scholarly journals Prolonged viral shedding of SARS-CoV-2 and related factors in symptomatic COVID-19 patients: a prospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hui Long ◽  
Jing Zhao ◽  
Hao-Long Zeng ◽  
Qing-Bin Lu ◽  
Li-Qun Fang ◽  
...  
Keyword(s):  
Symptom Onset ◽  
Cox Regression ◽  
Clinical Information ◽  
Population Level ◽  
Female Gender ◽  
Older Age ◽  
Related Factors ◽  
Viral Kinetics ◽  
Viral Loads ◽  
Viral Shedding

Abstract Background The temporal relationship between SARS-CoV-2 and antibody production and clinical progression remained obscure. The aim of this study was to describe the viral kinetics of symptomatic patients with SARS-CoV-2 infection and identify factors that might contribute to prolonged viral shedding. Methods Symptomatic COVID-19 patients were enrolled in two hospitals in Wuhan, China, from whom the respiratory samples were collected and measured for viral loads consecutively by reverse transcriptase quantitative PCR (RT-qPCR) assay. The viral shedding pattern was delineated in relate to the epidemiologic and clinical information. Results Totally 2726 respiratory samples collected from 703 patients were quantified. The SARS-CoV-2 viral loads were at the highest level during the initial stage after symptom onset, which subsequently declined with time. The median time to SARS-CoV-2 negativity of nasopharyngeal test was 28 days, significantly longer in patients with older age (> 60 years old), female gender and those having longer interval from symptom onset to hospital admission (> 10 days). The multivariate Cox regression model revealed significant effect from older age (HR 0.73, 95% CI 0.55–0.96), female gender (HR 0.72, 95% CI 0.55–0.96) and longer interval from symptom onset to admission (HR 0.44, 95% CI 0.33–0.59) on longer time to SARS-CoV-2 negativity. The IgM antibody titer was significantly higher in the low viral loads group at 41–60 days after symptom onset. At the population level, the average viral loads were higher in early than in late outbreak periods. Conclusions The prolonged viral shedding of SARS-CoV-2 was observed in COVID-19 patients, particularly in older, female and those with longer interval from symptom onset to admission.

scholarly journals Camptocormia in patients with multiple system atrophy at different disease durations: frequency and related factors

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ling Yu Zhang ◽  
Bei Cao ◽  
Qian-Qian Wei ◽  
Ru Wei Ou ◽  
Bi Zhao ◽  
...  
Keyword(s):  
Multiple System Atrophy ◽  
Disease Severity ◽  
Disease Duration ◽  
Rating Scale ◽  
Cox Regression ◽  
Age Of Onset ◽  
Older Age ◽  
Related Factors ◽  
Cox Regression Analysis ◽  
The Impact

Abstract Background Camptocormia is common in patients with multiple system atrophy (MSA). The current study was aimed at assessing the frequency of camptocormia and its related factors in MSA patients with different disease durations. Also, the impact of camptocormia on disability was evaluated. Methods A total of 716 patients were enrolled in the study. They were classified into three groups based on disease duration (≤ 3, 3–5, ≥ 5 years). Specific scales were used to evaluate the motor and non-motor symptoms. Disease severity was assessed using the Unified Multiple System Atrophy Rating Scale (UMSARS). The binary logistic regression model was used to explore the factors related to camptocormia. To analyze the impact of camptocormia on disability in patients with disease duration less than 5 years, propensity score matching (PSM) and stratified Cox regression analysis were used. Results In the current study, we found that the frequency of camptocormia was 8.9, 19.7 and 19.2% when the disease duration was ≤3, 3–5, ≥ 5 years, respectively. In the disease duration ≤3 years group, we found that MSA-parkinsonian subtype (MSA-P) (OR = 2.043, P = 0.043), higher total UMSARS score (OR = 1.063, P < 0.001), older age of onset (OR = 1.047, P = 0.042), and lower score on the frontal assessment battery (FAB) (OR = 0.899, P = 0.046) were associated with camptocormia. Only greater disease severity was associated with camptocormia in the group of patients with disease duration 3–5 years (OR = 1.494, P = 0.025) and in the group of patients with disease duration ≥5 years (OR = 1.076, P = 0.005). There was no significant impact of camptocormia on disability in patients with a disease duration of < 5 years (HR = 0.687, P = 0.463). Conclusion The frequency of camptocormia increased with prolonged disease duration. Disease severity was related to camptocormia at different stages of the disease. The MSA-P subtype, older age of onset, and lower FAB score were associated with camptocormia in the early stage of the disease.

Population-Level Incidence and Use-Related Factors of Comfort and Orthopedic Accessories Among Older Vehicle Occupants in NSW, Australia

2020 ◽  
pp. 073346482095012
Author(s):  
Raman Sran ◽  
Lisa Keay ◽  
Kristy Coxon ◽  
James McAuley ◽  
Tom Whyte ◽  
...  
Keyword(s):  
Older People ◽  
Travel Behavior ◽  
Seat Belt ◽  
Population Level ◽  
Female Gender ◽  
Motor Vehicles ◽  
Point Estimate ◽  
Related Factors ◽  
Convenience Sample ◽  
Increased Risk

The proportion of people aged 65 years and older regularly traveling in motor vehicles continues to grow worldwide. In a previous convenience sample, we observed many older people using comfort accessories when traveling in vehicles, and these may contribute to the known increased risk of injury in crashes among older people. In this study, we aimed to estimate population-level use of these devices and examine associations between demographic, health, and travel behavior factors and their use. The point estimate of self-reported use of comfort accessories was 25.7% (95% confidence interval [CI] = [19.6%, 31.9%]). Cushions on the vehicle seat were the most common type used (14.3%, 95% CI = [9.7%, 19.0%]), and increasing age, female gender, and frequent vehicle travel were significantly associated with their use. Less frequently used were seat belt padding (10.5%, 95% CI = [6.3%, 14.6%]) and back/neck supports (6.5%, 95% CI = [2.7%, 10.2%]). Back/neck and multiple area pain were significantly associated with the use of the latter.

scholarly journals Age and Emotional Distress during COVID-19: Findings from Two Waves of the Norwegian Citizen Panel

2021 ◽  
Vol 18 (18) ◽  
pp. 9568
Author(s):  
Line I. Berge ◽  
Marie H. Gedde ◽  
Bettina S. Husebo ◽  
Ane Erdal ◽  
Camilla Kjellstadli ◽  
...  
Keyword(s):  
Emotional Distress ◽  
Positive Emotions ◽  
Female Gender ◽  
Older Age ◽  
Related Factors ◽  
Factors Associated ◽  
Norwegian Population ◽  
Sum Score ◽  
Health Related ◽  
One Year

Older adults face the highest risk of COVID-19 morbidity and mortality. We investigated a one-year change in emotions and factors associated with emotional distress immediately after the onset of the pandemic, with emphasis on older age. Methods: The online Norwegian Citizen Panel includes participants drawn randomly from the Norwegian Population Registry. Emotional distress was defined as the sum score of negative (anxious, worried, sad or low, irritated, and lonely) minus positive emotions (engaged, calm and relaxed, happy). Results: Respondents to both surveys (n = 967) reported a one-year increase in emotional distress, mainly driven by elevated anxiety and worrying, but we found no difference in change by age. Multilevel mixed-effects linear regression comparing older age, economy-, and health-related factors showed that persons in their 60s (ß −1.87 (95%CI: −3.71, −0.04)) and 70s/80s (ß: −2.58 (−5.00, −0–17)) had decreased risk of emotional distress relative to persons under 60 years. Female gender (2.81 (1.34, 4.28)), expecting much lower income (5.09 (2.00, 8.17)), uncertainty whether infected with SARS-Cov2 (2.92 (1.21, 4.63)), and high self-rated risk of infection (1.77 (1.01, 2.53)) were associated with high levels of emotional distress. Conclusions: Knowledge of national determinants of distress is crucial to tailor accurate public health interventions in future outbreaks.

scholarly journals Association between RT-PCR Ct Values and COVID-19 New Daily Cases: A Multicenter Cross-Sectional Study

2020 ◽  
Author(s):  
Abdulkarim Abdulrahman ◽  
Saad Mallah ◽  
Abdulla Ismael AlAwadhi ◽  
Simone Perna ◽  
Essam Janahi ◽  
...  
Keyword(s):  
Population Studies ◽  
Population Level ◽  
Female Gender ◽  
Cross Sectional Study ◽  
Newly Diagnosed ◽  
Sectional Study ◽  
Rt Pcr ◽  
Cross Sectional ◽  
Viral Loads ◽  
Epidemiological Changes

Introduction: Proactive prediction of the epidemiologic dynamics of viral diseases and outbreaks of the likes of COVID-19 has remained a difficult pursuit for scientists, public health researchers, and policymakers. It is unclear whether RT-PCR Cycle Threshold (Ct) values of COVID-19 (or any other virus) as indicator of viral load, could represent a possible predictor for underlying epidemiological changes on a population level. Objectives: To investigate whether population-wide changes in SARS-CoV-2 RT-PCR Ct values over time are associated with the daily fraction of positive COVID-19 tests. In addition, this study analyses the factors that could influence the RT-PCR Ct values. Method: A retrospective cross-sectional study was conducted on 63,879 patients from May 4, 2020 to September 30, 2020, in all COVID-19 facilities in the Kingdom of Bahrain. Data collected included number of tests and newly diagnosed cases, as well as Ct values, age, gender nationality, and symptomatic status. Results: Ct values were found to be negatively and very weakly correlated with the fraction of daily positive cases in the population r = -0.06 (CI95%: -0.06; -0.05; p=0.001). The R-squared for the regression model (adjusting for age and number of daily tests) showed an accuracy of 45.3%. Ct Values showed an association with nationality (p=0.012). After the stratification, the association between Ct values and the fraction of daily positive cases was only maintained for the female gender and Bahraini-nationality. Symptomatic presentation was significantly associated with lower Ct values (higher viral loads). Ct values do not show any correlation with age (p=0.333) or gender (p=0.522). Conclusion: We report one of the first and largest studies to investigate the epidemiological associations of Ct values with COVID-19. Ct values offer a potentially simple and widely accessible tool to predict and model epidemiological dynamics on a population level. More population studies and predictive models from global cohorts are necessary.

scholarly journals Factors associated with prolonged viral shedding and impact of lopinavir/ritonavir treatment in hospitalised non-critically ill patients with SARS-CoV-2 infection

2020 ◽  
Vol 56 (1) ◽  
pp. 2000799 ◽  
Author(s):  
Dan Yan ◽  
Xiao-Yan Liu ◽  
Ya-nan Zhu ◽  
Li Huang ◽  
Bi-tang Dan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Symptom Onset ◽  
Antiviral Treatment ◽  
Older Age ◽  
Rna Detection ◽  
Factors Associated ◽  
Viral Shedding ◽  
Reverse Transcription Pcr ◽  
Independent Risk Factors ◽  
The Impact

BackgroundThe duration of viral shedding is central to the guidance of decisions about isolation precautions and antiviral treatment. However, studies regarding the risk factors associated with prolonged shedding of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the impact of lopinavir/ritonavir (LPV/r) treatment on viral shedding remain scarce.MethodsData were collected from all SARS-CoV-2 infected patients who were admitted to isolation wards and had reverse transcription PCR conversion at the No. 3 People's Hospital of Hubei province, China, between 31 January and 9 March 2020. We compared clinical characteristics and SARS-CoV-2 RNA shedding between patients initiated with LPV/r treatment and those without. Logistic regression analysis was employed to evaluate the risk factors associated with prolonged viral shedding.ResultsOf 120 patients, the median age was 52 years, 54 (45%) were male and 78 (65%) received LPV/r treatment. The median duration of SARS-CoV-2 RNA detection from symptom onset was 23 days (interquartile range 18–32 days). Older age (OR 1.03, 95% CI 1.00–1.05; p=0.03) and the lack of LPV/r treatment (OR 2.42, 95% CI 1.10–5.36; p=0.029) were independent risk factors for prolonged SARS-CoV-2 RNA shedding. Patients who initiated LPV/r treatment within 10 days from symptom onset, but not initiated from day 11 onwards, had significantly shorter viral shedding duration compared with those without LPV/r treatment (median 19 days versus 28.5 days; log-rank p<0.001).ConclusionOlder age and the lack of LPV/r treatment were independently associated with prolonged SARS-CoV-2 RNA shedding in patients with coronavirus disease 2019 (COVID-19). Earlier administration of LPV/r treatment could shorten viral shedding duration.

scholarly journals 513. Viral kinetics of SARS-CoV-2 in patients with COVID-19

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S322-S323
Author(s):  
Da Young Kim ◽  
Ju-Hyung Lee ◽  
Hyeon Jeong Oh ◽  
Jun-won Seo ◽  
Na Ra Yun ◽  
...  
Keyword(s):  
Chest Radiograph ◽  
Symptom Onset ◽  
Supplemental Oxygen ◽  
University Hospital ◽  
Upper Respiratory Tract ◽  
Rt Pcr ◽  
Viral Kinetics ◽  
Viral Loads ◽  
Severe Group ◽  
Kinetics Of

Abstract Background As only few studies have analyzed viral kinetics between the incubation and symptomatic periods of COVID-19 patients, we investigated the viral kinetics and compared viral loads between patients with mild and severe COVID-19. Methods We determined the viral kinetics of 10 patients diagnosed with COVID-19 at Chosun University Hospital. Six patients were classified into the “mild” group and 4 into the “severe” group according to supplemental oxygen use during admission. Samples were collected via nasopharyngeal swabs and sputum specimens. SARS-CoV-2 was detected using real-time reverse transcription-polymerase chain reaction (RT-PCR). Chest radiograph scores during hospitalization were obtained Results Ct values of the upper respiratory tract specimens were low during the early stages after symptom onset but gradually increased over time in both groups. The severe group had lower Ct values than the mild group. The Ct values of the RdRP and E genes on day 6 after symptom onset were significantly lower in the severe group than in the mild group (p &lt; 0.05). Three of 6 patients had positive results on RT-PCR even before symptom onset; 2 of them had the lowest Ct values. The chest radiograph scores were higher in the severe group than in the mild group, and the score in the severe group was the highest at approximately 3 weeks after symptom onset. Ct values when the RdRP gene and E gene were targeted to detect SARS-CoV-2 on the basis of the days after symptom onset in all the patients Conclusion Viral load and chest radiograph scores were significantly different between the severe and mild groups of COVID-19 patients. Disclosures All Authors: No reported disclosures

Anxiety symptoms in Korean elderly individuals: a two-year longitudinal community study

2015 ◽  
Vol 28 (3) ◽  
pp. 423-433 ◽  
Author(s):  
Hee-Ju Kang ◽  
Kyung-Yeol Bae ◽  
Sung-Wan Kim ◽  
Il-Seon Shin ◽  
Jin-Sang Yoon ◽  
...  
Keyword(s):  
Stressful Life Event ◽  
Female Gender ◽  
Anxiety Symptoms ◽  
Community Dwelling ◽  
Older Age ◽  
Medical Illness ◽  
Related Factors ◽  
Elderly Individuals ◽  
Korean Elderly

ABSTRACTBackground:Although late-life anxiety occurs frequently and is associated with higher morbidity, few longitudinal studies have been concerned with the evaluation thereof. We investigated the prevalence, incidence, and persistence of anxiety and related factors over a two-year period in community-dwelling Korean elderly individuals.Methods:A total of 1,204 Korean elderly individuals were evaluated at baseline, and 909 were followed up two years later. The community version of the Geriatric Mental State Schedule was used to estimate anxiety at both baseline and follow-up interviews. We defined “prevalence” as the rate of anxiety symptoms (for both anxiety cases and sub-threshold anxiety) at baseline; “incidence” as the rate of anxiety symptoms at follow-up in those without baseline anxiety symptoms; and “persistence” as the rate of anxiety symptoms at follow-up in those with baseline anxiety symptoms. Associations between various covariates and anxiety status were examined using multivariate logistic regression models.Results:The prevalence, incidence, and persistence of anxiety symptoms were 38.1%, 29.3%, and 41.1%, respectively. Prevalent anxiety symptoms were associated independently with female, rented housing, more stressful life event and medical illness, physical inactivity, depression, insomnia, and lower cognitive function. Incident anxiety symptoms were predicted by older age, female gender, depression, and insomnia; persistent anxiety symptoms were predicted by older age, more medical illness, and baseline depression.Conclusions:Since depression was associated with prevalent, incident, and persistent anxiety symptoms, effective detection and management thereof is important in older adults to reduce anxiety. Furthermore, preventive collaborative care should be considered, particularly for older, female, insomniac patients.

scholarly journals Factors associated with prolonged viral shedding and impact of Lopinavir/Ritonavir treatment in patients with SARS-CoV-2 infection

2020 ◽  
Author(s):  
Dan Yan ◽  
Xiao-Yan Liu ◽  
Ya-nan Zhu ◽  
Li Huang ◽  
Bi-tang Dan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Treatment Group ◽  
Logistic Regression Analysis ◽  
Median Duration ◽  
Symptom Onset ◽  
Older Age ◽  
Factors Associated ◽  
Viral Shedding

AbstractBackgroundThe duration of viral shedding is central to guide decisions around isolation precautions and antiviral treatment. However, studies about risk factors associated with prolonged SARS-CoV-2 shedding and the potential impact of Lopinavir/Ritonavir (LPV/r) treatment remain scarce.MethodsIn this retrospective study, data were collected from all SARS-CoV-2 infected patients who were admitted to isolation wards and had RT-PCR conversion at the NO.3 People’s hospital of Hubei province between 31 January and 09 March 2020. We compared clinical features and SARS-CoV-2 RNA shedding between patients with LPV/r treatment and those without. Logistic regression analysis was employed to evaluate risk factors associated with prolonged viral shedding.ResultsOf 120 patients, the median age was 52 years, 54 (45%) were male and 78 (65%) received LPV/r treatment. The median duration of SARS-CoV-2 RNA detection from symptom onset was 23 days (IQR, 18-32 days). Older age (odd ratio [OR] 1.03, 95% confidence interval [CI] 1.00-1.05, p=0.03) and lack of LPV/r treatment (OR 2.42, 95% CI 1.10-5.36, p=0.029) were independent risk factors for prolonged SARS-CoV-2 RNA shedding in multivariate logistic regression analysis. The median duration of viral shedding was shorter in the LPV/r treatment group (n=78) than that in no LPV/r treatment group (n=42) (median, 22 days vs. 28.5 days, p=0.02). Only earlier administration of LPV/r treatment (≤10 days from symptom onset) could shorten the duration of viral shedding.ConclusionsOlder age and lack of LPV/r treatment were independently associated with prolonged SARS-CoV-2 RNA shedding in patients with COVID-19. Earlier administration of LPV/r treatment could shorten viral shedding.Take home messageRisk factors for prolonged SARS-CoV-2 shedding included older age and lack of Lopinavir/Ritonavir treatment. Earlier administration of Lopinavir/Ritonavir treatment could shorten the duration of SARS-CoV-2 RNA shedding.

scholarly journals Epidemiological, Virological and Serological Features of Coronavirus Disease 2019 (COVID-19) Cases in People Living With Human Immunodeficiency Virus in Wuhan: A Population-based Cohort Study

2020 ◽  
Author(s):  
Jiao Huang ◽  
Nianhua Xie ◽  
Xuejiao Hu ◽  
Han Yan ◽  
Jie Ding ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Cohort Study ◽  
Demographic Data ◽  
Case Fatality ◽  
Population Based ◽  
Severe Illness ◽  
Viral Loads ◽  
Viral Shedding ◽  
Signal Value ◽  
Immunodeficiency Virus

Abstract Background We aimed to describe the epidemiological, virological, and serological features of coronavirus disease 2019 (COVID-19) cases in people living with human immunodeficiency virus (HIV; PLWH). Methods This population-based cohort study identified all COVID-19 cases among all PLWH in Wuhan, China, by 16 April 2020. The epidemiological, virological, and serological features were analyzed based on the demographic data, temporal profile of nucleic acid test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the disease, and SARS-CoV-2–specific immunoglobin (Ig) M and G after recovery. Results From 1 January to 16 April 2020, 35 of 6001 PLWH experienced COVID-19, with a cumulative incidence of COVID-19 of 0.58% (95% confidence interval [CI], .42–.81%). Among the COVID-19 cases, 15 (42.86) had severe illness, with 2 deaths. The incidence, case-severity, and case-fatality rates of COVID-19 in PLWH were comparable to those in the entire population in Wuhan. There were 197 PLWH who had discontinued combination antiretroviral therapy (cART), 4 of whom experienced COVID-19. Risk factors for COVID-19 were age ≥50 years old and cART discontinuation. The median duration of SARS-CoV-2 viral shedding among confirmed COVID-19 cases in PLWH was 30 days (interquartile range, 20–46). Cases with high HIV viral loads (≥20 copies/mL) had lower IgM and IgG levels than those with low HIV viral loads (&lt;20 copies/ml; median signal value divided by the cutoff value [S/CO] for IgM, 0.03 vs 0.11, respectively [P &lt; .001]; median S/CO for IgG, 10.16 vs 17.04, respectively [P = .069]). Conclusions Efforts are needed to maintain the persistent supply of antiretroviral treatment to elderly PLWH aged 50 years or above during the COVID-19 epidemic. The coinfection of HIV and SARS-CoV-2 might change the progression and prognosis of COVID-19 patients in PLWH.

scholarly journals Infectivity of healthcare workers diagnosed with coronavirus disease 2019 (COVID-19) approximately 2 weeks after onset of symptoms: A cross-sectional study

2021 ◽  
pp. 1-3
Author(s):  
Yves Longtin ◽  
Hugues Charest ◽  
Caroline Quach ◽  
Patrice Savard ◽  
Mariana Baz ◽  
...  
Keyword(s):  
Symptom Onset ◽  
Healthcare Workers ◽  
Positive Culture ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Viral Shedding ◽  
Viral Culture ◽  
Respiratory Coronavirus ◽  
Respiratory Specimens

Abstract We performed viral culture of respiratory specimens in 118 severe acute respiratory coronavirus virus 2 (SARS-CoV-2)–infected healthcare workers (HCWs), ∼2 weeks after symptom onset. Only 1 HCW (0.8%) had a positive culture. No factors for prolonged viral shedding were identified. Infectivity is resolved in nearly all HCWs ∼2 weeks after symptom onset.

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