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Research Paper|Volume 12, Issue 17|pp 16675—16689

Clinical course and risk factors for recurrence of positive SARS-CoV-2 RNA: a retrospective cohort study from Wuhan, China

Jie Chen1,2, Xiaoping Xu1, Jing Hu1,2, Qiangda Chen3, Fengfeng Xu1,2, Hui Liang1, Nanmei Liu1,2, Hengmei Zhu2,4, Jinlong Lan1, Lan Zhou1,2, Jiajun Xing1, Ning Pu3, Zhigang Cai1,2
  • 1Department of Cardiothoracic Surgery, Naval Medical Center of PLA, Shanghai 200052, People’s Republic of China
  • 2Department of Infectious Disease, Guanggu Branch of Hubei Province Maternity and Childcare Hospital, Hubei 430073, People’s Republic of China
  • 3Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, People’s Republic of China
  • 4Department of Special Treatment, Eastern Hepatobiliary Surgery Hospital, Naval Military Medical University, Shanghai 200438, People’s Republic of China
* Equal contribution and Co-first authors
Received: June 2, 2020Accepted: July 14, 2020Published: September 10, 2020
https://doi.org/10.18632/aging.103795

Copyright: © 2020 Chen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

The coronavirus disease 2019 (COVID-19) pandemic is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The objective of this study was to determine the clinical course and risk factors for patients showing recurrent SARS-CoV-2 RNA positivity. A total of 1087 COVID-19 patients confirmed by RT-PCR from February 24, 2020 to March 31, 2020 were retrospectively enrolled. Advanced age was significantly associated with mortality. In addition, 81 (7.6%) of the discharged patients tested positive for SARS-CoV-2 RNA during the isolation period. For patients with recurrent RT-PCR positivity, the median duration from illness onset to recurrence was 50 days. Multivariate regression analysis identified elevated serum IL-6, increased lymphocyte counts and CT imaging features of lung consolidation during hospitalization as the independent risk factors of recurrence. We hypothesized that the balance between immune response and virus toxicity may be the underlying mechanism of this phenomenon. For patients with a high risk of recurrence, a prolonged observation and additional preventative measures should be implemented for at least 50 days after illness onset to prevent future outbreaks.