住院的 SARS-CoV-2 感染患者病毒 RNA 持续脱落的决定因素。
Determinants of prolonged viral RNA shedding in hospitalized patients with SARS-CoV-2 infection.
机构信息
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
出版信息
Diagn Microbiol Infect Dis. 2021 Jun;100(2):115347. doi: 10.1016/j.diagmicrobio.2021.115347. Epub 2021 Feb 12.
OBJECTIVE
To evaluate determinants of prolonged viral RNA shedding in hospitalized patients with SARS-CoV-2 infection.
MATERIALS AND METHODS
Hospitalized patients with SARS-CoV-2 positive nasopharyngeal RT-PCR were included in a single-center, retrospective study. Patients were divided in 2 groups according to the timing of viral clearance [≤14 days, "early clearance (EC)" and >14 days, "late clearance (LC)"].
RESULTS
179 patients were included in the study (101 EC, 78 LC), with median age 62 years. Median time of viral shedding was 14 days (EC/LC 10 and 19 days, respectively, P < 0.0001). Univariate analyses showed that age, male gender, receiving corticosteroids, receiving tocilizumab, ICU admission, low albumin and NLR ratio were associated with late viral clearance. In the multivariable analysis, older age (P = 0.016), albumin level (P = 0.048), corticosteroids (P = 0.021), and tocilizumab (P = 0.015) were significantly associated with late viral clearance.
CONCLUSIONS
Age, albumin, tocilizumab and corticosteroid treatment were independently associated with a prolonged SARS-CoV-2 RNA shedding.
目的
评估住院 SARS-CoV-2 感染患者病毒 RNA 延长脱落的决定因素。
材料和方法
纳入了一项单中心、回顾性研究中的 SARS-CoV-2 鼻咽 RT-PCR 阳性的住院患者。根据病毒清除的时间（≤14 天，“早期清除（EC）”和>14 天，“晚期清除（LC）”）将患者分为两组。
结果
研究纳入了 179 例患者（101 例 EC，78 例 LC），中位年龄为 62 岁。病毒脱落的中位时间为 14 天（EC/LC 分别为 10 天和 19 天，P < 0.0001）。单因素分析显示，年龄、男性、使用皮质类固醇、使用托珠单抗、入住 ICU、低白蛋白和 NLR 比值与晚期病毒清除有关。多变量分析显示，年龄较大（P = 0.016）、白蛋白水平较低（P = 0.048）、皮质类固醇（P = 0.021）和托珠单抗（P = 0.015）与晚期病毒清除显著相关。
结论
年龄、白蛋白、托珠单抗和皮质类固醇治疗与 SARS-CoV-2 RNA 延长脱落独立相关。
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