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Prevalence and Clinical Significance of Persistent Viral Shedding in Hospitalized Adult Patients with SARS-CoV-2 Infection: A Prospective Observational Study
- Source :
- Infectious Diseases and Therapy
- Publication Year :
- 2021
- Publisher :
- Springer Healthcare, 2021.
-
Abstract
- Background The goal of this study was to investigate the prevalence and factors associated with persistent viral shedding (PVS) in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Methods This was a prospective observational study including all consecutive adults hospitalized with SARS-CoV-2 infection. When the first nasopharyngeal swab was positive for SARS-CoV-2 RNA (day 0), additional samples were obtained on days + 3, + 5, + 7 and then once every 7 days until virus detection was negative. PVS was defined as the duration of shedding of at least 21 days after diagnosis. The primary endpoint of this study was the prevalence of PVS. Results Data were obtained regarding 121 consecutive hospitalized patients with SARS-CoV-2 infection (median age 66 years, male sex 65.3%). Overall, the prevalence of PVS was 38% (46/121 patients). According to univariate analysis, factors associated with PVS were immunosuppression (6.7% vs 21.7%, p = 0.02), increased interleukin-6 (IL-6) levels (≥ 35 ng/ml) at the time of diagnosis (43.4% vs 67.3%, p = 0.02), time from onset of symptoms to diagnosis (median days 7.0 vs 3.5, p = 0.001), intensive care unit admission (22.7% vs 43.5%, p = 0.02), and need for invasive mechanical ventilation (20.0% vs 41.3%, p = 0.01). The multivariate analysis indicated that immunosuppression, increased IL-6 levels at the time of diagnosis, time from onset of symptoms to diagnosis, and need for mechanical ventilation were independent factors associated with PVS. Conclusions PVS was detected in up to 38% of hospitalized patients with SARS-CoV-2 infection and was strongly associated with immunosuppression, increased IL-6 levels, and the need for mechanical ventilation. Supplementary Information The online version contains supplementary material available at 10.1007/s40121-020-00381-8.
- Subjects :
- 0301 basic medicine
Microbiology (medical)
medicine.medical_specialty
Multivariate analysis
medicine.medical_treatment
030106 microbiology
law.invention
03 medical and health sciences
0302 clinical medicine
law
Internal medicine
Clinical endpoint
medicine
Clinical significance
030212 general & internal medicine
Viral shedding
Original Research
Outcome
Mechanical ventilation
Univariate analysis
IL-6
COVID-19
SARS-CoV-2
business.industry
Immunosuppression
Intensive care unit
Infectious Diseases
business
Subjects
Details
- Language :
- English
- ISSN :
- 21936382 and 21938229
- Database :
- OpenAIRE
- Journal :
- Infectious Diseases and Therapy
- Accession number :
- edsair.doi.dedup.....d5896dc5d57885cc872094bcdd041da8