Clinical characteristics of recovered COVID-19 patients with re-detectable positive RNA test.
Clinical characteristics of recovered COVID-19 patients with re-detectable positive RNA test.
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DOI：
10.21037/atm-20-5602
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发表时间：
2020-09
影响因子：
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通讯作者：
Zhang Z
中科院分区：
文献类型：
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作者：
An J;Liao X;Xiao T;Qian S;Yuan J;Ye H;Qi F;Shen C;Wang L;Liu Y;Cheng X;Li N;Cai Q;Wang F;Chen J;Li G;Cai Q;Liu Y;Wang Y;Zhang F;Fu Y;He Q;Tan X;Liu L;Zhang Z
2019冠状病毒病（COVID-19）康复患者出院后SARS-CoV-2诊断阳性（可再检测阳性，RP）的特征，意义和潜在原因仍然难以捉摸。2020年1月23日至2月25日期间出院的262名COVID-19患者共入组本研究。RP和非RP（NRP）患者根据疾病的严重程度进行分组，并在重新入院的表征进行了分析。检测SARS-CoV-2 RNA和血浆抗体水平，所有患者随访至少14天，截止日期为2020年3月10日。共检测到14.5%的RP患者。与NRP患者相比，这些患者的特征为年轻，表现为轻度和中度疾病，而无重度患者为RP。RP患者表现出较少的症状，但相似的血浆抗体水平在住院期间相比，NRP患者。在再次入院时，这些患者没有表现出明显的症状或疾病进展。所有21名RP患者的密切接触者的病毒RNA检测均为阴性，未出现可疑症状。在商业试剂盒检测到的24份RNA阴性样本中，有18份使用超敏方法检测出病毒RNA阳性，这表明这些患者在COVID-19康复后是潜在的病毒携带者。我们的研究结果表明，轻度诊断为COVID-19的年轻患者在出院后更有可能显示RP状态。这些患者在再次入院时没有表现出明显的症状或疾病进展。需要更灵敏的RNA检测方法来监测这些患者。我们的研究结果为恢复期COVID-19患者的管理提供了信息和证据。
The characteristics, significance and potential cause of positive SARS-CoV-2 diagnoses in recovered coronavirus disease 2019 (COVID-19) patients post discharge (re-detectable positive, RP) remained elusive. A total of 262 COVID-19 patients discharged from January 23 to February 25, 2020 were enrolled into this study. RP and non-RP (NRP) patients were grouped according to disease severity, and the characterization at re-admission was analyzed. SARS-CoV-2 RNA and plasma antibody levels were measured, and all patients were followed up for at least 14 days, with a cutoff date of March 10, 2020. A total of 14.5% of RP patients were detected. These patients were characterized as young and displayed mild and moderate conditions compared to NRP patients while no severe patients were RP. RP patients displayed fewer symptoms but similar plasma antibody levels during their hospitalization compared to NRP patients. Upon hospital readmission, these patients showed no obvious symptoms or disease progression. All 21 close contacts of RP patients were tested negative for viral RNA and showed no suspicious symptoms. Eighteen out of 24 of RNA-negative samples detected by the commercial kit were tested positive for viral RNA using a hyper-sensitive method, suggesting that these patients were potential carriers of the virus after recovery from COVID-19. Our results indicated that young patients, with a mild diagnosis of COVID-19 are more likely to display RP status after discharge. These patients show no obvious symptoms or disease progression upon re-admission. More sensitive RNA detection methods are required to monitor these patients. Our findings provide information and evidence for the management of convalescent COVID-19 patients.