Sadeghi Somayeh, Nasri Peiman, Nasri Elahe, Solgi Hamid, Nasirian Maryam, Pourajam Samaneh, Fakhim Hamed, Mirhendi Hossein, Ataei Behrooz, Mobarakeh Shadi Reisizadeh
Acquired Immunodeficiency Research Center, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Med Sci. 2022 Jun 30;27:43. doi: 10.4103/jrms.jrms_401_21. eCollection 2022.
Since December 2019, the world is struggling with an outbreak of coronavirus disease-2019 (COVID-19) infection mostly represented as an acute respiratory distress syndrome and has turned into the most critical health issue worldwide. Limited information is available about the association between dynamic changes in the naso/oropharyngeal viral shedding in infected patients and biomarkers, aiming to be assessed in the current study.
This quasi-cohort study was conducted on 31 patients with moderate severity of COVID-19 manifestations, whose real-time polymerase chain reaction (RT-PCR) test was positive for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) RNA at baseline. RT-PCR was rechecked for patients every 3-4 days until achieving two negative ones. In parallel, biomarkers, including lymphocyte count, lactate dehydrogenase (LDH), and C-reactive protein (CRP), were assessed every other day, as well. Viral shedding also was assessed.
Spearman's correlation test revealed a significant direct correlation between the viral shedding from the symptom onset and the time, in which CRP ( = 0.0015, = 0.54) and LDH ( = 0.001, = 0.6207) return to normal levels after symptom onset, but not for lymphocyte count ( = 0.068, = 0.34).
Based on the current study's findings, the duration of SARS-CoV-2 RNA shedding was directly correlated with the required time for LDH and CRP return to normal levels. Therefore, these factors can be considered the determinants for patients' discharge, isolation, and return to social activities; however, further investigations are required to generalize the outcomes.
自2019年12月以来,全球正与2019冠状病毒病(COVID-19)感染的爆发作斗争,该疾病主要表现为急性呼吸窘迫综合征,已成为全球最关键的健康问题。关于感染患者鼻/口咽病毒载量的动态变化与生物标志物之间的关联,目前可用信息有限,本研究旨在对此进行评估。
本准队列研究针对31例COVID-19表现为中度严重程度的患者开展,这些患者在基线时严重急性呼吸综合征冠状病毒2(SARS-CoV-2)RNA的实时聚合酶链反应(RT-PCR)检测呈阳性。每3 - 4天对患者重新进行RT-PCR检测,直至两次检测结果为阴性。同时,每隔一天评估包括淋巴细胞计数、乳酸脱氢酶(LDH)和C反应蛋白(CRP)在内的生物标志物。还对病毒载量进行了评估。
Spearman相关性检验显示,症状出现时的病毒载量与症状出现后CRP(ρ = 0.0015,r = 0.54)和LDH(ρ = 0.001,r = 0.6207)恢复至正常水平的时间之间存在显著正相关,但与淋巴细胞计数无关(ρ = 0.068,r = 0.34)。
基于本研究结果,SARS-CoV-2 RNA脱落持续时间与LDH和CRP恢复至正常水平所需时间直接相关。因此,这些因素可被视为患者出院、隔离及恢复社交活动的决定因素;然而,需要进一步研究以推广这些结果。