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. 2021 Jan;60(1):13-19.
doi: 10.1016/j.amepre.2020.08.014. Epub 2020 Sep 18.

Predictive Factors for a New Positive Nasopharyngeal Swab Among Patients Recovered From COVID-19

Francesco Landi  1 , Angelo Carfì  2 , Francesca Benvenuto  2 , Vincenzo Brandi  2 , Francesca Ciciarello  2 , Maria Rita Lo Monaco  2 , Anna Maria Martone  2 , Carmen Napolitano  2 , Francesco Pagano  2 , Annamaria Paglionico  2 , Luca Petricca  2 , Sara Rocchi  2 , Elisabetta Rota  2 , Andrea Salerno  2 , Marcello Tritto  2 , Elisa Gremese  2 , Roberto Bernabei  2 ; Gemelli Against COVID-19 Post-Acute Care Team  2
Affiliations

Predictive Factors for a New Positive Nasopharyngeal Swab Among Patients Recovered From COVID-19

Francesco Landi et al. Am J Prev Med. 2021 Jan.

Abstract

Introduction: As an emerging infectious disease, the clinical and virologic course of COVID-19 requires better investigation. The aim of this study is to identify the potential risk factors associated with persistent positive nasopharyngeal swab real-time reverse transcription‒polymerase chain reaction tests in a large sample of patients who recovered from COVID-19.

Methods: After the acute phase of SARS-CoV-2 epidemic infection, the Fondazione Policlinico A. Gemelli IRCSS of Rome established a post-acute care service for patients discharged from the hospital and recovered from COVID-19. Between April 21 and May 21, 2020, a total of 137 individuals who officially recovered from COVID-19 were enrolled in this study. All patients were tested for the SARS-CoV-2 virus with nucleic acid RT-PCR tests. Analysis was conducted in June 2020.

Results: Of the 131 patients who repeated the nasopharyngeal swab, 22 patients (16.7%) tested positive again. Some symptoms such as fatigue (51%), dyspnea (44%), and coughing (17%) were still present in a significant percentage of the patients, with no difference between patients with a negative test and those who tested positive. The likelihood of testing positive for SARS-CoV-2 infection was significantly higher among participants with persistent sore throat (prevalence ratio=6.50, 95% CI=1.38, 30.6) and symptoms of rhinitis (prevalence ratio=3.72, 95% CI=1.10, 12.5).

Conclusions: This study is the first to provide a given rate of patients (16.7%) who test positive on RT-PCR test for SARS-CoV-2 nucleic acid after recovering from COVID-19. These findings suggest that a significant proportion of patients who have recovered from COVID-19 still could be potential carriers of the virus. In particular, if patients continue to have symptoms related to COVID-19, such as sore throat and rhinitis, it is reasonable to be cautious by avoiding close contact, wearing a face mask, and possibly repeating a nasopharyngeal swab.

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