Okita Yasutaka, Morita Takayoshi, Kumanogoh Atsushi
Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.
Department of Immunopathology, World Premier International Immunology Frontier Research Center (iFReC), Suita, Osaka, Japan.
Inflamm Regen. 2022 Jun 1;42(1):16. doi: 10.1186/s41232-022-00205-x.
The duration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA positivity will be important to prevent the spread of coronavirus disease 2019 (COVID-19). A systematic review and meta-analysis were conducted following PRISMA to determine the duration from several parts of the body and clinical characteristics affecting it.
PubMed, Web of Science, Scopus, and CENTRAL were searched for original studies reporting the duration from COVID-19 onset to the disappearance of viral RNA. Of the 1682 studies identified, 100 met the selection criteria and 13,431 patients were included in this study. The duration of SARS-CoV-2 RNA positivity was 18.29 [95% confidence interval: 17.00-19.89] days in the upper respiratory tract samples, 23.79 [20.43-27.16] days in the sputum, 14.60 [12.16-17.05] days in the blood, and 22.38 [18.40-26.35] days in the stool. Sensitivity analysis revealed that the duration was positively correlated with age, comorbidities, severity, and usage of glucocorticoid. Subgroup analysis indicated that the presence or absence of complications had the greatest impact on the difference in DSRP.
The duration of SARS-CoV-2 RNA positivity was 18.29 days in the upper respiratory tract samples. The duration in the sputum and the stool was longer, while that in the blood was shorter. The duration in the upper respiratory tract samples was longer in older, with any comorbidities, severer, and treated with glucocorticoid. These results provide the basic data for the duration of SARS-CoV-2 RNA positivity, and in the future, the effect of vaccination against SARS-CoV-2 and the SARS-CoV-2 variants on the duration of RNA positivity should be assessed.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）RNA阳性持续时间对于预防2019冠状病毒病（COVID-19）传播至关重要。按照系统评价和Meta分析的首选报告项目（PRISMA）进行了一项系统评价和Meta分析，以确定来自身体多个部位的病毒RNA阳性持续时间以及影响该持续时间的临床特征。
检索了PubMed、Web of Science、Scopus和考克兰系统评价数据库（CENTRAL），查找报告从COVID-19发病到病毒RNA消失的持续时间的原始研究。在检索到的1682项研究中，100项符合纳入标准，本研究共纳入13431例患者。SARS-CoV-2 RNA在上呼吸道样本中的阳性持续时间为18.29天[95%置信区间：17.00 - 19.89天]，在痰液中为23.79天[20.43 - 27.16天]，在血液中为14.60天[12.16 - 17.05天]，在粪便中为22.38天[18.40 - 26.35天]。敏感性分析显示，该持续时间与年龄、合并症、疾病严重程度以及糖皮质激素使用情况呈正相关。亚组分析表明，并发症的有无对病毒RNA阳性持续时间的差异影响最大。
SARS-CoV-2 RNA在上呼吸道样本中的阳性持续时间为18.29天。在痰液和粪便中的持续时间较长，而在血液中的持续时间较短。在上呼吸道样本中，年龄较大、有合并症、病情较重且接受糖皮质激素治疗的患者，其病毒RNA阳性持续时间较长。这些结果为SARS-CoV-2 RNA阳性持续时间提供了基础数据，未来应评估接种针对SARS-CoV-2及其变异株疫苗对RNA阳性持续时间的影响。
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