Delayed hospital admission and high-dose corticosteroids potentially prolong SARS-CoV-2 RNA detection duration of patients with COVID-19.

Abstract

Coronavirus disease 2019 (COVID-19) with the infection of SARS-CoV-2 has become a serious pandemic worldwide. However, only few studies focused on risk factors of prolonged SARS-CoV-2 RNA detection among patients with COVID-19. We included 206 adult patients with laboratory-confirmed COVID-19 from two hospitals between 23 Jan and 1 April 2020. Least absolute shrinkage and selection operator (LASSO) analysis was used to screen out independent risk factors of SARS-CoV-2 RNA detection. By multivariate binomial logistic regression analysis and Cox regression analysis, we further determined the associations between SARS-CoV-2 RNA detection and potential risk factors. All patients had two negative SARS-CoV-2 tests with 33 days of median duration of SARS-CoV-2 RNA detection (interquartile range: 25.2-39 days). LASSO and binomial logistic regression analyses suggested that delayed hospital admission (adjusted OR = 3.70, 95% CI: 1.82-7.50), hypokalemia, and subpleural lesion (adjusted OR = 4.32, 95% CI: 1.10-16.97) were associated with prolonged SARS-CoV-2 RNA detection. By LASSO and multivariate Cox regression analyses, we observed that delayed hospital admission, subpleural lesion, and high-dose corticosteroid use were independent risk factors of prolonged SARS-CoV-2 RNA detection. Early hospital admission shortened 5.73 days of mean duration of SARS-CoV-2 RNA detection than delayed hospital admission after adjusting confounding factors. Our study demonstrated that delayed hospital admission and subpleural lesion were associated with prolonged SARS-CoV-2 RNA detection among patients with COVID-19. The use of high-dose corticosteroids should be interpreted with extreme caution in treating COVID-19.

• Authors: Zhigang Hu, Sijia Li, Ailan Yang, Wenxin Li, Xiaoqi Xiong, Jianwu Hu, Jun Jiang, Xinyu Song
• Journal: European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology (Eur J Clin Microbiol Infect Dis) Vol. 40 Issue 4 Pg. 841-848 (Apr 2021) ISSN: 1435-4373 [Electronic] Germany
• PMID: 33123934 (Publication Type: Journal Article)

Chemical References

• Antiviral Agents
• Glucocorticoids
• RNA, Viral
• Thymosin

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Antiviral Agents (therapeutic use)
• COVID-19 (therapy)
• Female
• Glucocorticoids (administration & dosage)
• Hospitalization (statistics & numerical data)
• Humans
• Logistic Models
• Male
• Middle Aged
• Noninvasive Ventilation
• Oxygen Inhalation Therapy
• Proportional Hazards Models
• RNA, Viral (isolation & purification)
• Respiration, Artificial
• Risk Factors
• SARS-CoV-2
• Thymosin (therapeutic use)
• Time Factors
• Virus Shedding
• Young Adult