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Kinetics of SARS-CoV-2 Positivity of Infected and Recovered Patients: A Single Center COVID-19 Experience and Potential Implications
45 Pages Posted: 7 Jul 2020More...
BACKGROUND: Recurrence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive detection in infected but recovered individuals has been reported. Patients who have recovered from coronavirus disease 2019 (COVID-19) could profoundly impact the health care system if a subset were to be polymerase chain reaction (PCR)-positive again with reactivated SARS-CoV-2. We sought to define the kinetics and relevance of PCR-positive recurrence during recovery from acute COVID-19 to better understand risks for prolonged infectivity and reinfection.
METHODS: A series of COVID-19 414 patients, at The Second Affiliated Hospital of Southern University of Science and Technology in Shenzhen, China from January 11 to April 23, 2020. Univariable and multivariable statistical analysis of inpatient data were performed to develop an algorithm to predict patients at risk of recurrence of PCR positivity.
FINDINGS: 16·7% recovered patients with PCR positive recurring one to three times, despite being in strict quarantine. Younger patients with mild pulmonary respiratory syndrome had higher risk of PCR positivity recurrence. The recurrence prediction model had an area under the ROC curve of 0·786.
INTERPRETATION: This case series provides clinical characteristics of recovered COVID-19 patients with recurrent SARS-CoV-2 positivity, despite strict quarantine, at a 16·7% rate. Use of a recurrence prediction algorithm may identify patients at high risk of recurrent SARS-CoV-2 positivity and help understand reactivation and reinfection possibilities to establish protocols for health policy.
FUNDING STATEMENT: This work was supported by grants from Sanming Project of Medicine in Shenzhen (Jia Huang, No. SZSM201812065); Bill & Melinda Gates Foundations (Lei Liu); and from National Natural Science Foundation of China (Jia Huang, No. 81501651)
DECLARATION OF INTERESTS: The authors declare no competing interests.
ETHICS APPROVAL STATEMENT: This study was approved by the Ethics Committee of the Second Affiliated Hospital of Southern University of Science and Technology. Written informed consent was obtained from all patients.
Keywords: COVID-19, SARS-CoV-2, PCR positive recurrence
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