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Clinical features of COVID-19 convalescent patients with re-positive nucleic acid detection
Hui Zhu1,2, Liyun Fu2,3, Yinhua Jin4
1Department of Experimental Medical Science, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, China.
Insights
Some COVID-19 patients test positive for SARS-CoV-2 after discharge. Follow-up is crucial for monitoring convalescent individuals and preventing disease spread.
Area of Science:
- Infectious Diseases
- Virology
- Immunology
Background:
- The COVID-19 pandemic necessitates understanding outcomes for discharged patients.
- Follow-up is essential to monitor convalescent individuals and assess disease trajectory.
Purpose of the Study:
- To investigate the outcomes of convalescent patients after COVID-19 discharge.
- To identify factors associated with SARS-CoV-2 re-positivity in recovered patients.
Main Methods:
- A retrospective study included 98 convalescent COVID-19 patients.
- Clinical data and post-discharge quarantine results were collected.
Main Results:
- 17.3% of patients tested positive for SARS-CoV-2 nucleic acid post-discharge.
- Re-positive patients had longer viral shedding times and higher NK cell levels.
- Pulmonary CT scans showed minimal changes in most re-positive cases.
Conclusions:
- SARS-CoV-2 re-positivity can occur in convalescent patients.
- Most re-positive cases do not show significant lung damage.
- Continued quarantine and monitoring are recommended for convalescent COVID-19 patients.
Background:
Coronavirus disease 2019 (COVID-19) is a pandemic that has rapidly spread worldwide. Increasingly, confirmed patients being discharged according to the current diagnosis and treatment protocols, follow-up of convalescent patients is important to knowing about the outcome.
Methods:
A retrospective study was performed among 98 convalescent patients with COVID-19 in a single medical center. The clinical features of patients during their hospitalization and 2-week postdischarge quarantine were collected.
Results:
Among the 98 COVID-19 convalescent patients, 17 (17.3%) were detected positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid during 2-week postdischarge quarantine. The median time from discharge to SARS-CoV-2 nucleic acid re-positive was 4 days (IQR, 3-8.5).The median time from symptoms onset to final respiratory SARS-CoV-2 detection of negative result was significantly longer in re-positive group (34 days [IQR, 29.5-42.5]) than in non-re-positive group (19 days [IQR, 16-26]). On the other hand, the levels of CD3-CD56 + NK cells during hospitalization and 2-week postdischarge were higher in re-positive group than in non-re-positive group (repeated measures ANOVA, P = .018). However, only one case in re-positive group showed exudative lesion recurrence in pulmonary computed tomography (CT) with recurred symptoms.
Conclusion:
It is still possible for convalescent patients to show positive for SARS-CoV-2 nucleic acid detection, but most of the re-positive patients showed no deterioration in pulmonary CT findings. Continuous quarantine and close follow-up for convalescent patients are necessary to prevent possible relapse and spread of the disease to some extent.
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