Clearance and persistence of SARS-CoV-2 RNA in patients with COVID-19
Clearance and persistence of SARS-CoV-2 RNA in patients with COVID-19
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DOI：
10.1002/jmv.26103
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发表时间：
2020-06-19
影响因子：
12.7
通讯作者：
Rodrigues, Fernando
中科院分区：
文献类型：
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作者：
Carmo, Analia;Pereira-Vaz, Joao;Rodrigues, Fernando
2019年冠状病毒病患者可能会根据症状的临床缓解以及上呼吸道病毒RNA清除的证据出院。了解严重急性呼吸系统综合征冠状病毒2（SARS-CoV-2）的病毒清除情况对于制定出院和结束隔离患者的重新检测计划至关重要。我们的目的是评估患者在上呼吸道标本（鼻咽拭子和/或口咽拭子）中达到无法检测到SARS-CoV-2水平所需的天数。在两组阳性患者中评估病毒RNA的清除率和持续性：两次逆转录聚合酶链反应（RT-PCR）试验阴性的患者和保持试验阳性的患者。此后，将患者分为两个亚组，轻度疾病患者出院回家，中度至重度疾病住院患者。然后将RT-PCR检测结果与免疫应答评价结果相关联。该研究证明，大多数患者检测呈阳性超过2周，病毒RNA的持续存在不一定与严重疾病相关，但可能是由于免疫反应较弱。
Patients with coronavirus disease-2019 may be discharged based on clinical resolution of symptoms, and evidence for viral RNA clearance from the upper respiratory tract. Understanding the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral clearance profile is crucial to establish a re-testing plan on discharge and ending isolation of patients. We aimed to evaluate the number of days that a patient needed to achieve undetectable levels of SARS-CoV-2 in upper respiratory tract specimens (nasopharyngeal swab and/or an oropharyngeal swab). The clearance and persistence of viral RNA was evaluated in two groups of positive patients: those who achieved two negative reverse transcription-polymerase chain reaction (RT-PCR) tests and those who kept testing positive. Patients were organized thereafter in two subgroups, mild illness patients discharged home and inpatients who had moderate to severe illness. Results from RT-PCR tests were then correlated with results from the evaluation of the immune response. The study evidenced that most patients tested positive for more than 2 weeks and that persistence of viral RNA is not necessarily associated with severe disease but may result from a weaker immune response instead.