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

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

10.1101/2020.04.28.20082784 ◽

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.

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

10.1101/2020.05.08.20037556 ◽

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.

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