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Risk factors for the COVID-19 severity and its correlation with viral shedding: A retrospective cohort study

Xinchun Zheng1, Jiehua Chen1, Lisi Deng1

  • 1Department of Infectious Diseases, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong, China.

Journal of Medical Virology
|July 30, 2020
PubMed

Insights

Early COVID-19 severity is linked to longer fever duration and higher C-reactive protein (CRP) levels. Viral shedding duration, however, does not correlate with disease severity in patients with Coronavirus disease 2019.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Virology

Background:

  • Coronavirus disease 2019 (COVID-19) rapidly became a global pandemic.
  • Understanding early risk factors for COVID-19 severity is crucial for patient management.
  • The relationship between viral shedding and disease progression requires further investigation.

Purpose of the Study:

  • To identify early risk factors associated with COVID-19 severity.
  • To explore the correlation between viral shedding duration and COVID-19 severity.

Main Methods:

  • Retrospective analysis of inpatient medical records for laboratory-confirmed COVID-19 cases discharged by March 9, 2020.
  • Comparison of biochemical indicators and clinical data between common and severe COVID-19 patient groups.
  • Multivariable regression analysis to determine independent predictors of severity.

Main Results:

  • Increased odds of COVID-19 severity were associated with longer fever duration (OR 1.42), elevated C-reactive protein (CRP) (OR 1.26), and low admission PO2 < 80 mm Hg (OR 28.07).
  • Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA was detected in respiratory and fecal samples for extended periods (up to 43 and 46 days, respectively).
  • No significant correlation was found between the duration of viral shedding and the severity of COVID-19.

Conclusions:

  • Duration of fever, elevated CRP, and low admission PO2 are significant early indicators of COVID-19 severity.
  • Prolonged viral shedding in respiratory and fecal samples does not predict disease severity in COVID-19 patients.

Keywords:
COVID-19retrospective cohort studyrisk factorsseverityviral shedding

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