Prevalence and risk factors associated with repeat positive SARS-CoV-2 nucleic acid test results among discharged COVID-19 patients

Medicine ◽  
2021 ◽  
Vol 100 (48) ◽  
pp. e27933
Author(s):  
Yanru Cui ◽  
Jilin Wang ◽  
Gaofeng Wang ◽  
Xiuguo Xie ◽  
Lizhen Tian
Keyword(s):  
Risk Factors ◽  
Nucleic Acid ◽  
Test Results ◽  
Nucleic Acid Test ◽  
Factors Associated ◽  
Acid Test

scholarly journals COVID-19 versus non-COVID-19 pneumonia: A retrospective cohort study in Chengdu, China

2020 ◽  
Author(s):  
Xiao-Jin Li ◽  
Bing-Xing Shuai ◽  
Zhong-Wei Zhang ◽  
Yan Kang
Keyword(s):  
Nucleic Acid ◽  
Retrospective Cohort ◽  
Clinical Characteristics ◽  
Epidemiological Data ◽  
Group Differences ◽  
Test Results ◽  
Imaging Findings ◽  
Viral Nucleic Acid ◽  
Nucleic Acid Test ◽  
Acid Test

Background and ObjectiveSince the outbreak of coronavirus disease 2019 (COVID-19) in December 2019 in Wuhan, Hubei Province, China, it has spread throughout the world and become a global public health emergency. It is important to distinguish COVID-19 from other viral pneumonias to properly screen and diagnose patients, reduce nosocomial infections, and complement the inadequacy of nucleic acid testing. In this study, we retrospectively analysed the clinical data of COVID-19 versus non-COVID-19 patients treated at our hospital between January 17 and February 27, 2020 to summarize our clinical experience in the differential diagnosis of COVID-19.MethodsIn this retrospective cohort study, 23 confirmed COVID-19 patients were consecutively enrolled from January 17 to February 27, 2020, and 29 confirmed non-COVID-19 patients were enrolled in the West China Hospital of Sichuan University. We collected baseline data, epidemiological data, clinical characteristics, imaging findings, viral nucleic acid test results, and survival data. SPSS v22.0 was used for the statistical analysis. Outcomes were followed-up until March 25.ResultsA total of 52 patients were included in this study, including 23 COVID-19 patients and 29 non-COVID-19 patients. No significant between-group differences were observed for age, sex, primary signs or symptoms, cellular immunity, or platelet count. Significant between-group differences were observed in clinical characteristics such as dry cough, contact with individuals from Wuhan, some underlying diseases, nucleated cell count, chest imaging findings, viral nucleic acid test results, 28-day mortality, and 28-day survival.ConclusionEpidemiological data, clinical symptoms, nucleic acid test results for COVID-19 and chest CT manifestation may help distinguish COVID-19 from non-COVID-19 cases, prevent imported cases and nosocomial infections.

scholarly journals A Research on the Results of Viral Nucleic Acid Tests and CT Imaging Variation of Patients with COVID-19

2020 ◽  
Author(s):  
Meng Xu ◽  
Xun Liu ◽  
Chuhong Su ◽  
Yuping Zeng ◽  
Jinqian Zhang ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Recovery Period ◽  
Ct Imaging ◽  
Nucleic Acid Detection ◽  
Test Results ◽  
Viral Nucleic Acid ◽  
Nucleic Acid Test ◽  
Acid Test ◽  
Pulmonary Ct ◽  
Nucleic Acid Tests

AbstractBackgroundCoronavirus disease 2019 (COVID-19) has become a global health problem. We aim to investigate the changes in the results of viral nucleic acid tests on pharyngeal swabs and feces of patients with COVID-19 and CT imaging of lungs as the disease progresses.MethodsSeven patients with COVID-19 in the third affiliated hospital of Sun Yat-sen University Yuedong Hospital were retrospectively enrolled with clinical features, including imaging staging, and performance characteristics of viral nucleic acid test results of pharyngeal swabs and feces. The dynamic changes of these features were observed during hospitalization, and therapeutic effect and prognosis of patients were evaluated.ResultsThe results of seven cases with COVID-19 were positive for viral nucleic acid tests on pharyngeal swabs early after the onset of symptoms, and then turned negative; while the results of viral nucleic acid tests on feces were persistently positive in the mid-term clinical treatment and recovery period. And the viral nucleic acid test results were capricious in three cases. Pulmonary CT imaging showed characteristic changes in early, advanced and recovery phases.ConclusionThe application of viral nucleic acid detection and pulmonary CT imaging can be used for screening of suspected cases. Fecal nucleic acid test should be recommended as the reference of discharge standard, in order to minimize the risk of transmission from digestive tract.

scholarly journals Epidemiological and Clinical Characteristics of 26 Asymptomatic Severe Acute Respiratory Syndrome Coronavirus 2 Carriers

2020 ◽  
Vol 221 (12) ◽  
pp. 1940-1947 ◽  
Author(s):  
Yanfeng Pan ◽  
Xue Yu ◽  
Xinwei Du ◽  
Qingqing Li ◽  
Xianyang Li ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Severe Acute Respiratory Syndrome ◽  
Clinical Characteristics ◽  
False Negative ◽  
Test Results ◽  
Nucleic Acid Test ◽  
Ct Findings ◽  
Asymptomatic Patients ◽  
Median Period ◽  
Acid Test

Abstract Background We retrospectively analyzed 26 persistently asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) carriers. Methods Epidemiological and clinical characteristics from the 26 asymptomatic patients with positive results for SARS-CoV-2 ribonucleic acid testing were obtained. Results Twenty-two patients (84.6%) correlated with clustering occurrence. The median period from contact to diagnosis and the last positive nucleic acid test was 19 (8–24 days) and 21.5 days (10–36 days), respectively. The median period from diagnosis to negative nucleic acid test was significantly different between patients with normal or atypical chest computed tomography (CT) findings (n = 16, 61.5%; 7.5 days [2–20 days]) and patients with typical ground-glass or patchy opacities on CT (n = 10, 38.5%; 12.5 days [8–22 days]; P < .01). Seven patients (70.0%) with initial positive nucleic acid test results had a negative result simultaneously with improved CT findings. Obvious improvement in CT findings was observed in 3 patients (30.0%) despite positive nucleic acid test results. Conclusions In asymptomatic patients, changes in biochemical and inflammatory variables are small and changes on chest CT can occur. It is worth noting that the long existence of SARS-CoV-2 in some asymptomatic patients and false-negative results need to be considered in SARS-CoV-2 nucleic acid test.

scholarly journals The value of lymphocyte count in determining the severity of COVID-19 and estimating the time for nucleic acid test results to turn negative

2020 ◽  
Author(s):  
Yuanchao Li ◽  
Tuoyun Yang ◽  
Sicong Wang ◽  
Junbo Zheng ◽  
Jing Zhou ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Chronic Diseases ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Lymphocyte Count ◽  
Critical Conditions ◽  
Test Results ◽  
Cutoff Value ◽  
Nucleic Acid Test ◽  
Acid Test

Peripheral blood lymphocyte count is shown to be decreased in patients with COVID-19 in the early stage of the disease. The degree of lymphocyte count reduction is related to COVID-19 severity and could be used as an indicator to reflect the disease severity. Our aim was to investigate the value of lymphocyte count in determining COVID-19 severity and estimating the time for SARS-CoV-2 nucleic acid test results to turn negative. We retrospectively analyzed clinical data of 201 patients with severe and critical COVID-19. The patients were admitted to the West Campus of Union Hospital of Tongji Medical College of Huazhong University of Science and Technology. The data included age, gender, chronic disease, lymphocyte count, and SARS-CoV-2 nucleic acid test results. The age of patients in critically ill group was higher than in severely ill group (p = 0.019). The lymphocyte count of critically ill patients was lower than of severely ill patients. The cutoff value of lymphocyte count to distinguish between the critically ill and the severely ill was 0.735 × 109/L (p = 0.001). The cutoff value of lymphocyte count for SARS-CoV-2 nucleic acid test results turning negative in severely and critically ill patients with chronic diseases (hypertension, diabetes, and coronary heart disease) was 0.835 × 109/L (p = 0.017). The cutoff value of lymphocyte count for SARS-CoV-2 nucleic acid test results turning negative in severely and critically ill male patients was 0.835 × 109/L (p < 0.0001). Lymphocyte count could be an effective indicator to predict COVID-19 severity. It may also be useful in determining the time for nucleic acid test results to turn negative in COVID-19 patients with underlying chronic diseases or male COVID-19 patients with severe and critical conditions.

scholarly journals Clinical characteristics of Covid-19 patients with re-positive test results: an observational study

2020 ◽  
Author(s):  
Ying Su ◽  
Ling-Shuang Zhu ◽  
Yong Gao ◽  
Yuncheng Li ◽  
Zhanlu Xiong ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Nucleic Acid ◽  
Clinical Characteristics ◽  
Test Results ◽  
Nucleic Acid Test ◽  
Artery Disease ◽  
Acid Test ◽  
Positive Results

AbstractBackgroundWith coronavirus disease 2019 (Covid-19) ravaging the global, concern has been aroused whether discharged Covid-19 patients with reappeared positive nucleic acid test results are infected again.ObjectiveTo analyze the clinical characteristics of discharged Covid-19 patients with reappeared positive nucleic acid test results and to track clinical outcomes of them.MethodsWe extracted clinical data on 938 Covid-19 patients from Wuhan Union Hospital (West Branch), and we obtained information about residual symptoms and nucleic acid tests after discharge through follow-up study. We evaluated the relationship of clinical characteristics and reappeared positive results. Each patient had at least 44 days of follow-up.ResultsOf 938 discharged patients, a total of 58 (6.2%) had reappeared positive nucleic acid test results and 880 remain negative. Among patients over the age of 50, the factors we found to be associated with re-positive results were coronary artery disease (14.1%, vs. 5.5% among those without coronary artery disease; odds ratio, 2.81; 95% confidence interval [CI], 1.28 to 6.15), and hypertension (9.5%, vs. 4.9% among those without hypertension; odds ratio, 2.05; 95% CI, 1.10 to 3.82). As of May 11, 2020, 54 (93.1%) re-positive patients turned negative again while two patients remained positive, and two patients was lost to the second follow-up.ConclusionCoexisting diseases including coronary artery disease and hypertension were substantial risk factors for re-positive outcomes among patients over 50. And most re-positive patients tended to return negative eventually.

scholarly journals Persistent SARS-COV-2 RNA positivity in a patient for 92 days after disease onset

2020 ◽  
Author(s):  
Junxue Wang ◽  
Xiaofeng Hang ◽  
Bo Wei ◽  
Dingchen Li ◽  
Fangyan Chen ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Body Surface ◽  
Disease Onset ◽  
Test Results ◽  
Nucleic Acid Test ◽  
Clinical Recovery ◽  
Surrounding Environment ◽  
Acid Test

Abstract Background: Recently, patients with COVID-19 who showed persistently positive SARS-CoV-2 nucleic acid test results despite resolved clinical symptoms have attracted a lot of attention. We report the case of a patient with mild symptoms of coronavirus disease (COVID-19), who achieved clinical recovery but showed persistently positive SARS-CoV-2 nucleic acid test results until Day 92 after disease onset.Case presentation: The patient is a 50-year-old man with mild symptoms of coronavirus disease (COVID-19). He was quarantined for 105 days. Of these, inpatient quarantine lasted for 75 days. When the nucleic acid test results were negative for 3 consecutive days, the patient was discharged at Day 75 after disease onset. During this period, multiple samples were collected from the patient’s body surface, the surrounding environment, and physical surfaces, but none of these tested positive for SARS-CoV-2. These samples included those from anal swabs, hands, inner surface of mask, cell phone, bed rails, floor around the bed, and toilet bowl surface. However, nucleic acid retest results on Day 80 and Day 92 after disease onset were positive for SARS-CoV-2 nucleic acids. The patient continued with quarantine and observation at home. After the test results on Days 101 and 105 after disease onset were negative, quarantine was terminated at last.Conclusion: Per our knowledge, this is the longest known time that a patient has tested positive for SARS-CoV-2 nucleic acids. No symptoms were observed during follow-up. During hospitalization, the SARS-CoV-2 nucleic acid positivity was not observed in samples from the body surface and surrounding environment, and no verified transmission event occurred during the quarantine at home. After undergoing clinical recovery a minority of patients with COVID-19 have shown long-term positive results for the presence of the SARS-CoV-2 nucleic acid. This has provided new understanding and research directions for coronavirus infection. Long-term follow-up and quarantine measures have been employed for such patients. Further studies are required to analyze potential infectivity in such patients and determine whether more effective antiviral drugs or regimens to enable these patients to completely clear viral infection should be researched.

What is the meaning of a nonresolved viral nucleic acid test-reactive minipool?

Transfusion ◽  
2014 ◽  
Vol 55 (2) ◽  
pp. 395-404 ◽  
Author(s):  
Lunan Wang ◽  
Le Chang ◽  
Yunzheng Xie ◽  
Chengyin Huang ◽  
Lei Xu ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Viral Nucleic Acid ◽  
Nucleic Acid Test ◽  
Acid Test

scholarly journals Cases Report of Cured Novel Coronavirus-infected Pneumonia Patients with Viral Nucleic Acid Test Positive in Fecal Specimens

2020 ◽  
Author(s):  
Mei Han ◽  
Jingbo Zou ◽  
Wenguang Tian ◽  
Xiaoyu Wei ◽  
Yang Zhou ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Molecular Diagnostic ◽  
Clinical Practices ◽  
Rt Pcr ◽  
Viral Nucleic Acid ◽  
Nucleic Acid Test ◽  
Assessment Standard ◽  
Novel Coronavirus ◽  
Acid Test ◽  
Respiratory Specimens

Abstract Background: The outbreak of the novel coronavirus in China (COVID-19) represents a significant and urgent threat to global health. We report here five cases of COVID-19 infection patients in our clinical practices who are medically stable and presumed to successfully “cleared” the virus after antiviral treatments. Case presentation: The clinical evaluation depends on the viral nucleic acid test in respiratory specimens by real-time PCR reverse transcription (RT-PCR) assays according to the authorized guidance. We found that the stool samples of these cured patients remain positive in RT-PCR assay while the virus is undetectable in respiratory specimens. RT-PCR molecular diagnostic assay was designed to specifically detect the presence of viral RNA. Thus, the positive result in the fecal specimens implies the existence of viable virions with the patients. Conclusions: This highlights the importance to look closely at the assessment standard of medical treatment, as well as the need for reevaluation of the criteria for the initial screening, prevention, and care of patients with this emerging infection.

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