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. 2021 Mar 4:14:555-565.
doi: 10.2147/JMDH.S302891. eCollection 2021.

Viral Clearance Course of COVID-19 Outbreaks

Shaher M Samrah  1 , Abdel-Hameed Al-Mistarehi  2 , Tariq Kewan  3 , Sohaib M Al-Khatib  4 , Ali M Ibnian  1 , Randa S Samrah  5 , Basheer Y Khassawneh  1
Affiliations

Viral Clearance Course of COVID-19 Outbreaks

Shaher M Samrah et al. J Multidiscip Healthc. .

Abstract

Background: Coronavirus disease 2019 (COVID-19) viral course and behavior remain unpredictable. This study describes incubation time and viral clearance of COVID-19 hospitalized cases in Northern Jordan.

Methods: All COVID-19 confirmed cases hospitalized from March 15 to June 09, 2020, were included. Nasopharyngeal swabs were collected, and COVID-19 reverse transcription-polymerase chain reaction (RT-PCR) was performed every two days in all cases. The viral cure was defined when two negative RT-PCR tests were obtained ≥ 24 hours apart. Viral clearance time (VCT) reflects the time from the first positive nasopharyngeal swab to the first of two consecutive negative tests.

Results: In this cohort, a total of 157 patients were included. Most cases resulted from two major outbreaks. The median incubation period was 6 days (IQR, 3-10) and ranged from 1 to 17 days. The median VCT was 13 days (IQR, 7-2) and ranged from 1 to 40 days. Symptomatic presentation and abnormal chest radiograph were predictors for a prolonged VCT (p=0.015 and p=0.014, respectively). The median time of resolution of symptoms was 7 days (IQR, 3-10 days). Most symptomatic cases (91.7%) remained RT-PCR positive for up to 20 days after symptoms resolution, with a median of 13.5 days. VCT significantly correlated with the incubation period (p=0.013).

Conclusion: Viral cure lagged for as long as 20 days after resolution of symptoms. Continuing with social-distancing, frequent hand hygiene, and wearing facial mask remains essential and is recommended even after clinical resolution of symptoms.

Keywords: CDC; COVID-19; coronavirus; incubation period; pandemic; viral clearance; viral shedding.

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Conflict of interest statement

The authors declare that they have no competing interests in this work.

Figures

Figure 1
Figure 1
Daily number of patients’ hospitalization, discharge, and death.
Figure 2
Figure 2
Duration to viral clearance in weeks.
Figure 3
Figure 3
Kaplan–Meier curves for negative viral conversion ratio between asymptomatic and symptomatic COVID-19 patients.
Figure 4
Figure 4
Kaplan–Meier curves for negative viral conversion ratio in COVID-19 patients according to radiological findings upon admission.
See this image and copyright information in PMC

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