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.
Int Immunopharmacol. 2021 Jun;95:107579. doi: 10.1016/j.intimp.2021.107579. Epub 2021 Mar 12.
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.
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.
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.
Longer viral shedding duration and lower IgG levels are risk factors for re-positivity of SARS-CoV-2 for discharged COVID-19 patients.
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。
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。
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。
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。
