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COVID-19 恢复期患者核酸检测复阳的临床特征。

Clinical features of COVID-19 convalescent patients with re-positive nucleic acid detection.

机构信息

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.

出版信息

J Clin Lab Anal. 2020 Jul;34(7):e23392. doi: 10.1002/jcla.23392. Epub 2020 Jun 7.

Abstract

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

背景

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。

方法

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。

结果

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。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f86/7370737/38a2708daa45/JCLA-34-e23392-g001.jpg

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