Respiratory Department, Shandong Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China; Respiratory Department, Shandong Provincial Qianfoshan Hospital, Shandong University, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Jinan, China.
Department of Respiratory and Critical Care Medicine, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
Int J Infect Dis. 2021 Mar;104:685-692. doi: 10.1016/j.ijid.2021.01.064. Epub 2021 Feb 1.
Almost a year after the outbreak of coronavirus disease 2019 (COVID-19), many hospitalized COVID-19 patients have recovered. However, little is known about the long-term follow-up (> 2 months) of discharged patients.
This study enrolled 527 discharged COVID-19 patients from 05 February to 11 March 2020. Basic characteristics, imaging features, nucleic acid detection results, and antibody levels of these patients were retrospectively reviewed.
Of the 527 discharged patients, 32 (6.1%) had re-detectable positive (RP) nucleic acid results for SARS-CoV-2 during follow-up examinations, with 11 and four detections entailing stool samples and anal swabs, respectively, rather than respiratory samples. Juveniles were more susceptible to "infection recurrence" than other age groups, with shorter time spans for re-detectable positive (RP) RNA tests (an average of 8.8 days [6.0-9.0 days]), while the reverse was true for the middle-aged group (17.5 days on average [14.0-17.5 days]). Similar improvements in the imaging features of both RP and no RP (NRP) groups were observed. Negative antibody detections in patients at 3 and 6 months after discharge were 14.2% and 25.0%, respectively. Cases evidencing negative antibodies were more common among juvenile patients (40% vs. 15.6%, P=0.03) 6 months post-discharge.
A total of 6.1% of 527 discharged patients showed RP status, which may be easier to be identified from stool samples than from other samples. Given the dropping rate of SARS-CoV-2 antibodies, reinfection may happen, especially in juvenile patients (aged<18 years). These findings have implications for the long-term management of recovered COVID-19 patients.
新冠肺炎(COVID-19)爆发近一年后,许多住院 COVID-19 患者已康复。然而,对于出院患者的长期随访(>2 个月)知之甚少。
本研究纳入了 2020 年 2 月 5 日至 3 月 11 日期间出院的 527 例 COVID-19 患者。回顾性分析了这些患者的基本特征、影像学特征、核酸检测结果和抗体水平。
在 527 例出院患者中,32 例(6.1%)在随访检查中再次检测到 SARS-CoV-2 阳性(RP)核酸结果,其中 11 例和 4 例分别为粪便样本和肛门拭子,而不是呼吸道样本。与其他年龄组相比,青少年更容易发生“感染复发”,再次检测到阳性(RP)RNA 检测的时间间隔更短(平均 8.8 天[6.0-9.0 天]),而中年组则相反(平均 17.5 天[14.0-17.5 天])。RP 和无 RP(NRP)组的影像学特征均有相似的改善。出院后 3 个月和 6 个月时,患者的抗体检测均呈阴性的比例分别为 14.2%和 25.0%。出院后 6 个月时,无抗体的病例在青少年患者中更为常见(40%比 15.6%,P=0.03)。
共有 527 例出院患者中 6.1%的患者出现 RP 状态,从粪便样本中比从其他样本中更容易识别。鉴于 SARS-CoV-2 抗体的下降率,可能会发生再感染,尤其是在青少年患者(<18 岁)中。这些发现对康复 COVID-19 患者的长期管理具有重要意义。