Department of Experimental Medical Science, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, China.
Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Zhejiang Province, Ningbo, China.
J Clin Lab Anal. 2020 Jul;34(7):e23392. doi: 10.1002/jcla.23392. Epub 2020 Jun 7.
Coronavirus disease 2019 (COVID-19) is a pandemic that has rapidly spread worldwide. Increasingly, confirmed patients being discharged according to the current diagnosis and treatment protocols, follow-up of convalescent patients is important to knowing about the outcome.
A retrospective study was performed among 98 convalescent patients with COVID-19 in a single medical center. The clinical features of patients during their hospitalization and 2-week postdischarge quarantine were collected.
Among the 98 COVID-19 convalescent patients, 17 (17.3%) were detected positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid during 2-week postdischarge quarantine. The median time from discharge to SARS-CoV-2 nucleic acid re-positive was 4 days (IQR, 3-8.5).The median time from symptoms onset to final respiratory SARS-CoV-2 detection of negative result was significantly longer in re-positive group (34 days [IQR, 29.5-42.5]) than in non-re-positive group (19 days [IQR, 16-26]). On the other hand, the levels of CD3-CD56 + NK cells during hospitalization and 2-week postdischarge were higher in re-positive group than in non-re-positive group (repeated measures ANOVA, P = .018). However, only one case in re-positive group showed exudative lesion recurrence in pulmonary computed tomography (CT) with recurred symptoms.
It is still possible for convalescent patients to show positive for SARS-CoV-2 nucleic acid detection, but most of the re-positive patients showed no deterioration in pulmonary CT findings. Continuous quarantine and close follow-up for convalescent patients are necessary to prevent possible relapse and spread of the disease to some extent.
2019 年冠状病毒病(COVID-19)是一种在全球迅速传播的大流行疾病。越来越多的确诊患者根据目前的诊断和治疗方案出院,对康复患者的随访对于了解其结局很重要。
对单一医疗中心的 98 例 COVID-19 康复患者进行回顾性研究。收集患者住院期间和出院后 2 周隔离期的临床特征。
在 98 例 COVID-19 康复患者中,有 17 例(17.3%)在出院后 2 周隔离期检测到严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)核酸阳性。从出院到 SARS-CoV-2 核酸再次阳性的中位数时间为 4 天(IQR,3-8.5)。再次阳性组从症状出现到最终呼吸道 SARS-CoV-2 检测结果阴性的中位数时间明显长于非再次阳性组(34 天 [IQR,29.5-42.5])比非再阳性组(19 天 [IQR,16-26])。另一方面,再次阳性组患者在住院期间和出院后 2 周的 CD3-CD56+NK 细胞水平高于非再次阳性组(重复测量方差分析,P=0.018)。然而,在再次阳性组中只有 1 例患者的肺部计算机断层扫描(CT)显示渗出性病变复发,并伴有症状复发。
康复患者仍有可能检测到 SARS-CoV-2 核酸阳性,但大多数再次阳性患者的肺部 CT 表现无恶化。对康复患者进行持续隔离和密切随访,在一定程度上可以防止疾病的复发和传播。