Factors associated with prolonged viral detection in asymptomatic and mildly symptomatic patients with SARS-CoV-2 infection

Introduction: Data on the clinical course and duration of viral RNA detection in patients with mild or asymptomatic coronavirus disease 2019 are limited. Methodology: In this retrospective analysis, clinical characteristics and serial real-time reverse transcriptase-polymerase chain reaction (RT...

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Main Authors: Yong Hoon Lee, Chae Moon Hong, Taek Hoo Lee, Yoon Jin Hwang, Dae Hyun Kim, Jaetae Lee
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2022-02-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/15072
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author Yong Hoon Lee
Chae Moon Hong
Taek Hoo Lee
Yoon Jin Hwang
Dae Hyun Kim
Jaetae Lee
author_facet Yong Hoon Lee
Chae Moon Hong
Taek Hoo Lee
Yoon Jin Hwang
Dae Hyun Kim
Jaetae Lee
author_sort Yong Hoon Lee
collection DOAJ
description Introduction: Data on the clinical course and duration of viral RNA detection in patients with mild or asymptomatic coronavirus disease 2019 are limited. Methodology: In this retrospective analysis, clinical characteristics and serial real-time reverse transcriptase-polymerase chain reaction (RT-PCR) results were reviewed in a cohort of 1186 asymptomatic and mildly symptomatic coronavirus disease 2019 patients in South Korea. Factors associated with prolonged duration of RT-PCR positivity for severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) were also evaluated. Patients with two consecutive negative RT-PCR tests ≥ 24 hours apart were considered to be in virologic remission and discharged. Results: The average virologic remission period, defined as the number of days from diagnosis to virologic remission, was 22.0 ± 9.7 days; patients with longer than 30 days accounted for 21.2% (251/1186) of the population. Patients who took longer than 30 days to achieve virologic remission had a higher frequency of overall symptoms (p < 0.001) and respiratory symptoms (p < 0.001). In multivariate analysis using Cox-proportional hazard regression, it was confirmed that respiratory symptoms (hazard ratio [HR], 0.7372; 95% confidence interval [CI], 0.6540-0.8311) and gastrointestinal symptoms (HR, 0.8213; 95% CI, 0.6970-0.9679) were independent factors associated with prolonged virologic remission. Age and co-morbidity such as diabetes and hypertension were not associated with the prolonged RT-PCR positivity. Conclusions: A considerable percentage of asymptomatic and mildly symptomatic patients with coronavirus disease 2019 showed prolonged RT-PCR positivity for SARS-CoV-2; which was independently associated with the presence of symptoms, but not with age and co-morbidity.
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spelling doaj-art-ea55e9daa9c744ccaa18d17fa92c3df92025-08-20T03:52:42ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802022-02-01160210.3855/jidc.15072Factors associated with prolonged viral detection in asymptomatic and mildly symptomatic patients with SARS-CoV-2 infectionYong Hoon Lee0Chae Moon Hong1Taek Hoo Lee2Yoon Jin Hwang3Dae Hyun Kim4Jaetae Lee5Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, South KoreaDepartment of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu, South KoreaDepartment of Obstetrics and Gynecology, School of Medicine, Kyungpook National University, Daegu, South KoreaDepartment of Surgery, School of Medicine, Kyungpook National University, Daegu, South KoreaDepartment of Family Medicine, Keimyung University Dongsan Medical Center, Daegu, South KoreaDepartment of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea Introduction: Data on the clinical course and duration of viral RNA detection in patients with mild or asymptomatic coronavirus disease 2019 are limited. Methodology: In this retrospective analysis, clinical characteristics and serial real-time reverse transcriptase-polymerase chain reaction (RT-PCR) results were reviewed in a cohort of 1186 asymptomatic and mildly symptomatic coronavirus disease 2019 patients in South Korea. Factors associated with prolonged duration of RT-PCR positivity for severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) were also evaluated. Patients with two consecutive negative RT-PCR tests ≥ 24 hours apart were considered to be in virologic remission and discharged. Results: The average virologic remission period, defined as the number of days from diagnosis to virologic remission, was 22.0 ± 9.7 days; patients with longer than 30 days accounted for 21.2% (251/1186) of the population. Patients who took longer than 30 days to achieve virologic remission had a higher frequency of overall symptoms (p < 0.001) and respiratory symptoms (p < 0.001). In multivariate analysis using Cox-proportional hazard regression, it was confirmed that respiratory symptoms (hazard ratio [HR], 0.7372; 95% confidence interval [CI], 0.6540-0.8311) and gastrointestinal symptoms (HR, 0.8213; 95% CI, 0.6970-0.9679) were independent factors associated with prolonged virologic remission. Age and co-morbidity such as diabetes and hypertension were not associated with the prolonged RT-PCR positivity. Conclusions: A considerable percentage of asymptomatic and mildly symptomatic patients with coronavirus disease 2019 showed prolonged RT-PCR positivity for SARS-CoV-2; which was independently associated with the presence of symptoms, but not with age and co-morbidity. https://jidc.org/index.php/journal/article/view/15072SARS-CoV-2COVID-19Community Treatment CenterRT-PCRSymptomsComorbidity
spellingShingle Yong Hoon Lee
Chae Moon Hong
Taek Hoo Lee
Yoon Jin Hwang
Dae Hyun Kim
Jaetae Lee
Factors associated with prolonged viral detection in asymptomatic and mildly symptomatic patients with SARS-CoV-2 infection
Journal of Infection in Developing Countries
SARS-CoV-2
COVID-19
Community Treatment Center
RT-PCR
Symptoms
Comorbidity
title Factors associated with prolonged viral detection in asymptomatic and mildly symptomatic patients with SARS-CoV-2 infection
title_full Factors associated with prolonged viral detection in asymptomatic and mildly symptomatic patients with SARS-CoV-2 infection
title_fullStr Factors associated with prolonged viral detection in asymptomatic and mildly symptomatic patients with SARS-CoV-2 infection
title_full_unstemmed Factors associated with prolonged viral detection in asymptomatic and mildly symptomatic patients with SARS-CoV-2 infection
title_short Factors associated with prolonged viral detection in asymptomatic and mildly symptomatic patients with SARS-CoV-2 infection
title_sort factors associated with prolonged viral detection in asymptomatic and mildly symptomatic patients with sars cov 2 infection
topic SARS-CoV-2
COVID-19
Community Treatment Center
RT-PCR
Symptoms
Comorbidity
url https://jidc.org/index.php/journal/article/view/15072
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