Factors associated with negative conversion of SARS-CoV-2 RNA in hospitalized patients have not yet been systematically determined. We conducted a retrospective cohort study of COVID-19 patients in Qingdao, China. Both univariate and multivariate analysis were performed to identify independent factors for time to viral RNA negative conversion. Data on patients with re-detectable viral RNA after showing negative on RT-PCR test (intermittent negative status) were also analyzed. A total of 59 patients confirmed with COVID-19 were included in this study, with a median duration of 1 (interquartile range, IQR: 0-2) day from symptom onset to hospital admission. Median communicable period (from first day of positive nucleic acid test to first day of consecutive negative results) was 14 (IQR: 10-18) days, and 7 (IQR: 6-10) days for 10 patients with intermittent negative results. Age older than 45 years (hazard ratio, HR: 0.378; 95% confidence interval, CI: 0.205-0.698) and chest tightness (HR: 0.290; 95%CI: 0.091-0.919) were factors indecently affecting negative conversion of SARS-CoV-2 RNA. Headache (odds ratio: 7.553; 95%CI: 1.011-28.253) was significantly associated with intermittent negative status, with a predicted probability of 60%. Older age and chest tightness were independently associated with delayed clearance of SARS-CoV-2 RNA in hospitalized patients. These predictors would provide a new perspective on early identification of patients with prolonged viral shedding and facilitate optimal isolation protocols and treatment strategies.
Keywords: Coronavirus disease 2019 (COVID-19); Hazard ratio; Negative conversion; Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
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Conflict of interest statement
Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Factors associated with prolonged viral RNA shedding in patients with COVID-19.Clin Infect Dis. 2020 Apr 9:ciaa351. doi: 10.1093/cid/ciaa351. Online ahead of print. Clin Infect Dis. 2020. PMID: 32271376 Free PMC article.
Dynamic profile of RT-PCR findings from 301 COVID-19 patients in Wuhan, China: A descriptive study.J Clin Virol. 2020 Jun;127:104346. doi: 10.1016/j.jcv.2020.104346. Epub 2020 Apr 11. J Clin Virol. 2020. PMID: 32361324 Free PMC article.
The presence of SARS-CoV-2 RNA in the feces of COVID-19 patients.J Med Virol. 2020 Apr 3. doi: 10.1002/jmv.25825. Online ahead of print. J Med Virol. 2020. PMID: 32243607
Prolonged viral shedding in feces of pediatric patients with coronavirus disease 2019.J Microbiol Immunol Infect. 2020 Mar 28:S1684-1182(20)30081-5. doi: 10.1016/j.jmii.2020.03.021. Online ahead of print. J Microbiol Immunol Infect. 2020. PMID: 32276848 Free PMC article. Review.
Features, Evaluation and Treatment Coronavirus (COVID-19).2020 Apr 6. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan–. StatPearls. 2020 Jan–. PMID: 32150360 Free Books & Documents. Review.
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