Clinical predictors and timing of cessation of viral RNA shedding in patients with COVID-19.
Identifieur interne : 000726 ( Main/Curation ); précédent : 000725; suivant : 000727Clinical predictors and timing of cessation of viral RNA shedding in patients with COVID-19.
Auteurs : Cristina Corsini Campioli [États-Unis] ; Edison Cano Cevallos [États-Unis] ; Mariam Assi [États-Unis] ; Robin Patel [États-Unis] ; Matthew J. Binnicker [États-Unis] ; John C. O'Horo [États-Unis]Source :
- Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology [ 1873-5967 ] ; 2020.
Descripteurs français
- KwdFr :
- ARN viral (analyse), Adulte (MeSH), Adulte d'âge moyen (MeSH), Betacoronavirus (MeSH), Comorbidité (MeSH), Excrétion virale (MeSH), Femelle (MeSH), Humains (MeSH), Infections à coronavirus (diagnostic), Infections à coronavirus (virologie), Jeune adulte (MeSH), Mâle (MeSH), Pandémies (MeSH), Partie nasale du pharynx (virologie), Pneumopathie virale (diagnostic), Pneumopathie virale (virologie), Sujet âgé (MeSH), Techniques de diagnostic moléculaire (MeSH), Techniques de laboratoire clinique (MeSH), Études rétrospectives (MeSH).
- MESH :
- analyse : ARN viral.
- diagnostic : Infections à coronavirus, Pneumopathie virale.
- virologie : Infections à coronavirus, Partie nasale du pharynx, Pneumopathie virale.
- Adulte, Adulte d'âge moyen, Betacoronavirus, Comorbidité, Excrétion virale, Femelle, Humains, Jeune adulte, Mâle, Pandémies, Sujet âgé, Techniques de diagnostic moléculaire, Techniques de laboratoire clinique, Études rétrospectives.
English descriptors
- KwdEn :
- Adult (MeSH), Aged (MeSH), Betacoronavirus (MeSH), Clinical Laboratory Techniques (MeSH), Comorbidity (MeSH), Coronavirus Infections (diagnosis), Coronavirus Infections (virology), Female (MeSH), Humans (MeSH), Male (MeSH), Middle Aged (MeSH), Molecular Diagnostic Techniques (MeSH), Nasopharynx (virology), Pandemics (MeSH), Pneumonia, Viral (diagnosis), Pneumonia, Viral (virology), RNA, Viral (analysis), Retrospective Studies (MeSH), Virus Shedding (MeSH), Young Adult (MeSH).
- MESH :
- chemical , analysis : RNA, Viral.
- diagnosis : Coronavirus Infections, Pneumonia, Viral.
- virology : Coronavirus Infections, Nasopharynx, Pneumonia, Viral.
- Adult, Aged, Betacoronavirus, Clinical Laboratory Techniques, Comorbidity, Female, Humans, Male, Middle Aged, Molecular Diagnostic Techniques, Pandemics, Retrospective Studies, Virus Shedding, Young Adult.
Abstract
BACKGROUND
Molecular detection of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is key in the diagnosis of coronavirus disease 2019 (COVID-19) and has been widely used for followup of cases as a proxy for contagiousness. The persistence of SARS-CoV-2 RNA shedding in the context of clinical features and comorbidities is understudied.
METHODS
We retrospectively reviewed laboratory-confirmed COVID-19 adult symptomatic cases at Mayo Clinic, eventually achieving cessation of viral RNA shedding (CVS), defined as two consecutive negative SARS-CoV-2 PCR results on nasopharyngeal swabs collected at least 24 h apart.
RESULTS
A total of 251 patients were included, median age was 53 years and 59 % female. The most common symptoms at diagnosis were cough, myalgia, dyspnea, fever and chills. Myalgia, cough, anosmia, ageusia and sore throat were common at CVS, but fever and dyspnea were not observed. The median time from symptom onset to CVS was 23 days, and did not differ by symptoms. The weekly cumulative CVS rate was 2, 14, 44, 73, 91 and 95 % at 1-6 weeks from symptom onset, respectively. Cough and fever were associated with a positive PCR test if tested within 2 weeks of symptoms (P < 0.05). Patients with asthma or immunosuppression were less likely to achieve CVS if tested 3 weeks into symptoms (P < 0.04).
CONCLUSIONS
The cumulative CVS rate at 3 weeks from symptom-onset is 44 % in our entire cohort. The findings of our study highlight the low yield of repeating a SARS-CoV-2 NP PCR test within 21 days of a laboratoryconfirmed COVID-19 diagnosis.
DOI: 10.1016/j.jcv.2020.104577
PubMed: 32777762
PubMed Central: PMC7405830
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pubmed:32777762Le document en format XML
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<term>Clinical Laboratory Techniques (MeSH)</term>
<term>Comorbidity (MeSH)</term>
<term>Coronavirus Infections (diagnosis)</term>
<term>Coronavirus Infections (virology)</term>
<term>Female (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Male (MeSH)</term>
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<term>Molecular Diagnostic Techniques (MeSH)</term>
<term>Nasopharynx (virology)</term>
<term>Pandemics (MeSH)</term>
<term>Pneumonia, Viral (diagnosis)</term>
<term>Pneumonia, Viral (virology)</term>
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<term>Excrétion virale (MeSH)</term>
<term>Femelle (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Infections à coronavirus (diagnostic)</term>
<term>Infections à coronavirus (virologie)</term>
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<front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b>
</p>
<p>Molecular detection of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is key in the diagnosis of coronavirus disease 2019 (COVID-19) and has been widely used for followup of cases as a proxy for contagiousness. The persistence of SARS-CoV-2 RNA shedding in the context of clinical features and comorbidities is understudied.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>METHODS</b>
</p>
<p>We retrospectively reviewed laboratory-confirmed COVID-19 adult symptomatic cases at Mayo Clinic, eventually achieving cessation of viral RNA shedding (CVS), defined as two consecutive negative SARS-CoV-2 PCR results on nasopharyngeal swabs collected at least 24 h apart.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>A total of 251 patients were included, median age was 53 years and 59 % female. The most common symptoms at diagnosis were cough, myalgia, dyspnea, fever and chills. Myalgia, cough, anosmia, ageusia and sore throat were common at CVS, but fever and dyspnea were not observed. The median time from symptom onset to CVS was 23 days, and did not differ by symptoms. The weekly cumulative CVS rate was 2, 14, 44, 73, 91 and 95 % at 1-6 weeks from symptom onset, respectively. Cough and fever were associated with a positive PCR test if tested within 2 weeks of symptoms (P < 0.05). Patients with asthma or immunosuppression were less likely to achieve CVS if tested 3 weeks into symptoms (P < 0.04).</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b>
</p>
<p>The cumulative CVS rate at 3 weeks from symptom-onset is 44 % in our entire cohort. The findings of our study highlight the low yield of repeating a SARS-CoV-2 NP PCR test within 21 days of a laboratoryconfirmed COVID-19 diagnosis.</p>
</div>
</front>
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<Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Molecular detection of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is key in the diagnosis of coronavirus disease 2019 (COVID-19) and has been widely used for followup of cases as a proxy for contagiousness. The persistence of SARS-CoV-2 RNA shedding in the context of clinical features and comorbidities is understudied.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">We retrospectively reviewed laboratory-confirmed COVID-19 adult symptomatic cases at Mayo Clinic, eventually achieving cessation of viral RNA shedding (CVS), defined as two consecutive negative SARS-CoV-2 PCR results on nasopharyngeal swabs collected at least 24 h apart.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">A total of 251 patients were included, median age was 53 years and 59 % female. The most common symptoms at diagnosis were cough, myalgia, dyspnea, fever and chills. Myalgia, cough, anosmia, ageusia and sore throat were common at CVS, but fever and dyspnea were not observed. The median time from symptom onset to CVS was 23 days, and did not differ by symptoms. The weekly cumulative CVS rate was 2, 14, 44, 73, 91 and 95 % at 1-6 weeks from symptom onset, respectively. Cough and fever were associated with a positive PCR test if tested within 2 weeks of symptoms (P < 0.05). Patients with asthma or immunosuppression were less likely to achieve CVS if tested 3 weeks into symptoms (P < 0.04).</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">The cumulative CVS rate at 3 weeks from symptom-onset is 44 % in our entire cohort. The findings of our study highlight the low yield of repeating a SARS-CoV-2 NP PCR test within 21 days of a laboratoryconfirmed COVID-19 diagnosis.</AbstractText>
<CopyrightInformation>Copyright © 2020 Elsevier B.V. All rights reserved.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Corsini Campioli</LastName>
<ForeName>Cristina</ForeName>
<Initials>C</Initials>
<AffiliationInfo><Affiliation>Division of Infectious Diseases, Rochester, MN, USA. Electronic address: corsinicampioli.cristina@mayo.edu.</Affiliation>
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<ForeName>Mariam</ForeName>
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</AffiliationInfo>
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<AffiliationInfo><Affiliation>Infectious Diseases Research Laboratory, Rochester, MN, USA; Division of Clinical Microbiology, Rochester, MN, USA.</Affiliation>
</AffiliationInfo>
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<MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName>
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<KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">COVID-19</Keyword>
<Keyword MajorTopicYN="N">PCR testing</Keyword>
<Keyword MajorTopicYN="N">SARSCo-V-2</Keyword>
<Keyword MajorTopicYN="N">Viral RNA shedding</Keyword>
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<PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year>
<Month>07</Month>
<Day>21</Day>
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<PubMedPubDate PubStatus="revised"><Year>2020</Year>
<Month>07</Month>
<Day>30</Day>
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<PubMedPubDate PubStatus="accepted"><Year>2020</Year>
<Month>08</Month>
<Day>03</Day>
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<PubMedPubDate PubStatus="entrez"><Year>2020</Year>
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<ArticleIdList><ArticleId IdType="pubmed">32777762</ArticleId>
<ArticleId IdType="pii">S1386-6532(20)30319-X</ArticleId>
<ArticleId IdType="doi">10.1016/j.jcv.2020.104577</ArticleId>
<ArticleId IdType="pmc">PMC7405830</ArticleId>
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