Evaluation of potential COVID-19 recurrence in patients with late repeat positive SARS-CoV-2 testing.
Evaluation of potential COVID-19 recurrence in patients with late repeat positive SARS-CoV-2 testing.
复制标题
DOI：
10.1371/journal.pone.0251214
复制
发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Brown SM
中科院分区：
文献类型：
--
作者：
Peltan ID;Beesley SJ;Webb BJ;Lopansri BK;Sinclair W;Jacobs JR;Brown SM
SARS-CoV-2 reinfection and reactivation has mostly been described in case reports. We therefore investigated the epidemiology of recurrent COVID-19 SARS-CoV-2. Among patients testing positive for SARS-CoV-2 between March 11 and July 31, 2020 within an integrated healthcare system, we identified patients with a recurrent positive SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) assay ≥60 days after an initial positive test. To assign an overall likelihood of COVID-19 recurrence, we combined quantitative data from initial and recurrent positive RT-PCR cycle thresholds—a value inversely correlated with viral RNA burden— with a clinical recurrence likelihood assigned based on independent, standardized case review by two physicians. “Probable” or “possible” recurrence by clinical assessment was confirmed as the final recurrence likelihood only if a cycle threshold value obtained ≥60 days after initial testing was lower than its preceding cycle threshold or if the patient had an interval negative RT-PCR. Among 23,176 patients testing positive for SARS-CoV-2, 1,301 (5.6%) had at least one additional SARS-CoV-2 RT-PCRs assay ≥60 days later. Of 122 testing positive, 114 had sufficient data for evaluation. The median interval to the recurrent positive RT-PCR was 85.5 (IQR 74–107) days. After combining clinical and RT-PCR cycle threshold data, four patients (3.5%) met criteria for probable COVID-19 recurrence. All four exhibited symptoms at recurrence and three required a higher level of medical care compared to their initial diagnosis. After including six additional patients (5.3%) with possible recurrence, recurrence incidence was 4.3 (95% CI 2.1–7.9) cases per 10,000 COVID-19 patients. Only 0.04% of all COVID-19 patients in our health system experienced probable or possible recurrence; 90% of repeat positive SARS-CoV-2 RT-PCRs were not consistent with true recurrence. Our pragmatic approach combining clinical and quantitative RT-PCR data could aid assessment of COVID-19 reinfection or reactivation by clinicians and public health personnel.
登录
查看更多内容
影响因子：
19
作者：
Singanayagam, Anika;Patel, Monika;Gopal, Robin
通讯作者：
Gopal, Robin
DOI：
10.15585/mmwr.mm7008a3externalicon
发表时间：
2021-02-26
影响因子：
33.9
作者：
Cavanaugh, Alyson M.;Thoroughman, Douglas;Spicer, Kevin
通讯作者：
Spicer, Kevin
DOI：
10.1056/nejmoa2034545
发表时间：
2021-02-11
期刊：
The New England journal of medicine
影响因子：
--
作者：
Lumley SF;O'Donnell D;Stoesser NE;Matthews PC;Howarth A;Hatch SB;Marsden BD;Cox S;James T;Warren F;Peck LJ;Ritter TG;de Toledo Z;Warren L;Axten D;Cornall RJ;Jones EY;Stuart DI;Screaton G;Ebner D;Hoosdally S;Chand M;Crook DW;O'Donnell AM;Conlon CP;Pouwels KB;Walker AS;Peto TEA;Hopkins S;Walker TM;Jeffery K;Eyre DW;Oxford University Hospitals Staff Testing Group
通讯作者：
Oxford University Hospitals Staff Testing Group
影响因子：
11.8
作者：
Bullard, Jared;Dust, Kerry;Poliquin, Guillaume
通讯作者：
Poliquin, Guillaume
影响因子：
82.9
作者：
He, Xi;Lau, Eric H. Y.;Leung, Gabriel M.
通讯作者：
Leung, Gabriel M.