Factors associated with viral clearance periods from patients with COVID-19: A retrospective observational cohort study.
Factors associated with viral clearance periods from patients with COVID-19: A retrospective observational cohort study.
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DOI：
10.1016/j.jiac.2021.02.015
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发表时间：
2021-06
期刊：
影响因子：
--
通讯作者：
Kasahara K
中科院分区：
文献类型：
--
作者：
Hirai N;Nishioka Y;Sekine T;Nishihara Y;Okuda N;Nishimura T;Fujikura H;Imakita N;Fukumori T;Ogawa T;Hishiya N;Suzuki Y;Nakano R;Yano H;Sato M;Maeda K;Imamura T;Kasahara K
对严重急性呼吸综合征冠状病毒-2 (SARS-CoV-2) 感染的病毒学过程的了解有限，特别是病毒清除所需的时间和停止隔离的最佳时间。本研究旨在确定影响 COVID-19 患者病毒清除所需时间的临床和人口统计因素，以确定最佳隔离期。这项两中心回顾性观察队列研究于2020年3月1日至6月31日进行。纳入经实时逆转录聚合酶链反应确诊的COVID-19患者。数据是从医疗记录中提取的。使用广义线性模型评估阳性持续时间，定义为从症状出现之日到阴性转化之日的时间。我们纳入了 63 名患者。平均阳性持续时间为 20 天。 30岁以下和30-60岁患者的阳性持续时间明显短于60岁以上患者。我们观察到老年患者的阳性持续时间分布比年轻患者更分散。从 COVID-19 中康复的年轻患者比老年患者清除 SARS-CoV-2 的时间更短；因此，可以考虑根据年龄对隔离期进行分类。由于潜在医疗状况等偏差，老年患者的统一病毒清除期可能很难确定。建议采取进一步的监测措施，以确定病毒清除时间和最佳隔离期。
Knowledge is limited on the virologic course of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, particularly the time taken for viral clearance and the optimal time to discontinue isolation. This study aims to identify the clinical and demographic factors influencing the time taken for viral clearance in patients with COVID-19 to determine the optimal isolation period. This two-center retrospective observational cohort study was conducted between March 1 and June 31, 2020. Patients with COVID-19, which was confirmed by real-time reverse transcription polymerase chain reaction, were included. Data were extracted from medical records. The positive duration, which was defined as the period from the day of symptom onset to the negative conversion day, was assessed using a generalized linear model. We included 63 patients. The mean positive duration was 20 days. The positive duration was significantly shorter for patients younger than 30 years of age and those between 30 and 60 years of age than for patients older than 60 years of age. We observed a more scattered distribution of the positive duration in older patients than in younger patients. Younger patients who recovered from COVID-19 took less time to clear SARS-CoV-2 than older patients; thus, a classification of the isolation periods based on age could be considered. A uniform viral clearance period for older patients may be difficult to determine because of biases such as underlying medical conditions. Further surveillance measures are recommended to determine the viral clearance time and the optimal isolation period.
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