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再住院 COVID-19 患者再次出现 SARS-CoV-2 RNA 阳性的临床特征:一项回顾性研究。

Clinical characteristics of re-hospitalized COVID-19 patients with recurrent positive SARS-CoV-2 RNA: a retrospective study.

机构信息

Department of Respiratory and Critical Care Medicine, Binzhou Medical University Hospital, Binzhou, China.

Department of Respiratory Medicine, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Medical College of PLA, Chinese PLA General Hospital, Beijing, China.

出版信息

Eur J Clin Microbiol Infect Dis. 2021 Jun;40(6):1245-1252. doi: 10.1007/s10096-020-04151-9. Epub 2021 Jan 15.

Abstract

At present, it has been noticed that some patients recovered from COVID-19 present a recurrent positive RNA test of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) after being discharged from hospitals. The purpose of the current study was to characterize the clinical features of re-hospitalized patients with recurrent SARS-CoV-2 positive results. From January 12 to April 1 of 2020, our retrospective study was conducted in China. The exposure history, baseline data, laboratory findings, therapeutic schedule, and clinical endpoints of the patients were collected. All the patients were followed until April 10, 2020. Among all COVID-19 patients included in the current study, there were 14 re-hospitalized patients due to recurrent positive tests of SARS-CoV-2 RNA. Fever (11 [78.6%]), cough (10 [71.4%]), and fatigue (7 [50.0%]) were the most common symptoms on the patient's first admission, and less symptoms were found on their second admission. The average duration from the onset of symptoms to admission to hospital was found to be 8.4 days for the first admission and 2.6 days for the second admission (P = 0.002). The average time from the detection of RNA (+) to hospitalization was 1.9 days for the first admission and 2.6 days for the second admission (P = 0.479), and the average time from RNA (+) to RNA (-) was 11.1 days for the first admission and 6.3 days for the second admission (P = 0.030). Moreover, the total time in hospital was 18.6 days for the first admission and 8.0 days for the second admission (P = 0.000). It may be necessary to increase the isolation observation time and RT-PCR tests should be timely performed on multiple samples as soon as possible.

摘要

目前,已经注意到一些从 COVID-19 中康复的患者在出院后出现了 SARS-CoV-2(严重急性呼吸综合征冠状病毒 2)的 RNA 持续阳性检测。本研究的目的是描述再入院的 SARS-CoV-2 阳性结果患者的临床特征。本回顾性研究于 2020 年 1 月 12 日至 4 月 1 日在中国进行。收集了患者的暴露史、基线数据、实验室检查结果、治疗方案和临床终点。所有患者均随访至 2020 年 4 月 10 日。在本研究纳入的所有 COVID-19 患者中,有 14 例因 SARS-CoV-2 RNA 持续阳性而复诊。首次入院时,最常见的症状是发热(11 例[78.6%])、咳嗽(10 例[71.4%])和乏力(7 例[50.0%]),第二次入院时症状较少。首次入院的症状到入院时间平均为 8.4 天,第二次入院为 2.6 天(P=0.002)。首次入院时从 RNA(+)到入院的平均时间为 1.9 天,第二次入院为 2.6 天(P=0.479),首次入院时从 RNA(+)到 RNA(-)的平均时间为 11.1 天,第二次入院为 6.3 天(P=0.030)。此外,首次入院的住院总时间为 18.6 天,第二次入院为 8.0 天(P=0.000)。可能需要增加隔离观察时间,并尽快对多个样本进行 RT-PCR 检测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6dc/7808928/d9bf277baca5/10096_2020_4151_Fig1_HTML.jpg

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