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

BMC Infectious Diseases

Qing-Bin Lu¹  Hao-Long Zeng²  Qing-Ming Wu³  Qiang Wang³  Jing Zhao⁴  Li-Qun Fang⁴  Wei Liu⁴  Hui Long⁵ 

[1] Department of Laboratorial Science and Technology, School of Public Health, Peking University;Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology;Institute of Infection, Immunology and Tumor Microenvironment, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Medical College, Wuhan University of Science and Technology;State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology;Tianyou Hospital, Wuhan University of Science and Technology;

关键词: COVID-19;    SARS-CoV-2;    Viral shedding;    Antibody;    Risk factor;   

DOI  :  10.1186/s12879-021-07002-w

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown