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Meta-Analysis
. 2020 Nov 26;10(1):20692.
doi: 10.1038/s41598-020-77739-y.

Recurrent SARS-CoV-2 RNA positivity after COVID-19: a systematic review and meta-analysis

Mahalul Azam  1 , Rina Sulistiana  2 , Martha Ratnawati  3 , Arulita Ika Fibriana  2 , Udin Bahrudin  4 , Dian Widyaningrum  5 , Syed Mohamed Aljunid  6
Affiliations
Meta-Analysis

Recurrent SARS-CoV-2 RNA positivity after COVID-19: a systematic review and meta-analysis

Mahalul Azam et al. Sci Rep. .

Abstract

Present study aimed to estimate the incidence of recurrent SARS-CoV-2 RNA positivity after recovery from COVID-19 and to determine the factors associated with recurrent positivity. We searched the PubMed, MedRxiv, BioRxiv, the Cochrane Library, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry for studies published to June 12, 2020. Studies were reviewed to determine the risk of bias. A random-effects model was used to pool results. Heterogeneity was assessed using I2. Fourteen studies of 2568 individuals were included. The incidence of recurrent SARS-CoV-2 positivity was 14.8% (95% confidence interval [CI] 11.44-18.19%). The pooled estimate of the interval from disease onset to recurrence was 35.4 days (95% CI 32.65-38.24 days), and from the last negative to the recurrent positive result was 9.8 days (95% CI 7.31-12.22 days). Patients with younger age and a longer initial illness were more likely to experience recurrent SARS-CoV-2 positivity, while patients with diabetes, severe disease, and a low lymphocyte count were less likely to experience. Present study concluded that the incidence of recurrent SARS-CoV-2 positivity was 14.8% suggesting further studies must be conducted to elucidate the possibility of infectious individuals with prolonged or recurrent RNA positivity.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
PRISMA-P study selection diagram.
Figure 2
Figure 2
A meta-analysis of the pooled estimated incidence of recurrent SARS-CoV-2 RNA positivity.
Figure 3
Figure 3
(a) A meta-analysis of the pooled estimated interval from onset to recurrent SARS-CoV-2 RNA positivity (days) and (b) A meta-analysis of the pooled estimated interval from last negative to recurrent SARS-CoV-2 RNA positivity (days).
Figure 4
Figure 4
A meta-analysis of the pooled estimated RR of age, sex, and BMI to recurrent SARS-CoV-2 RNA positivity.
Figure 5
Figure 5
A meta-analysis of the pooled estimated RR of comorbidity, hypertension, and DM to recurrent SARS-CoV-2 RNA positivity.
Figure 6
Figure 6
A meta-analysis of the pooled estimated RR of fever and clinical features to recurrent SARS-CoV-2 RNA positivity.
Figure 7
Figure 7
A sub-group meta-analysis of severity for the pooled estimated interval from onset to last negative to recurrent SARS-CoV-2 RNA positivity.
See this image and copyright information in PMC

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