lancet-header
Preprints with The Lancet is part of SSRN´s First Look, a place where journals and other research experts identify content of interest prior to publication. These preprint papers are not peer-reviewed. Authors have either opted in at submission to The Lancet family of journals to post their preprints on Preprints with The Lancet, or submitted directly via SSRN. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These papers should not be used for clinical decision making or reporting of research to a lay audience without indicating that this is preliminary research that has not been peer-reviewed. For more information see the Comment published in The Lancet, or visit The Lancet´s FAQ page, and for any feedback please contact preprints@lancet.com

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

31 Pages Posted: 14 Apr 2020

See all articles by Li-Fei Wang

Li-Fei Wang

Southern University of Science and Technology - Department of Radiology

Huzheng Yan

National Sun Yat-sen University - Department of interventional radiology

Die Zhang

Southern University of Science and Technology - Department of Radiology

Yongxing Yun

Southern University of Science and Technology - Department of Radiology

Chen Zhang

Southern University of Science and Technology - Department of Radiology

Chao An

Southern University of Science and Technology - Department of Radiology

Jing Zhao

Southern University of Science and Technology - Department of Radiology

Fujun Zhang

Sun Yat-Sen University (SYSU) - Department of interventional Radiology

Liu Lei

Southern University of Science and Technology - National Clinical Research Center for Infectious Diseases

More...

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

Suggested Citation

Wang, Li-Fei and Yan, Huzheng and Zhang, Die and Yun, Yongxing and Zhang, Chen and An, Chao and Zhao, Jing and Zhang, Fujun and Lei, Liu, Clinical Characteristics and Imaging Findings of 35 Patients Recovered from COVID-19 with Recurrent Positive RT-PCR Test Results (3/26/2020). Available at SSRN: https://ssrn.com/abstract=3564400 or http://dx.doi.org/10.2139/ssrn.3564400

Li-Fei Wang

Southern University of Science and Technology - Department of Radiology ( email )

China

Huzheng Yan

National Sun Yat-sen University - Department of interventional radiology ( email )

China

Die Zhang

Southern University of Science and Technology - Department of Radiology ( email )

China

Yongxing Yun

Southern University of Science and Technology - Department of Radiology ( email )

China

Chen Zhang

Southern University of Science and Technology - Department of Radiology ( email )

China

Chao An

Southern University of Science and Technology - Department of Radiology ( email )

China

Jing Zhao

Southern University of Science and Technology - Department of Radiology ( email )

China

Fujun Zhang (Contact Author)

Sun Yat-Sen University (SYSU) - Department of interventional Radiology ( email )

Guangzhou
China

Liu Lei

Southern University of Science and Technology - National Clinical Research Center for Infectious Diseases ( email )

China
+86-13510333313 (Phone)

Click here to go to TheLancet.com

Paper statistics

Abstract Views
739
Downloads
112