Duration of COVID-19: Data from an Italian Cohort and Potential Role for Steroids

Abstract

The diffusion of SARS-CoV-2, starting from China in December 2019, has led to a pandemic, reaching Italy in February 2020. Previous studies in Asia have shown that the median duration of SARS-CoV-2 viral shedding was approximately 12-20 days. We considered a cohort of patients recovered from COVID-19 showing that the median disease duration between onset and end of COVID-19 symptoms was 27.5 days (interquartile range (IQR): 17.0-33.2) and that the median duration between onset of symptoms and microbiological healing, defined by two consecutive negative nasopharyngeal swabs, was 38 days (IQR: 31.7-50.2). A longer duration of COVID-19 with delayed clinical healing (symptom-free) occurred in patients presenting at admission a lower PaO₂/FiO₂ ratio (p < 0.001), a more severe clinical presentation (p = 0.001) and a lower lymphocyte count (p = 0.035). Moreover, patients presenting at admission a lower PaO₂/FiO₂ ratio and more severe disease showed longer viral shedding (p = 0.031 and p = 0.032, respectively). In addition, patients treated with corticosteroids had delayed clinical healing (p = 0.013).

Keywords: COVID-19; SARS-CoV-2; steroids; viral shedding.

Figure 1

The figure explains the different clinical durations of COVID-19 in patients treated with corticosteroids and not treated with corticosteroids (p = 0.013); the bottom of the boxplot indicates the 25th percentile, and the top indicates the 75th percentile. Horizontal lines in the boxes are medians. The lower end of the whiskers represents the extremes of Tukey confidence intervals. The p-value reported in the figure is relative to differences between groups and was derived from a linear mixed-effects model. The median value of disease duration in patients treated with use of corticosteroids was 30.0 days (IQR: 27.5–39.0); the median value of disease duration in patients treated without use of corticosteroids was 22.0 days (IQR: 15.5–31.0).