SARS-CoV-2 Persistent Viral Shedding in the Context of Hydroxychloroquine-Azithromycin Treatment.
SARS-CoV-2 Persistent Viral Shedding in the Context of Hydroxychloroquine-Azithromycin Treatment.
复制标题
DOI：
10.3390/v13050890
复制
发表时间：
2021-05-12
期刊：
影响因子：
--
通讯作者：
Colson P
中科院分区：
文献类型：
--
作者：
Drancourt M;Cortaredona S;Melenotte C;Amrane S;Eldin C;La Scola B;Parola P;Million M;Lagier JC;Raoult D;Colson P
SARS-CoV-2鼻咽脱落有助于COVID-19疫情的传播。在2020年3月3日至4月27日在法国马赛医院大学感染研究所接受治疗的3271例COVID-19患者中，至少进行了两次qRT-PCR检测，中位SARS-CoV-2鼻咽脱落持续时间为6天（范围为2-54天）。与短脱毛者（qRT-PCR阳性< 10天）相比，34例（1.04%）持续性脱毛者（qRT-PCR阳性≥17天，平均±SD: 23.3±3.8天）明显变老，伴有淋巴细胞减少、红细胞减少、d -二聚体升高、肌钙蛋白升高等并发症（p < 0.05）， 17.7%比1.1%的患者住院（p < 0.0001）。10天后，6例持续性脱毛患者的病毒培养呈阳性，其中1例患者在17天后脱毛，33例患者未检测到病毒共病原体。26/34例（76.5%）持续性崩落者接受阿奇霉素加羟氯喹治疗≥3天，显著低于短崩落者（86.6%）（p = 0.042）。因此，死亡率分别为14.7%和0.5% （p < 0.0001）。持续脱落与持续呼吸困难和嗅觉缺失/衰老显著相关（p < 0.05）。在COVID-19治疗的背景下，包括阿奇霉素加羟氯喹治疗，持续出现SARS-CoV-2鼻咽脱落是罕见的事件，最常见于合并合并症且缺乏阿奇霉素加羟氯喹治疗的老年患者。
SARS-CoV-2 nasopharyngeal shedding contributes to the spread of the COVID-19 epidemic. Among 3271 COVID-19 patients treated at the Hospital University Institute Méditerranée Infection, Marseille, France from 3 March to 27 April 2020, tested at least twice by qRT-PCR, the median SARS-CoV-2 nasopharyngeal shedding duration was 6 days (range 2–54 days). Compared with short shedders (qRT-PCR positivity < 10 days), 34 (1.04%) persistent shedders (qRT-PCR positivity ≥ 17 days; mean ± SD: 23.3 ± 3.8 days) were significantly older, with associated comorbidities, exhibiting lymphopenia, eosinopenia, increased D-dimer and increased troponin (p < 0.05), and were hospitalized in intensive care unit in 17.7% vs. 1.1% of cases (p < 0.0001). Viral culture was positive in six persistent shedders after day 10, including in one patient after day 17, and no viral co-pathogen was detected in 33 tested patients. Persistent shedders received azithromycin plus hydroxychloroquine ≥ 3 days in 26/34 (76.5%) patients, a figure significantly lower than in short shedders (86.6%) (p = 0.042). Accordingly, mortality was 14.7% vs. 0.5% (p < 0.0001). Persistent shedding was significantly associated with persistent dyspnea and anosmia/ageusia (p < 0.05). In the context of COVID-19 treatment, including treatment with azithromycin plus hydroxychloroquine, the persistence of SARS-CoV-2 nasopharyngeal shedding was a rare event, most frequently encountered in elderly patients with comorbidities and lacking azithromycin plus hydroxychloroquine treatment.
登录
查看更多内容
影响因子：
1.2
作者：
DeVine, Mackenzie N.;Maxwell, Sarah;Boguniewicz, Juri
通讯作者：
Boguniewicz, Juri
DOI：
10.1007/s10096-020-03913-9
发表时间：
2020-04-27
影响因子：
4.5
作者：
La Scola, Bernard;Le Bideau, Marion;Raoult, Didier
通讯作者：
Raoult, Didier
DOI：
10.1093/cid/ciab072
发表时间：
2021-08-02
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Hensley MK;Bain WG;Jacobs J;Nambulli S;Parikh U;Cillo A;Staines B;Heaps A;Sobolewski MD;Rennick LJ;Macatangay BJC;Klamar-Blain C;Kitsios GD;Methé B;Somasundaram A;Bruno TC;Cardello C;Shan F;Workman C;Ray P;Ray A;Lee J;Sethi R;Schwarzmann WE;Ladinsky MS;Bjorkman PJ;Vignali DA;Duprex WP;Agha ME;Mellors JW;McCormick KD;Morris A;Haidar G
通讯作者：
Haidar G
DOI：
10.1186/s13049-020-00764-3
发表时间：
2020-07-13
影响因子：
3.3
作者：
Myrstad, Marius;Ihle-Hansen, Hakon;Berge, Trygve
通讯作者：
Berge, Trygve
DOI：
10.1016/j.ijantimicag.2020.105949
发表时间：
2020-07-01
影响因子：
10.8
作者：
Gautret, Philippe;Lagier, Jean-Christophe;Raoult, Didier
通讯作者：
Raoult, Didier