Negative Nasopharyngeal SARS-CoV-2 PCR Conversion in Response to Different Therapeutic Interventions

Cureus. 2022 Jan 20;14(1):e21442. doi: 10.7759/cureus.21442. eCollection 2022 Jan.


Background The current management practices for patients with COVID-19 consist of infection prevention and supportive care. We aimed to explore the association between negative nasopharyngeal SARS-CoV-2 polymerase chain reaction (PCR) clearance and different therapeutic interventions. Methods This study is a retrospective cohort study of 93 patients who were admitted to a tertiary hospital in Saudi Arabia with a PCR confirmed diagnosis of COVID-19. There were three intervention subgroups (group A) (n = 45), which included those who received chloroquine or hydroxychloroquine (HCQ) only (A1), those who received chloroquine or HCQ in combination with azithromycin (A2), and those who received chloroquine or HCQ in combination with antiviral drugs with or without azithromycin (A3), as well as one supportive care group (group B) (n = 48). The primary and secondary endpoints were achieving negative SARS-CoV-2 nasopharyngeal PCR samples within five and 12 days from the start of the intervention, respectively. Results A median time of three days (interquartile range (IQR): 2.00-6.50) is needed from the time of starting the intervention/supportive care to the first negative PCR sample. There was no statistically significant difference neither between the percentage of patients in the intervention group and the supportive care group who achieved the primary or secondary endpoint nor in the median time needed to achieve the first negative PCR sample (p > 0.05). Conclusion Prescribing antimalarial medications was not shown to shorten the disease course nor to accelerate the negative PCR conversion rate.

Keywords: covid-19; hydroxychloroquine; infectious disease; novel coronavirus; sars-cov-2.