Repeat testing for SARS‐CoV‐2: persistence of viral RNA is common, and clearance is slower in older people

Stehlik, Paulina; Alcorn, Kylie; Jones, Anna; Schlebusch, Sanmarié; Wattiaux, Andre; Henry, David

doi:10.5694/mja2.51036

Cited by 6 publications

(6 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Multiple factors have been found to associate with prolonged viral RNA shedding in previous studies, such as old age [22] , compromised immune status [23] , treatment with corticosteroids [24] , [25] , [26] and disease severity [27] , [28] . Meanwhile, biological sex and comorbidities, such as hypertension and diabetes, were found not to associate with the viral RNA shedding [29] , [30] , [31] . Unlike most previous works, our current study investigated the impacts of vaccination status and multiple laboratory variables during early infection on the duration of viral RNA shedding.…”

Section: Discussionmentioning

confidence: 85%

The impacts of vaccination status and host factors during early infection on SARS-CoV-2 persistence: a retrospective single-center cohort study

Tian

Zhang

Wang

et al. 2023

International Immunopharmacology

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 85%

The impacts of vaccination status and host factors during early infection on SARS-CoV-2 persistence: a retrospective single-center cohort study

Tian

Zhang

Wang

et al. 2023

International Immunopharmacology

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 91%

“…Multiple factors have been found to associate with prolonged viral RNA shedding in previous studies, such as old age (19), compromised immune status (20), treatment with corticosteroids (21-23) and disease severity (24, 25). Meanwhile, biological sex and comorbidities, such as hypertension and diabetes, were found not to associate with the viral RNA shedding (26-28). Unlike most previous works, our current study investigated the impacts of vaccination status and multiple laboratory variables in early infection on the duration of viral RNA shedding.…”

Section: Discussionmentioning

confidence: 92%

Comprehensive analyses reveal the impacts of vaccination status and physiological variables in early infection on viral persistence in COVID-19 patients: a retrospective single-center cohort study

Tian

Zhang

Wang

et al. 2022

Preprint

View full text Add to dashboard Cite

BACKGROUNDViral persistence is a crucial factor that influences the communicability of SARS-CoV-2 infection. However, the impacts of vaccination status and physiological variables on viral RNA shedding have not been adequately clarified.METHODSIn this study, we retrospectively collected the clinical records of 377 hospitalized COVID-19 patients, which contained unvaccinated patients and patients received two doses of an inactivated vaccine or an mRNA vaccine. Firstly, we analyzed the impacts of vaccination on disease severity and viral RNA persistence. Next, to clarify the impacts of physiological variables on viral RNA shedding in COVID-19 patients, we retrieved 49 laboratory variables and analyzed their correlations with the duration of viral RNA shedding. Finally, we established a multivariate regression model to predict the duration of viral RNA shedding.RESULTSOur results showed that both inactivated and mRNA vaccines significantly reduced the rate of moderate cases, while the vaccine related shortening of viral RNA shedding were only observed in moderate patients. Correlation analysis showed that 10 significant laboratory variables were shared by the unvaccinated mild patients and mild patients inoculated with an inactivated vaccine, but not by the mild patients inoculated with an mRNA vaccine. Moreover, we demonstrated that a multivariate regression model established based on the variables correlating with viral persistence in unvaccinated mild patients could predict the duration of viral shedding for all groups of patients.CONCLUSIONSVaccination contributed limitedly to the clearance viral RNA in COVID-19 patients. While, laboratory variables in early infection could predict the persistence of viral RNA.

show abstract

“…This is consistent with previous studies that identified older age and disease severity as risk factors for delayed VC. [25][26][27][28] Zou et al 29 showed that the viral RNA shedding pattern of patients with COVID-19 was similar to that of patients with influenza, whereby nasopharyngeal viral clearance was delayed in patients at advanced ages and with more severe forms of disease. In addition, older patients are more often affected by comorbidities.…”

Section: Discussionmentioning

confidence: 99%

“…Of these 490 patients, 54.7% achieved VC during hospitalization, while the remaining 45.3% reached VC during the post-discharge follow-up period. Median time to VC was 25 (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34) days.…”

Section: Sars-cov-2 Clearancementioning

confidence: 99%

505. Impact of Remdesivir on SARS-CoV-2 Clearance in a Real-Life Setting: A Matched-Cohort Study

Spagnuolo

Voarino

Tonelli

et al. 2021

Open Forum Infectious Diseases

View full text Add to dashboard Cite

Background Evidence regarding the impact of remdesivir (RDV) on SARS-CoV-2 viral clearance (VC) is scarce. Aim of this study was to compare VC timing in COVID-19 patients who received RDV with those who did not. Methods Matched-cohort study conducted (25 February 2020-15 April 2021) at the IRCSS San Raffaele, Milan, Italy. The study enrolled hospitalized patients with pneumonia and a SARS-CoV-2 positive nasopharyngeal swab (NPS) at admission and at least one NPS during follow-up. Follow-up started at hospital admission and ended at the date of the first negative NPS (within 30 days after discharge). Patients who received RDV (cases) and patients who did not (controls) were matched based on age (±5 years), sex and PaO2/FiO2 (P/F; ±10 mmHg) values at admission. NPS were analyzed with RT-PCR. Results described as median (IQR) or frequency (%). Time to VC was estimated with Kaplan-Meier curve and compared with log-rank test. Results 648 patients were enrolled: 216 cases and 432 controls. Patients’ characteristics at admission are reported in Table 1. VC was observed in 490 patients (75.6%) in a median time of 25 (16-34) days. Overall, time to VC was similar in patients receiving or not receiving remdesivir (p=0.519). However, time to VC was different when considering both the use of RDV (yes vs no) and age (≤ or > 63 years), as shown in Figure 1A. A significant finding was also observed considering the use of RDV and P/F values at admission (≤ or > 200 mmHg), as reported in Figure 1B. Among the 490 patients who reached VC during follow-up, overall time to VC was similar in patients receiving or not receiving RDV (p=0.075; Figure 2A); however, RDV use was associated with a higher probability of VC in the subgroup of patients with P/F admission values ≤ 200mmHg (p=0.035; Figure 2B), in the age group 55-65 years (p=0.025; Figure 2C) and in patients with comorbidities (p=0.028). Time to viral clearance among the 490 patients who reached VC during follow-up. Panel A: time to VC according to RDV use. Panel B: time to VC according to RDV and P/F ratio value at admission. Panel C: time to VC according to RDV in the age group 55-65 years. Conclusion Time to viral clearance was similar in patients receiving or not receiving remdesivir; however the use of RDV was associated with a benefit on time to viral clearance in younger patients and in those with a P/F ratio at admission ≤200 mmHg. Disclosures Vincenzo Spagnuolo, MD, ViiV Healthcare (Other Financial or Material Support, Preparation of educational material) Antonella Castagna, MD, Gilead Sciences (Other Financial or Material Support, Speaking fee)Jansenn-Cilag (Other Financial or Material Support, Speaking fee)MSD (Other Financial or Material Support, Speaking fee)Theratechnologies (Other Financial or Material Support, Speaking fee)ViiV Healthcare (Other Financial or Material Support, Speaking fee)

show abstract

Repeat testing for SARS‐CoV‐2: persistence of viral RNA is common, and clearance is slower in older people

Cited by 6 publications

References 7 publications

The impacts of vaccination status and host factors during early infection on SARS-CoV-2 persistence: a retrospective single-center cohort study

The impacts of vaccination status and host factors during early infection on SARS-CoV-2 persistence: a retrospective single-center cohort study

Comprehensive analyses reveal the impacts of vaccination status and physiological variables in early infection on viral persistence in COVID-19 patients: a retrospective single-center cohort study

505. Impact of Remdesivir on SARS-CoV-2 Clearance in a Real-Life Setting: A Matched-Cohort Study

Contact Info

Product

Resources

About