Risk factors for SARS-CoV-2 re-positivity in COVID-19 patients after discharge

doi:10.1016/j.intimp.2021.107579

. 2021 Jun:95:107579.

doi: 10.1016/j.intimp.2021.107579. Epub 2021 Mar 12.

Risk factors for SARS-CoV-2 re-positivity in COVID-19 patients after discharge

Lu-Xiao Hong¹, Lian Liu², Aifen Lin³, Wei-Hua Yan⁴

Affiliations

¹ Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province, Luqiao, Zhejiang 318050, China.
² Department of Pediatrics, Taizhou Hospital of Zhejiang Province, Luqiao, Zhejiang 318050, China.
³ Biological Resource Center, Taizhou Hospital of Zhejiang Province, Linhai, Zhejiang 317000, China; Key Laboratory of Minimally Invasive Techniques & Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Taizhou Hospital of Zhejiang Province, Linhai, Zhejiang, China.
⁴ Medical Research Center, Taizhou Hospital of Zhejiang Province, Linhai, Zhejiang 317000, China; Key Laboratory of Minimally Invasive Techniques & Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Taizhou Hospital of Zhejiang Province, Linhai, Zhejiang, China. Electronic address: yanwhcom@yahoo.com.

PMID: 33756229
PMCID: PMC7953440
DOI: 10.1016/j.intimp.2021.107579

Risk factors for SARS-CoV-2 re-positivity in COVID-19 patients after discharge

Lu-Xiao Hong et al. Int Immunopharmacol. 2021 Jun.

. 2021 Jun:95:107579.

doi: 10.1016/j.intimp.2021.107579. Epub 2021 Mar 12.

Authors

Lu-Xiao Hong¹, Lian Liu², Aifen Lin³, Wei-Hua Yan⁴

Affiliations

¹ Department of Infectious Diseases, Taizhou Hospital of Zhejiang Province, Luqiao, Zhejiang 318050, China.
² Department of Pediatrics, Taizhou Hospital of Zhejiang Province, Luqiao, Zhejiang 318050, China.
³ Biological Resource Center, Taizhou Hospital of Zhejiang Province, Linhai, Zhejiang 317000, China; Key Laboratory of Minimally Invasive Techniques & Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Taizhou Hospital of Zhejiang Province, Linhai, Zhejiang, China.
⁴ Medical Research Center, Taizhou Hospital of Zhejiang Province, Linhai, Zhejiang 317000, China; Key Laboratory of Minimally Invasive Techniques & Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Taizhou Hospital of Zhejiang Province, Linhai, Zhejiang, China. Electronic address: yanwhcom@yahoo.com.

PMID: 33756229
PMCID: PMC7953440
DOI: 10.1016/j.intimp.2021.107579

Abstract

Objective: Re-positivity of SARS-CoV-2 in discharged COVID-19 patients have been reported; however, early risk factors for SARS-CoV-2 re-positivity evaluation are limited.

Methods: This is a prospective study, a total of 145 COVID-19 patients were treated and all discharged according to the guideline criteria by Mar 11th 2020. After discharge, clinical visits and viral RT-PCR tests by the second and fourth week follow-up were carried-out. Patient demographic and clinical characteristics and laboratory data on admission and discharge were retrieved, and predictive factors for SARS-CoV-2 re-positivity were analyzed.

Results: 13 out of 145 (9.0%) COVID-19 patients were confirmed re-positivity of SARS-CoV-2 by RT-PCR test. The median interval between disease onset to recurrence was 38 days. SARS-CoV-2 re-positive cases were of significantly longer virus shedding duration, notably higher body temperature, heart rate and lower TNF-α and IgG levels on admission. Covariate logistic regression analysis revealed virus shedding duration and IgG levels are independent risk factors for SARS-CoV-2 return positive after discharge.

Conclusion: Longer viral shedding duration and lower IgG levels are risk factors for re-positivity of SARS-CoV-2 for discharged COVID-19 patients.

Keywords: COVID-19; Re-positivity; Risk factor; SARS-CoV-2.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

**Fig. 1**
ROC curve for viral shedding duration and IgG levels to distinguish COVID-19 patients with virus remain negative and re-positivity after discharge.

See this image and copyright information in PMC

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References

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[1] Hong L.-X., Lin A., He Z.-B., Zhao H.-H., Zhang J.-G., Zhang C., Ying L.-J., Ge Z.-M., Zhang X., Han Q.-Y., Chen Q.-Y., Ye Y.-H., Zhu J.-S., Chen H.-X., Yan W.-H. Mask wearing in pre-symptomatic patients prevents SARS-CoV-2 transmission: An epidemiological analysis. Travel Med. Infect. Dis. 2020;36:101803. doi: 10.1016/j.tmaid.2020.101803. - DOI - PMC - PubMed

[2] Hong L.-X., Lin A., He Z.-B., Zhao H.-H., Zhang J.-G., Zhang C., Ying L.-J., Ge Z.-M., Zhang X., Han Q.-Y., Chen Q.-Y., Ye Y.-H., Zhu J.-S., Chen H.-X., Yan W.-H. Mask wearing in pre-symptomatic patients prevents SARS-CoV-2 transmission: An epidemiological analysis. Travel Med. Infect. Dis. 2020;36:101803. doi: 10.1016/j.tmaid.2020.101803. - DOI - PMC - PubMed

[3] Ye G., Pan Z., Pan Y., Deng Q., Chen L., Li J., Li Y., Wang X. Clinical characteristics of severe acute respiratory syndrome coronavirus 2 reactivation. J. Infect. 2020;80(5):e14–e17. doi: 10.1016/j.jinf.2020.03.001. - DOI - PMC - PubMed

[4] Ye G., Pan Z., Pan Y., Deng Q., Chen L., Li J., Li Y., Wang X. Clinical characteristics of severe acute respiratory syndrome coronavirus 2 reactivation. J. Infect. 2020;80(5):e14–e17. doi: 10.1016/j.jinf.2020.03.001. - DOI - PMC - PubMed

[5] Dao T.L., Hoang V.T., Gautret P. Recurrence of SARS-CoV-2 viral RNA in recovered COVID-19 patients: a narrative review. Eur. J. Clin. Microbiol. Infect. Dis. 2021;40(1):13–25. doi: 10.1007/s10096-020-04088-z. - DOI - PMC - PubMed

[6] Dao T.L., Hoang V.T., Gautret P. Recurrence of SARS-CoV-2 viral RNA in recovered COVID-19 patients: a narrative review. Eur. J. Clin. Microbiol. Infect. Dis. 2021;40(1):13–25. doi: 10.1007/s10096-020-04088-z. - DOI - PMC - PubMed

[7] Lan L., Xu D., Ye G., Xia C., Wang S., Li Y., Xu H. Positive RT-PCR Test Results in Patients Recovered From COVID-19. JAMA. 2020;323(15):1502. doi: 10.1001/jama.2020.2783. - DOI - PMC - PubMed

[8] Lan L., Xu D., Ye G., Xia C., Wang S., Li Y., Xu H. Positive RT-PCR Test Results in Patients Recovered From COVID-19. JAMA. 2020;323(15):1502. doi: 10.1001/jama.2020.2783. - DOI - PMC - PubMed

[9] Gao Z., Xu Y., Guo Y.e., Xu D., Zhang L.i., Wang X.u., Sun C., Qiu S., Ma K. A systematic review of re-detectable positive virus nucleic acid among COVID-19 patients in recovery phase. Infect. Genet. Evol. 2020;85:104494. doi: 10.1016/j.meegid.2020.104494. - DOI - PMC - PubMed

[10] Gao Z., Xu Y., Guo Y.e., Xu D., Zhang L.i., Wang X.u., Sun C., Qiu S., Ma K. A systematic review of re-detectable positive virus nucleic acid among COVID-19 patients in recovery phase. Infect. Genet. Evol. 2020;85:104494. doi: 10.1016/j.meegid.2020.104494. - DOI - PMC - PubMed

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Risk factors for SARS-CoV-2 re-positivity in COVID-19 patients after discharge

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Risk factors for SARS-CoV-2 re-positivity in COVID-19 patients after discharge

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