Zang Xin, Xiong Liangkun, Zhu Junyao, Zhao Fangfang, Wang Shihong, Zeng Wenhui, Yu Kaihuan, Zhai Yongzhen
Department of Infectious Disease, Shengjing Hospital of China Medical University, Shenyang, China.
Department of Hepatobiliary Surgery, Renmin Hospital of Wuhan University, Wuhan, China.
Front Med (Lausanne). 2022 Apr 28;9:826900. doi: 10.3389/fmed.2022.826900. eCollection 2022.
The outbreak of coronavirus disease (COVID-19) poses a great threat to global public health. At present, the number of newly confirmed COVID-19 cases and deaths is increasing worldwide. The strategy of comprehensive and scientific detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) through quantitative real-time polymerase chain reaction (qRT-PCR) for special populations and environments provides great support for the prevention and control of this pandemic in China. Our study focused on determining the factors associated with the length of time from symptom onset to the first positive nucleic acid test of throat swabs in COVID-19 patients, evaluating the effect of early positive nucleic acid detection on the disease severity and its significance in prognosis, and predicting the factors associated with the time from positive SARS-CoV-2 RNA test to negative conversion (negative conversion of SARS-CoV-2 virus) in COVID-19 patients.
This study included 116 hospitalized patients with COVID-19 from January 30, 2020 to March 4, 2020 in Wuhan, China. Throat swab samples were collected for qRT-PCR testing of SARS-CoV-2 RNA, and all patients included in this study were positive for this test.
The multivariate Cox proportional hazards model showed that disease severity (HR = 0.572; 95% CI 0.348-0.942; = 0.028) was a protective factor for the time from symptom onset to positive nucleic acid detection. Meanwhile, the time from symptom onset to positive nucleic acid detection (HR = 1.010; 95% CI 1.005-1.020; = 0.0282) was an independent risk factor for the delay in negative conversion time of SARS-CoV-2 virus. However, the severity of the disease (HR=1.120; 95% CI 0.771-1.640; = 0.544) had no correlation with the negative conversion time of SARS-CoV-2 virus.
Patients with more severe disease had a shorter time from symptom onset to a positive nucleic acid test. Prolonged time from symptom onset to positive nucleic acid test was an independent risk factor for the delay in negative conversion time of SARS-CoV-2 virus, and the severity of the disease had no correlation with negative conversion time of SARS-CoV-2 virus.
冠状病毒病（COVID-19）的爆发对全球公共卫生构成了巨大威胁。目前，全球范围内COVID-19新确诊病例数和死亡人数都在增加。通过定量实时聚合酶链反应（qRT-PCR）对特殊人群和环境进行全面、科学的严重急性呼吸综合征冠状病毒2（SARS-CoV-2）检测策略，为中国防控这一疫情提供了有力支持。我们的研究重点在于确定COVID-19患者从症状出现到首次咽拭子核酸检测呈阳性的时间长度相关因素，评估早期核酸检测阳性对疾病严重程度的影响及其在预后中的意义，以及预测COVID-19患者从SARS-CoV-2 RNA检测阳性到转阴（SARS-CoV-2病毒转阴）的时间相关因素。
本研究纳入了2020年1月30日至2020年3月4日在中国武汉住院的116例COVID-19患者。采集咽拭子样本进行SARS-CoV-2 RNA的qRT-PCR检测，本研究纳入的所有患者该检测均呈阳性。
多因素Cox比例风险模型显示，疾病严重程度（HR = 0.572；95%CI 0.348 - 0.942；P = 0.028）是从症状出现到核酸检测呈阳性时间的保护因素。同时，从症状出现到核酸检测呈阳性的时间（HR = 1.010；95%CI 1.005 - 1.020；P = 0.0282）是SARS-CoV-2病毒转阴时间延迟的独立危险因素。然而，疾病严重程度（HR = 1.120；95%CI 0.771 - 1.640；P = 0.544）与SARS-CoV-2病毒转阴时间无相关性。
病情越严重的患者从症状出现到核酸检测呈阳性的时间越短。从症状出现到核酸检测呈阳性时间延长是SARS-CoV-2病毒转阴时间延迟的独立危险因素，且疾病严重程度与SARS-CoV-2病毒转阴时间无相关性。
