Risk and predictive factors of prolonged viral RNA shedding in upper respiratory specimens in a large cohort of COVID-19 patients admitted to an Italian reference hospital

Mondi, Annalisa; Lorenzini, Patrizia; Castilletti, Concetta; Gagliardini, Roberta; Lalle, Eleonora; Corpolongo, Angela; Valli, Maria Beatrice; Taglietti, Fabrizio; Cicalini, Stefania; Loiacono, Laura; Gennaro, Francesco Di; D’Offizi, Gianpiero; Palmieri, Fabrizio; Nicastri, Emanuele; Agrati, Chiara; Petrosillo, Nicola; Ippolito, Giuseppe; Vaia, Francesco; Girardi, Enrico; Capobianchi, Maria Rosaria; Antinori, Andrea; Zito, Sara; Abbonizio, Maria Alessandra; Abdeddaim, Amina; Agostini, Elisabetta; Albarello, Fabrizio; Amadei, Gioia; Amendola, Alessandra; Antonica, Maria Assunta; Antonini, Mario; Bartoli, Tommaso Ascoli; Baldini, Francesco; Barbaro, Raffaella; Bartolini, Barbara; Bellagamba, Rita; Benigni, Martina; Bevilacqua, Nazario; Biava, G; Bibas, Michele; Bordi, Licia; Bordoni, Veronica; Boumis, Evangelo; Branca, Marta; Buonomo, Rosanna; Busso, Donatella; Camici, Marta; Campioni, Paolo; Canichella, Flaminia; Capone, Alessandro; Caporale, Cinzia; Caraffa, Emanuela; Caravella, Ilaria; Carletti, Fabrizio; Cataldo, Adriana; Cerilli, Stefano; Cerva, Carlotta; Chiappini, Roberta; Chinello, Pierangelo; Cianfarani, Maria Assunta; Ciaralli, Carmine; Cimaglia, Claudia; Cinicola, Nicola; Ciotti, Veronica; Colavita, Francesca; Cristofaro, Massimo; Curiale, Salvatore; D’Abramo, Alessandra; Dantimi, Cristina; Angelis, Alessia De; Angelis, Giada De; Palo, Maria Grazia De; Zottis, Federico De; Bari, Virginia Di; Lorenzo, Rachele Di; Stefano, Federica Di; Donno, Davide Roberto; Evangelista, Francesca; Faraglia, Francesca; Farina, Anna; Ferraro, Federica; Fiorentini, Lorena; Frustaci, Andrea; Fusetti, Matteo; Galati, Vincenzo; Galli, P.; Garotto, Gabriele; Gaviano, Ilaria; Teklè, Saba Gebremeskel; Giancola, Maria Letizia; Giansante, Filippo; Giombini, Emanuela; Granata, Guido; Greci, Maria Cristina; Grilli, Elisabetta; Grisetti, Susanna; Gualano, Gina; Iacomi, Fabio; Iaconi, Marta; Iannicelli, G.; Inversi, Carlo; Lamanna, Maria; Lanini, Simone; Lapa, Daniele; Lepore, Luciana; Libertone, Raffaella; Lionetti, Raffaella; Liuzzi, Giuseppina; Lúcia, Andréa; Lufrani, Franco; Macchione, Manuela; Maffongelli, Gaetano; Marani, Alessandra; Marchioni, Luisa; Mariano, Andrea; Marini, Maria Cristina; Maritti, Micaela; Mastrobattista, Annelisa; Mastrorosa, Ilaria; Matusali, Giulia; Mazzotta, Valentina; Mencarini, Paola; Meschi, Silvia; Messina, Francesco; Micarelli, Sibiana; Mogavero, Giulia; Montalbano, Marzia; Montaldo, Chiara; Mosti, Silvia; Murachelli, Silvia; Musso, Maria; Nardi, Michela; Navarra, Assunta; Nocioni, Martina; Noto, Pasquale; Noto, Roberto; Oliva, Alessandra; Onnis, Ilaria; Ottou, Sandrine; Palazzolo, Claudia; Pallini, Emanuele; Palombi, Giulio; Pareo, Carlo; Passeri, Virgilio; Pelliccioni, Federico; Penna, Giovanna; Petrecchia, Antonella; Petrone, Ada; Pianura, Elisa; Pinnetti, Carmela; Pisciotta, Maria; Piselli, Pierluca; Pittalis, Silvia; Pontarelli, Agostina; Proietti, Costanza; Puro, Vincenzo; Ramazzini, Paolo Migliorisi; Rianda, Alessia; Rinonapoli, Gabriele; Rosati, Silvia; Rubino, Dorotea; Rueca, Martina; Ruggeri, Alberto; Sacchi, Alessandra; Sampaolesi, Alessandro; Sanasi, Francesco; Santagata, Carmen; Scarabello, Alessandra; Scarcia, Silvana; Schininà, Vincenzo; Scognamiglio, Paola; Scorzolini, Laura; Stazi, Giulia; Strano, Giacomo; Taibi, Chiara; Taloni, Giorgia; Tetaj, Nardi; Tonnarini, Roberto; Topino, Simone; Tozzi, Martina; Vairo, Francesco; Vergori, Alessandra; Vincenzi, Laura; Visco-Comandini, Ubaldo; Vita, Serena; Vittozzi, Pietro; Zaccarelli, Mauro; Zanetti, Antonella

doi:10.1016/j.ijid.2021.02.117

Cited by 23 publications

(20 citation statements)

References 29 publications

(54 reference statements)

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“…In our cohort, patients with the longest viral shedding duration were 42 days. The range of duration SARS-CoV-2 RNA viral shedding was consistent with other studies, which ranged between 11 and 31 days [ 10 ].…”

Section: Discussionsupporting

confidence: 89%

Influence of Fasting Plasma Glucose Level on Admission of COVID-19 Patients: A Retrospective Study

Zhao

Xing

2022

Journal of Diabetes Research

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Background. The coronavirus disease 2019 (COVID-19) is a serious global health threat and has spread dramatically worldwide. Prolonged viral shedding is associated with a more severe disease course and inflammatory reaction. Blood glucose levels were significantly associated with an increased hazard ratio (HR) for poor outcomes in COVID-19 patients. Objective. Previous studies focused primarily on the relationship between blood glucose and mortality or severe outcomes, but there were few research studies on the relationship between fasting plasma glucose (FPG) and duration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA positive status. To explore the relationship between FPG levels and prolonged duration of SARS-CoV-2 viral positivity, the clinical data of COVID-19 patients were analyzed. Method. In this retrospective study, 99 cases of COVID-19 patients in Beijing Ditan Hospital were recruited, and their clinical and laboratory findings at admission were collected and analyzed. Furthermore, the risk factors for prolonged duration of SARS-CoV-2 RNA shedding were identified, and the relationship between FPG levels and the prolonged presence of SARS-CoV-2 RNA was evaluated. Result. We found that elevated FPG levels were correlated with longer duration of SARS-CoV-2 RNA positivity, classification of COVID-19, imaging changes of chest CT, inflammation-related biomarkers, and CD8+ T cell number in COVID-19 patients. In a logistic regression model, after adjusting for gender and age, COVID-19 patients with elevated FPG were more likely to had longer duration of SARS-CoV-2 RNA positivity than those with normal FPG levels (OR 3.053 [95% CI 1.343, 6.936]). Conclusion. Higher FPG levels (≥6.1 mmol/l) at admission was an independent predictor for prolonged SARS-CoV-2 shedding, regardless of a known history of diabetes. It suggests that intensive monitoring and control of blood glucose are important for all COVID-19 patients.

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Section: Discussionsupporting

confidence: 89%

Influence of Fasting Plasma Glucose Level on Admission of COVID-19 Patients: A Retrospective Study

Zhao

Xing

2022

Journal of Diabetes Research

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“…Hospital admission could be facilitated early, particularly in regions of the world experiencing a reduction in COVID-19 infections because of successful vaccination campaigns. 73…”

Section: Assessing Risk For Covid-19 Severity In Cvidmentioning

confidence: 99%

Common Variable Immunodeficiency Disorders, T-Cell Responses to SARS-CoV-2 Vaccines, and the Risk of Chronic COVID-19

Ameratunga

Longhurst

Steele

et al. 2021

The Journal of Allergy and Clinical Immunology: In Practice

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COVID-19 has had a calamitous effect on the global community. In spite of intense study, the immunological response to the infection is only partially understood. In addition to older age and ethnicity, patients with co-morbidities including obesity, diabetes, hypertension, coronary artery disease, malignancy, renal and pulmonary disease, may experience severe outcomes. Some patients with primary and secondary immunodeficiencies also appear to be at increased risk from COVID-19. In addition to their vulnerability to SARS-CoV-2, patients with primary immunodeficiencies (PIDs) often suffer from chronic pulmonary disease and may not respond to vaccines, exacerbating their long-term risks. Patients with Common Variable Immunodeficiency disorders (CVID), the most frequent symptomatic PID in adults and children, have a spectrum of B and T cell defects. It may be possible to stratify their risk of severe COVID-19 based on age, ethnicity, the severity of their T cell defect as well as the presence of other co-morbidities. Patients with CVID and other immunodeficiencies are at risk of chronic COVID-19, a dangerous stalemate between a suboptimal immune response and SARS-CoV-2. Intra-host viral evolution could result in the rapid emergence of vaccine resistant mutants and is a public health emergency. Vaccination and prevention of Chronic COVID-19 in immunodeficient patients is therefore of the highest priority. Having a reliable diagnostic assay for T cell immunity to SARS-CoV-2 is critical for evaluating responses to vaccines in these patients. New treatments such as NZACE2-Pātari for COVID-19, are likely to be of particular benefit to immunodeficient patients, especially those who fail to mount a robust T cell response to vaccines.

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“…[62] Testing at presentation of symptoms should be performed in all HM patients regardless of their current disease status and therapy. Following several reports on prolonged viral shedding especially in patients with severe course of the disease and those with low numbers of B cells, [63][64][65] it should be considered to perform follow-up tests until negative results are confirmed before the admission to the Care Units.…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

Managing hematological cancer patients during the COVID-19 pandemic: an ESMO-EHA Interdisciplinary Expert Consensus

et al. 2022

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Risk and predictive factors of prolonged viral RNA shedding in upper respiratory specimens in a large cohort of COVID-19 patients admitted to an Italian reference hospital

Cited by 23 publications

References 29 publications

Influence of Fasting Plasma Glucose Level on Admission of COVID-19 Patients: A Retrospective Study

Influence of Fasting Plasma Glucose Level on Admission of COVID-19 Patients: A Retrospective Study

Common Variable Immunodeficiency Disorders, T-Cell Responses to SARS-CoV-2 Vaccines, and the Risk of Chronic COVID-19

Managing hematological cancer patients during the COVID-19 pandemic: an ESMO-EHA Interdisciplinary Expert Consensus

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