were classified as moderate risk, 7 studies (11, 53, 56, 57, 62, 86, 89) as high risk and three studies (10, 60, 70) as low risk (Supplementary Table 2). The included studies had deficiencies in items related to external validity (Supplementary Table 2).…”

Section: Resultsmentioning

confidence: 99%

“…Initial findings from earlier studies suggested that reinfection with SARS-CoV-2 was not rare (20)(21)(22)(23), and this was worsened by sensational news reporting. However, a growing understanding of COVID-19 has allayed these initial fears as most of early cases were more likely to be due to either prolonged viral shedding or reactivation of an incompletely cleared virus, that may have been harbored in the nasal cavity, termed repositivity (24)(25)(26). While repositive cases may not be as worrying as true reinfections, it is important to understand how prevalent these cases are, and whether they are infective or not.…”

Section: Added Value Of This Studymentioning

confidence: 99%

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The prevalence of adaptive immunity to COVID-19 and reinfection after recovery – a comprehensive systematic review and meta-analysis

Chivese

Matizanadzo

Musa

et al. 2021

Preprint

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Objectives This study aims to estimate the prevalence and longevity of detectable SARS-CoV-2 antibodies as well as T and B memory cells during infection with SARS-CoV-2 and after recovery. In addition, prevalence of COVID-19 reinfection, and the preventive efficacy of previous infection with SARS-CoV-2 were investigated. Methods and analyses A synthesis of existing research was conducted. The Cochrane Library for COVID-19 resources, the China Academic Journals Full Text Database, PubMed, and Scopus as well as preprint servers were searched for studies conducted between 1 January 2020 to 1 April 2021. We included studies with the relevant outcomes of interest. All included studies were assessed for methodological quality and pooled estimates of relevant outcomes were obtained in a meta-analysis using a bias adjusted synthesis method. Proportions were synthesized with the Freeman-Tukey double arcsine transformation and binary outcomes using the odds ratio (OR). Heterogeneity between included studies was assessed using the I2 and Cochrans Q statistics and publication bias was assessed using Doi plots. Results Fifty-four studies, from 18 countries, with a total of 12 011 447 individuals, followed up to 8 months after recovery were included. At 6-8 months after recovery, the prevalence of SARS-CoV-2 specific immunological memory remained high; IgG 90.4% (95%CI 72.2 to 99.9, I2=89.0%, 5 studies), CD4+ 91.7% (95%CI 78.2 to 97.1, one study), and memory B cells 80.6% (95%CI 65.0 to 90.2, one study) and the pooled prevalence of reinfection was 0.2% (95%CI 0.0 to 0.7, I2 = 98.8, 9 studies). Individuals previously infected with SARS-CoV-2 had an 81% reduction in odds of a reinfection (OR 0.19, 95% CI 0.1 to 0.3, I2 = 90.5%, 5 studies). Conclusion Around 90% of people previously infected with SARS-CoV-2 had evidence of immunological memory to SARS-CoV-2, which was sustained for at least 6-8 months after recovery, and had a low risk of reinfection.

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“…COVID-19 patients discharged in China were RT-PCR tested and found to be positive for SARS-CoV-2 again during follow-up care ( China News Weekly, 2020 ; Dou et al, 2020 ; Lan et al, 2020 ; Li et al, 2020a ; Tang et al, 2020 ; Xiao, Tong & Zhang, 2020 ; Xing et al, 2020 ; Zhang et al, 2020 ; Zheng et al, 2020 ). Other countries have also reported patients that were positive when retested ( Abdullah et al, 2020 ; Cento et al, 2020 ; Hartman, Hess & Connor, 2020 ; Zanardini et al, 2020 ). These studies have not shown that patients who retested positively were contagious ( Wang, 2020 ), however, it has created public concern.…”

Section: Introductionmentioning

confidence: 99%

Continued nucleic acid tests for SARS-CoV-2 following discharge of patients with COVID-19 in Lu’an, China

Lyu¹,

Wang

et al. 2021

PeerJ

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Background Studies have shown that discharged Coronavirus disease 2019 (COVID-19) patients have retested positive for SARS-CoV-2 during a follow-up RT-PCR test. We sought to assess the results of continued nucleic acid testing for SARS-CoV-2 patients in COVID-19 patients after they were discharged in Lu’an, China. Methods We conducted RT-PCR tests on sputum, throat swabs, fecal or anal swabs, and urine samples collected from 67 COVID-19 patients following discharge. Samples were collected on the 7th and 14th days following discharge. Patients testing positive on the 7th or 14th day were retested after 24 hours until they tested negative twice. Results Seventeen (17/67, 25.4%) discharged COVID-19 patients had a positive RT-PCR retest for SARS-CoV-2. Among them, 14 (82.4%) were sputum positive, five (29.4%) were throat swab positive, seven (41.2%) were fecal or anal swab positive, one (5.9%) was urine sample positive, five (29.4%) were both sputum and throat swab positive, four (23.5%) were both sputum and fecal test positive, and one (5.9%) was positive of all four specimens. The shortest period of time between discharge and the last positive test was 7 days, the longest was 48 days, and the median was 16 days. The proportion of positive fecal or anal swab tests increased from the third week. The median Cq cut-off values after onset were 26.7 after the first week, 37.7 the second to sixth week, and 40 after the sixth week. There were no significant differences between the RT-PCR retest positive group and the unrecovered positive group. Conclusions There was a high proportion of patients who retested positive for COVID-19. Discharge criteria have remained fairly consistent so we encourage regions affected by COVID-19 to appropriately amend their current criteria.

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Post discharge positive re-tests in COVID-19: common but clinically non-significant

Cited by 10 publications

References 8 publications

The prevalence of adaptive immunity to COVID-19 and reinfection after recovery – a comprehensive systematic review and meta-analysis

The prevalence of adaptive immunity to COVID-19 and reinfection after recovery – a comprehensive systematic review and meta-analysis

The prevalence of adaptive immunity to COVID-19 and reinfection after recovery – a comprehensive systematic review and meta-analysis

Continued nucleic acid tests for SARS-CoV-2 following discharge of patients with COVID-19 in Lu’an, China

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