Clinical Characteristics and Imaging Findings of 35 Patients Recovered from COVID-19 with Recurrent Positive RT-PCR Test Results

Abstract

Background: Currently, a gradual increase in recurrent positive RT-PCR test results have been seen in clinically diagnosed recovered COVID-19 patients.The purpose of this study is to follow up and analyze these patients’ clinical characteristics and imaging findings.

Methods: From January 19, 2020 to March 14, 2020, 35 patients displayed recurrent positive RT-PCR test results discharge, and all of these patients received a second admission. Multi-site monitoring methods of the RT-PCR test results were adopted after their discharge, and a semi quantitative score was used to evaluate dynamic changes in the CT imaging. Patients' clinical characteristics and imaging findings between the first discharge and second admission were then compared.

Results: The recurrent positive patients accounted for 8.3% (35/420) of all diagnosed patients and 8.8% (35/399) of discharged patients.A total of 85.7% of the patients had positive RT-PCR test results only at 1–2 sites and tested negative at other sites during their discharge monitoring.The median interval from the first negative RT-PCR to the recurrent positive was ten days (IQR, 7–16). All recurrent positive patients had no fever and 91.4% did not have symptoms. There was no significant change in the abnormal laboratory indicators. The median semi quantitative CT score was 4(2–5.5)(the first discharge) and 2.5(0.25–4) (the second admission), and the score of the second admission was lower than the first discharge (p=0.002).

Interpretation: Patients with recurrent positive RT-PCR test results from clinically diagnosed recovery did not show recurrence of clinical symptoms. However, the semi quantitative score found further absorption of intrapulmonary inflammation. Therefore, it is necessary to develop a clearer and more precise chest CT discharge evaluation criteria to help evaluate patient discharge decisions.Also, monitoring of RT-PCR test results should be strengthened in clinically diagnosed discharged patients.

Funding Statement: This work was supported by the Fujun Zhang team of three famous projects in Shenzhen(fund No:SZSM201612053).

Declaration of Interests: The authors declare no competing interests.

Ethics Approval Statement: This study was approved by the ethics committee of The Third People's Hospital of Shenzhen, which waived the requirement for patient consent for this retrospective analysis.

Keywords: COVID-19, pneumonia, recurrent positive, RT-PCR test result