Factors associated with negative conversion of viral RNA in patients hospitalized with COVID-19
Factors associated with negative conversion of viral RNA in patients hospitalized with COVID-19
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DOI：
10.1016/j.scitotenv.2020.138812
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发表时间：
2020-08-01
影响因子：
9.8
通讯作者：
Jiang, Fachun
中科院分区：
文献类型：
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作者：
Hu, Xiaowen;Xing, Yuhan;Jiang, Fachun
与住院患者SARS-CoV-2 RNA阴性转化相关的因素尚未系统确定。我们对中国青岛的COVID-19患者进行了回顾性队列研究。进行了单因素和多因素分析，以确定病毒RNA阴性转化时间的独立因素。对RT-PCR检测呈阴性（间歇性阴性）后病毒RNA再检测患者的数据也进行了分析。本研究共纳入59例COVID-19确诊患者，从症状出现到入院的中位持续时间为1天（四分位数间距，IQR: 0-2）。中位传染期（从核酸检测阳性第一天到连续阴性第一天）为14天（IQR: 10-18），间歇阴性10例为7天（IQR: 6-10）。年龄大于45岁（风险比，HR: 0.378； 95%可信区间，CI: 0.205 ~ 0.698）和胸闷（HR: 0.290; 95%CI: 0.091 ~ 0.919）是影响SARS-CoV-2 RNA阴性转化的独立因素。头痛（优势比：7.553;95%CI: 1.011-28.253）与间歇性阴性状态显著相关，预测概率为60%。住院患者年龄和胸闷与SARS-CoV-2 RNA清除延迟独立相关。这些预测因子将为长期病毒脱落患者的早期识别提供新的视角，并促进最佳隔离方案和治疗策略。
Factors associated with negative conversion of SARS-CoV-2 RNA in hospitalized patients have not yet been systematically determined. We conducted a retrospective cohort study of COVID-19 patients in Qingdao, China. Both univariate and multivariate analysis were performed to identify independent factors for time to viral RNA negative conversion. Data on patients with re-detectable viral RNA after showing negative on RT-PCR test (intermittent negative status) were also analyzed. A total of 59 patients confirmed with COVID-19 were included in this study, with a median duration of 1 (interquartile range, IQR: 0-2) day from symptom onset to hospital admission. Median communicable period (from first day of positive nucleic acid test to first day of consecutive negative results) was 14 (IQR: 10-18) days, and 7 (IQR: 6-10) days for 10 patients with intermittent negative results. Age older than 45 years (hazard ratio, HR: 0.378; 95% confidence interval, CI: 0.205-0.698) and chest tightness (HR: 0.290; 95%CI: 0.091-0.919) were factors independently affecting negative conversion of SARS-CoV-2 RNA. Headache (odds ratio: 7.553; 95%CI: 1.011-28.253) was significantly associated with intermittent negative status, with a predicted probability of 60%. Older age and chest tightness were independently associated with delayed clearance of SARS-CoV-2 RNA in hospitalized patients. These predictors would provide a new perspective on early identification of patients with prolonged viral shedding and facilitate optimal isolation protocols and treatment strategies.