Login Register Cart 0
Generic placeholder image

Infectious Disorders - Drug Targets

Editor-in-Chief

ISSN (Print): 1871-5265
ISSN (Online): 2212-3989

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

The Persistence Time of SARS-CoV-2 RNA in Hospitalized COVID-19 Patients: A Prospective Study

Author(s): Jila Yavarian, Mohammad Javaherian, Somayeh Shatizadeh Malekshahi, Zahra Ahmadinejad, Fatemeh Ghiasvand, Elaheh Ahmadi, Ladan Abbasian, Malihe Hasannezhad, Narges Dabaghipour, Nazanin-Zahra Shafiei-Jandaghi, Talat Mokhtari-Azad and Mahboubeh Hajiabdolbaghi*

Volume 22, Issue 6, 2022

Published on: 23 May, 2022

Article ID: e230222201383 Pages: 6

DOI: 10.2174/1871526522666220223162445

Price: $65

conference banner
Abstract

Background: In late December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), the causative agent of coronavirus disease 2019 (COVID-19), spread to almost all countries worldwide. The outbreak of this virus has been confirmed on 19th February, 2020, in Iran.

Objective: The aim of this study was to investigate the time of viral RNA clearance in swab and serum samples of COVID-19 patients having received different medications. We also evaluated different factors that may affect viral RNA persistence in patients infected by SARS-CoV-2.

Methods: In March 2020, twenty-one hospitalized COVID-19 patients participated in this prospective study. All patients received antiviral agents in their routine care. Throat swabs and blood samples were obtained from all patients in different intervals, including day 3 or 5, day 7, day 10, and finally, 14 days after the first positive real-time RT-PCR (rRT-PCT) test.

Results: The median time from the symptom onset (SO) to the first negative rRT-PCR results for throat swabs and serum samples of COVID-19 patients was 18 and 14 days, respectively. These times were more significant in patients with lymphopenia, oxygen saturation ≤ 90%, and comorbidity.

Conclusion: This preliminary study highlights that SASR-CoV-2 RNA was not detectable in the upper respiratory tract for longer than three weeks. In addition, SARS-CoV-2 may persist for a long period of time in the respiratory than in the serum samples. This study supports the idea that in limited resource settings, the patients should be tested earlier than three weeks for discharge management.

Keywords: COVID-19, SARS-CoV-2, RNA, clearance, RT-PCR, serum.

Graphical Abstract

[1]
Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020; 382(8): 727-33.
[http://dx.doi.org/10.1056/NEJMoa2001017] [PMID: 31978945]
[2]
WHO. Coronavirus disease 2019 (COVID-19) - Situation report - 72. 2020. Available from: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200401-sitrep-72-covid-19.pdf?sfvrsn=3dd8971b_2
[3]
Yavarian J, Shafiei-Jandaghi N-Z, Sadeghi K, et al. First cases of SARS-CoV-2 in Iran, 2020: Case series report. Iran J Public Health 2020; 49(8): 1564-8.
[http://dx.doi.org/10.18502/ijph.v49i8.3903] [PMID: 33083334]
[4]
Worldometer. Total Coronaviruses Case in Iran. 2020. Available from: https://www.worldometers.info/coronavirus/country/iran/
[5]
Read JM, Bridgen JR, Cummings DA, Ho A, Jewell CP. Novel coronavirus 2019.medRxiv
[http://dx.doi.org/10.1101/2020.01.23.20018549]
[6]
Huang C, Wang Y, Li X, et al. Clinical features of patients in-fected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395(10223): 497-506.
[http://dx.doi.org/10.1016/S0140-6736(20)30183-5] [PMID: 31986264]
[7]
Chu DK, Pan Y, Cheng S, Hui KP, Krishnan P, Liu Y, et al. Molecular diagnosis of a novel coronavirus (2019-nCoV) caus-ing an outbreak of pneumonia. Clin Chem 2020; 66(4): 549-.
[http://dx.doi.org/10.1093/clinchem/hvaa029] [PMID: 32031583]
[8]
Ling Y, Xu S-B, Lin Y-X, et al. Persistence and clearance of viral RNA in 2019 novel coronavirus disease rehabilitation pa-tients. Chin Med J (Engl) 2020; 133(9): 1039-43.
[http://dx.doi.org/10.1097/CM9.0000000000000774] [PMID: 32118639]
[9]
Chen Y, Chen L, Deng Q, et al. The presence of SARS-CoV-2 RNA in the feces of COVID-19 patients. J Med Virol 2020; 92(7): 833-40.
[http://dx.doi.org/10.1002/jmv.25825] [PMID: 32243607]
[10]
Li J, Wei X, Tian W, et al. Clinical features of discharged COVID-19 patients with an extended SARS-CoV-2 RNA posi-tive signal in respiratory samples. Virus Res 2020; 286198047
[http://dx.doi.org/10.1016/j.virusres.2020.198047] [PMID: 32522535]
[11]
Jeong HW, Kim S-M, Kim H-S, et al. Viable SARS-CoV-2 in various specimens from COVID-19 patients. Clin Microbiol Infect 2020; 26(11): 1520-4.
[http://dx.doi.org/10.1016/j.cmi.2020.07.020] [PMID: 32711057]
[12]
Sun J, Xiao J, Sun R, et al. Prolonged persistence of SARS-CoV-2 RNA in body fluids. Emerg Infect Dis 2020; 26(8): 1834-8.
[http://dx.doi.org/10.3201/eid2608.201097] [PMID: 32383638]
[13]
Walsh KA, Jordan K, Clyne B, Rohde D, Drummond L, Byrne P, et al. SARS-CoV-2 detection, viral load and infectivity over the course of an infection: SARS-CoV-2 detection, viral load and infectivity. J Infect 81(3): 357-71.
[http://dx.doi.org/10.1016/j.jinf.2020.06.067]
[14]
Rees EM, Nightingale ES, Jafari Y, Waterlow NR, Clifford S, Pearson CA, et al. COVID-19 length of hospital stay: A system-atic review and data synthesis. medRxiv 2020.
[http://dx.doi.org/10.1101/2020.04.30.20084780]
[15]
Xu D, Zhang Z, Jin L, et al. Persistent shedding of viable SARS-CoV in urine and stool of SARS patients during the convales-cent phase. Eur J Clin Microbiol Infect Dis 2005; 24(3): 165-71.
[http://dx.doi.org/10.1007/s10096-005-1299-5] [PMID: 15789222]
[16]
Corman VM, Albarrak AM, Omrani AS, et al. Viral shedding and antibody response in 37 patients with Middle East respira-tory syndrome coronavirus infection. Clin Infect Dis 2016; 62(4): 477-83.
[http://dx.doi.org/10.1093/cid/civ951] [PMID: 26565003]
[17]
Zou L, Ruan F, Huang M, et al. SARS-CoV-2 viral load in upper respiratory specimens of infected patients. N Engl J Med 2020; 382(12): 1177-9.
[http://dx.doi.org/10.1056/NEJMc2001737] [PMID: 32074444]
[18]
Wang K, Zhang X, Sun J, Ye J, Wang F, Hua J, et al. Differences of SARS-CoV-2 shedding duration in sputum and nasopharyn-geal swab specimens among adult inpatients with COVID-19. Chest 2020; 158(5): 1876-84.
[http://dx.doi.org/10.1016/j.chest.2020.06.015] [PMID: 32569635]
[19]
Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study. Lancet 2020; 395(10229): 1054-62.
[http://dx.doi.org/10.1016/S0140-6736(20)30566-3] [PMID: 32171076]
[20]
Wang L, Gao Y-H, Lou L-L, Zhang G-J. The clinical dynamics of 18 cases of COVID-19 outside of Wuhan, China. Eur Respir J 2020; 55(4)2000398
[http://dx.doi.org/10.1183/13993003.00398-2020] [PMID: 32139464]
[21]
Carmo A, Pereira-Vaz J, Mota V, et al. Clearance and persis-tence of SARS-CoV-2 RNA in patients with COVID-19. J Med Virol 2020; 92(10): 2227-31.
[http://dx.doi.org/10.1002/jmv.26103] [PMID: 32484958]
[22]
Fu Y, Han P, Zhu R, et al. Risk factors for viral RNA shedding in COVID-19 patients. Eur Respir J 2020; 56(1)2001190
[http://dx.doi.org/10.1183/13993003.01190-2020] [PMID: 32398298]
[23]
Zhou B, She J, Wang Y, Ma X. Duration of viral shedding of discharged patients with severe COVID-19. Clin Infect Dis 2020.ciaa451
[http://dx.doi.org/10.1093/cid/ciaa451] [PMID: 32302000]
[24]
Tu Y-H, Wei Y-Y, Zhang D-W, Chen C-S, Hu X-W, Fei G. Analysis of factors affected the SARS-CoV-2 viral shedding time of COVID-19 patients in Anhui, China: A retrospective study. Res Square 2020
[http://dx.doi.org/10.21203/rs.3.rs-20954/v1]
[25]
Wang W, Xu Y, Gao R, et al. Detection of SARS-CoV-2 in dif-ferent types of clinical specimens. JAMA 2020; 323(18): 1843-4.
[http://dx.doi.org/10.1001/jama.2020.3786] [PMID: 32159775]
[26]
Qian G-Q, Chen X-Q, Lv D-F, et al. Duration of SARS-CoV-2 viral shedding during COVID-19 infection. Infect Dis (Lond) 2020; 52(7): 511-2.
[http://dx.doi.org/10.1080/23744235.2020.1748705] [PMID: 32275181]
[27]
Zhang W, Du R-H, Li B, et al. Molecular and serological inves-tigation of 2019-nCoV infected patients: Implication of multiple shedding routes. Emerg Microbes Infect 2020; 9(1): 386-9.
[http://dx.doi.org/10.1080/22221751.2020.1729071] [PMID: 32065057]
[28]
Wölfel R, Corman VM, Guggemos W, et al. Virological assess-ment of hospitalized patients with COVID-2019. Nature 2020; 581(7809): 465-9.
[http://dx.doi.org/10.1038/s41586-020-2196-x] [PMID: 32235945]
[29]
Kim J-M, Kim HM, Lee EJ, et al. Detection and isolation of SARS-CoV-2 in serum, urine, and stool specimens of COVID-19 patients from the Republic of Korea. Osong Public Health Res Perspect 2020; 11(3): 112-7.
[http://dx.doi.org/10.24171/j.phrp.2020.11.3.02] [PMID: 32528816]
[30]
Fang L, Karakiulakis G, Roth M. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? Lancet Respir Med 2020; 8(4)e21
[http://dx.doi.org/10.1016/S2213-2600(20)30116-8] [PMID: 32171062]
[31]
Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of corona-virus disease 2019 in China. N Engl J Med 2020; 382(18): 1708-20.
[http://dx.doi.org/10.1056/NEJMoa2002032] [PMID: 32109013]
[32]
Chen X, Hu W, Ling J, Mo P, Zhang Y, Jiang Q, et al. Hyperten-sion and diabetes delay the viral clearance in COVID-19 pa-tients. medRxiv 2020.
[http://dx.doi.org/10.1101/2020.03.22.20040774]
[33]
Yan D, Liu X-Y, Zhu YN, et al. Factors associated with pro-longed viral shedding and impact of lopinavir/ritonavir treat-ment in hospitalised non-critically ill patients with SARS-CoV-2 infection. Eur Respir J 2020; 56(1)2000799
[http://dx.doi.org/10.1183/13993003.00799-2020] [PMID: 32430428]
[34]
Shi D, Wu W, Wang Q, Xu K, Xie J, Wu J, et al. Clinical charac-teristics and factors associated with long-term viral excretion in patients with SARS-CoV-2 infection: A single center 28-day study. J Infect Dis 2020; 222(6): 910-8.
[http://dx.doi.org/10.1093/infdis/jiaa388]
[35]
Mueller AL, McNamara MS, Sinclair DA. Why does COVID-19 disproportionately affect older people? Aging (Albany NY) 2020; 12(10): 9959-81.
[http://dx.doi.org/10.18632/aging.103344] [PMID: 32470948]
[36]
Bartoli-Leonard F, Wilkinson FL, Schiro A, Inglott FS, Alexan-der MY, Weston R. Suppression of SIRT1 in diabetic conditions induces osteogenic differentiation of human vascular smooth muscle cells via RUNX2 signalling. Sci Rep 2019; 9(1): 878.
[http://dx.doi.org/10.1038/s41598-018-37027-2] [PMID: 30696833]

Rights & Permissions Print Cite
Article Metrics
19
1
© 2024 Bentham Science Publishers | Privacy Policy