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新冠肺炎患者出院后新冠病毒再次阳性的风险因素。

Risk factors for SARS-CoV-2 re-positivity in COVID-19 patients after discharge.

机构信息

Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province, Luqiao, Zhejiang 318050, China.

Department of Pediatrics, Taizhou Hospital of Zhejiang Province, Luqiao, Zhejiang 318050, China.

出版信息

Int Immunopharmacol. 2021 Jun;95:107579. doi: 10.1016/j.intimp.2021.107579. Epub 2021 Mar 12.

Abstract

OBJECTIVE

Re-positivity of SARS-CoV-2 in discharged COVID-19 patients have been reported; however, early risk factors for SARS-CoV-2 re-positivity evaluation are limited.

METHODS

This is a prospective study, a total of 145 COVID-19 patients were treated and all discharged according to the guideline criteria by Mar 11th 2020. After discharge, clinical visits and viral RT-PCR tests by the second and fourth week follow-up were carried-out. Patient demographic and clinical characteristics and laboratory data on admission and discharge were retrieved, and predictive factors for SARS-CoV-2 re-positivity were analyzed.

RESULTS

13 out of 145 (9.0%) COVID-19 patients were confirmed re-positivity of SARS-CoV-2 by RT-PCR test. The median interval between disease onset to recurrence was 38 days. SARS-CoV-2 re-positive cases were of significantly longer virus shedding duration, notably higher body temperature, heart rate and lower TNF-α and IgG levels on admission. Covariate logistic regression analysis revealed virus shedding duration and IgG levels are independent risk factors for SARS-CoV-2 return positive after discharge.

CONCLUSION

Longer viral shedding duration and lower IgG levels are risk factors for re-positivity of SARS-CoV-2 for discharged COVID-19 patients.

摘要

目的

已报道出院的 COVID-19 患者中 SARS-CoV-2 的再阳性;然而,SARS-CoV-2 再阳性评估的早期危险因素有限。

方法

这是一项前瞻性研究,共有 145 例 COVID-19 患者于 2020 年 3 月 11 日按照指南标准进行治疗和出院。出院后,进行第二次和第四次随访的临床就诊和病毒 RT-PCR 检测。检索患者的人口统计学和临床特征以及入院和出院时的实验室数据,并分析 SARS-CoV-2 再阳性的预测因素。

结果

145 例 COVID-19 患者中,有 13 例(9.0%)通过 RT-PCR 检测证实 SARS-CoV-2 再阳性。从发病到复发的中位间隔时间为 38 天。SARS-CoV-2 再阳性病例的病毒脱落持续时间明显更长,入院时体温、心率显著更高,TNF-α和 IgG 水平显著更低。协变量逻辑回归分析显示,病毒脱落持续时间和 IgG 水平是出院后 SARS-CoV-2 再次阳性的独立危险因素。

结论

较长的病毒脱落持续时间和较低的 IgG 水平是出院 COVID-19 患者 SARS-CoV-2 再阳性的危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfa2/7953440/3e32fd6d5a57/gr1_lrg.jpg

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