Ren Xiangying, Ren Xiangge, Lou Jiaao, Wang Yongbo, Huang Qiao, Shi Yuexian, Deng Yuqing, Li Xiaoyan, Lu Liye, Yan Siyu, Wang Yunyun, Luo Lisha, Zeng Xiantao, Yao Xiaomei, Jin Yinghui
Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.
College of Nursing and Health, Henan University, Kaifeng, Henan, China.
EClinicalMedicine. 2021 Apr;34:100839. doi: 10.1016/j.eclinm.2021.100839. Epub 2021 Apr 17.
With the increased number of patients discharged after having COVID-19, more and more studies have reported cases whose retesting was positive (RP) during the convalescent period, which brings a new public health challenge to the world.
We searched PubMed, Web of Science, The Cochrane Library, CNKI, WanFang and VIP from December 1, 2019 to December 31, 2020. The included studies were assessed using JBI critical appraisal tools and Newcastle-Ottawa Scale. The RP rate of discharge patients was analyzed by a meta-analysis. We adhered to PRISMA reporting guideline.
We have included 117 studies with 2669 RP participants after discharge. The methodological quality of 66 case reports were low to high, 42 case series and 3 cohort study were moderate to high, 3 case-control studies were moderate and 3 cross-sectional studies were low to moderate. The clinical manifestations of most RP patients were mild or asymptomatic, and CT imaging and laboratory examinations were usually normal. The existing risk factors suggest that more attention should be paid to sever patients, elderly patients, and patients with co-morbidities. The summary RP rate was 12·2% (95% CI 10·6-13·7) with high heterogeneity ( = 85%).
To date, the causes and risk factors of RP result in discharged patients are not fully understood. High-quality etiological and clinical studies are needed to investigate these issues to further help us to make strategies to control and prevent its occurrence.
随着新冠病毒病（COVID-19）康复出院患者数量的增加，越来越多的研究报告了康复期复测呈阳性（RP）的病例，这给全球带来了新的公共卫生挑战。
我们检索了2019年12月1日至2020年12月31日期间的PubMed、Web of Science、Cochrane图书馆、中国知网、万方数据和维普资讯。采用JBI批判性评价工具和纽卡斯尔-渥太华量表对纳入的研究进行评估。通过荟萃分析分析出院患者的RP率。我们遵循PRISMA报告指南。
我们纳入了117项研究，其中有2669名出院后RP参与者。66篇病例报告的方法学质量从低到高，42篇病例系列和3项队列研究为中到高，3项病例对照研究为中等，3项横断面研究为低到中等。大多数RP患者的临床表现为轻度或无症状，CT成像和实验室检查通常正常。现有的风险因素表明，应更多关注重症患者、老年患者和合并症患者。汇总的RP率为12.2%（95%CI 10.6-13.7），异质性高（I² = 85%）。
迄今为止，出院患者RP结果的原因和风险因素尚未完全明确。需要高质量的病因学和临床研究来调查这些问题，以进一步帮助我们制定控制和预防其发生的策略。
