Factors affecting duration of SARS-Cov-2 viral shedding in mildly symptomatic patients isolated in a community facility
Introduction Mildly symptomatic cases of Covid-19 in previously-well individuals form the majority of infections and also serve as potent vectors of transmission. The factors affecting the duration of SARS-CoV-2 RNA viral shedding (DVS) in these patients remain largely unknown. Objectives To perform...
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| description | Introduction Mildly symptomatic cases of Covid-19 in previously-well individuals form the majority of infections and also serve as potent vectors of transmission. The factors affecting the duration of SARS-CoV-2 RNA viral shedding (DVS) in these patients remain largely unknown. Objectives To perform a systematic analysis of the clinical, radiologic, laboratory investigations in patients with few comorbidities infected with mild Covid-19 to identify factors associated with the DVS. Methods In this retrospective cohort study, patients with mild or asymptomatic Covid-19 were included. Baseline characteristics including age, nationality, comorbidities, concomitant medications, and type of isolation arrangement in the facility (single or in pairs) were collected. Clinical features and radiologic/haematologic findings were also collected. Taking day 28 as the cut-off, 187 patients who had a negative swab result up to day 28 (no prolonged DVS) were compared to 126 patients with a persistently positive result on or after day 28 (prolonged DVS). Results Of 964 consecutive patients included, 851 (88.3%) patients were symptomatic. 266 patients had a documented negative RT-PCR assay with a median DVS of 25 days (range: 13 to 96 days; interquartile range (IQR): 22 to 33 days). Patients isolated in pairs were associated with prolonged DVS (OR: 2.7; 95% CI: 1.7 to 4.5; p |
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The factors affecting the duration of SARS-CoV-2 RNA viral shedding (DVS) in these patients remain largely unknown. Objectives To perform a systematic analysis of the clinical, radiologic, laboratory investigations in patients with few comorbidities infected with mild Covid-19 to identify factors associated with the DVS. Methods In this retrospective cohort study, patients with mild or asymptomatic Covid-19 were included. Baseline characteristics including age, nationality, comorbidities, concomitant medications, and type of isolation arrangement in the facility (single or in pairs) were collected. Clinical features and radiologic/haematologic findings were also collected. Taking day 28 as the cut-off, 187 patients who had a negative swab result up to day 28 (no prolonged DVS) were compared to 126 patients with a persistently positive result on or after day 28 (prolonged DVS). Results Of 964 consecutive patients included, 851 (88.3%) patients were symptomatic. 266 patients had a documented negative RT-PCR assay with a median DVS of 25 days (range: 13 to 96 days; interquartile range (IQR): 22 to 33 days). Patients isolated in pairs were associated with prolonged DVS (OR: 2.7; 95% CI: 1.7 to 4.5; p<0.0001) compared to those isolated individually. Among vital signs, only tachycardia was associated with prolonged DVS (OR: 2.6; 95% CI: 1.0 to 7.1; p = 0.03). Amongst investigations, only a raised CRP was associated with prolonged DVS (OR: 2.7; 95% CI: 1.1 to 6.8; p = 0.02). Conclusions In young, mildly symptomatic Covid-19 patients, prolonged DVS was associated with being isolated in pairs compared to individually. In situations where a negative RT-PCR test result is required, retesting in patients who were not isolated individually, or who had baseline tachycardia or a raised CRP, may be delayed to increase the yield of a negative result.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0257565</identifier><identifier>PMID: 34570805</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Asthma ; Biology and Life Sciences ; Cardiac arrhythmia ; Coronaviruses ; COVID-19 ; COVID-19 vaccines ; Disease prevention ; Disease transmission ; Evaluation ; Fever ; Gastroesophageal reflux ; Immunization ; Infections ; Leukopenia ; Medicine ; Medicine and Health Sciences ; Patients ; Polymerase chain reaction ; Research and Analysis Methods ; Severe acute respiratory syndrome ; Severe acute respiratory syndrome coronavirus 2 ; Shedding ; Tachycardia ; Vectors ; Vital signs</subject><ispartof>PloS one, 2021-09, Vol.16 (9), p.e0257565-e0257565</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Cheng et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Cheng et al 2021 Cheng et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c669t-eec3784cbdae5a0b4c5c8193429b9366a75e9f4846db24898108b94b9df053603</citedby><cites>FETCH-LOGICAL-c669t-eec3784cbdae5a0b4c5c8193429b9366a75e9f4846db24898108b94b9df053603</cites><orcidid>0000-0001-7349-2948 ; 0000-0001-8894-6711</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8476038/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8476038/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793</link.rule.ids></links><search><contributor>Chen, Robert Jeenchen</contributor><creatorcontrib>Cheng, Hui Mei</creatorcontrib><creatorcontrib>Zhao, Xiahong</creatorcontrib><creatorcontrib>Lim, Wei Shyann</creatorcontrib><creatorcontrib>Tan, Beatrice Jia Min</creatorcontrib><creatorcontrib>Tey, Hong Liang</creatorcontrib><title>Factors affecting duration of SARS-Cov-2 viral shedding in mildly symptomatic patients isolated in a community facility</title><title>PloS one</title><description>Introduction Mildly symptomatic cases of Covid-19 in previously-well individuals form the majority of infections and also serve as potent vectors of transmission. The factors affecting the duration of SARS-CoV-2 RNA viral shedding (DVS) in these patients remain largely unknown. Objectives To perform a systematic analysis of the clinical, radiologic, laboratory investigations in patients with few comorbidities infected with mild Covid-19 to identify factors associated with the DVS. Methods In this retrospective cohort study, patients with mild or asymptomatic Covid-19 were included. Baseline characteristics including age, nationality, comorbidities, concomitant medications, and type of isolation arrangement in the facility (single or in pairs) were collected. Clinical features and radiologic/haematologic findings were also collected. Taking day 28 as the cut-off, 187 patients who had a negative swab result up to day 28 (no prolonged DVS) were compared to 126 patients with a persistently positive result on or after day 28 (prolonged DVS). Results Of 964 consecutive patients included, 851 (88.3%) patients were symptomatic. 266 patients had a documented negative RT-PCR assay with a median DVS of 25 days (range: 13 to 96 days; interquartile range (IQR): 22 to 33 days). Patients isolated in pairs were associated with prolonged DVS (OR: 2.7; 95% CI: 1.7 to 4.5; p<0.0001) compared to those isolated individually. Among vital signs, only tachycardia was associated with prolonged DVS (OR: 2.6; 95% CI: 1.0 to 7.1; p = 0.03). Amongst investigations, only a raised CRP was associated with prolonged DVS (OR: 2.7; 95% CI: 1.1 to 6.8; p = 0.02). Conclusions In young, mildly symptomatic Covid-19 patients, prolonged DVS was associated with being isolated in pairs compared to individually. In situations where a negative RT-PCR test result is required, retesting in patients who were not isolated individually, or who had baseline tachycardia or a raised CRP, may be delayed to increase the yield of a negative result.</description><subject>Asthma</subject><subject>Biology and Life Sciences</subject><subject>Cardiac arrhythmia</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 vaccines</subject><subject>Disease prevention</subject><subject>Disease transmission</subject><subject>Evaluation</subject><subject>Fever</subject><subject>Gastroesophageal reflux</subject><subject>Immunization</subject><subject>Infections</subject><subject>Leukopenia</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Patients</subject><subject>Polymerase chain reaction</subject><subject>Research and Analysis Methods</subject><subject>Severe acute respiratory syndrome</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Shedding</subject><subject>Tachycardia</subject><subject>Vectors</subject><subject>Vital 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affecting duration of SARS-Cov-2 viral shedding in mildly symptomatic patients isolated in a community facility</title><author>Cheng, Hui Mei ; Zhao, Xiahong ; Lim, Wei Shyann ; Tan, Beatrice Jia Min ; Tey, Hong Liang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c669t-eec3784cbdae5a0b4c5c8193429b9366a75e9f4846db24898108b94b9df053603</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Asthma</topic><topic>Biology and Life Sciences</topic><topic>Cardiac arrhythmia</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>COVID-19 vaccines</topic><topic>Disease prevention</topic><topic>Disease transmission</topic><topic>Evaluation</topic><topic>Fever</topic><topic>Gastroesophageal reflux</topic><topic>Immunization</topic><topic>Infections</topic><topic>Leukopenia</topic><topic>Medicine</topic><topic>Medicine and Health Sciences</topic><topic>Patients</topic><topic>Polymerase chain reaction</topic><topic>Research and Analysis Methods</topic><topic>Severe acute respiratory syndrome</topic><topic>Severe acute respiratory syndrome coronavirus 2</topic><topic>Shedding</topic><topic>Tachycardia</topic><topic>Vectors</topic><topic>Vital signs</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cheng, Hui Mei</creatorcontrib><creatorcontrib>Zhao, Xiahong</creatorcontrib><creatorcontrib>Lim, Wei Shyann</creatorcontrib><creatorcontrib>Tan, Beatrice Jia Min</creatorcontrib><creatorcontrib>Tey, Hong Liang</creatorcontrib><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research 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Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cheng, Hui Mei</au><au>Zhao, Xiahong</au><au>Lim, Wei Shyann</au><au>Tan, Beatrice Jia Min</au><au>Tey, Hong Liang</au><au>Chen, Robert Jeenchen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Factors affecting duration of SARS-Cov-2 viral shedding in mildly symptomatic patients isolated in a community facility</atitle><jtitle>PloS one</jtitle><date>2021-09-27</date><risdate>2021</risdate><volume>16</volume><issue>9</issue><spage>e0257565</spage><epage>e0257565</epage><pages>e0257565-e0257565</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Introduction Mildly symptomatic cases of Covid-19 in previously-well individuals form the majority of infections and also serve as potent vectors of transmission. The factors affecting the duration of SARS-CoV-2 RNA viral shedding (DVS) in these patients remain largely unknown. Objectives To perform a systematic analysis of the clinical, radiologic, laboratory investigations in patients with few comorbidities infected with mild Covid-19 to identify factors associated with the DVS. Methods In this retrospective cohort study, patients with mild or asymptomatic Covid-19 were included. Baseline characteristics including age, nationality, comorbidities, concomitant medications, and type of isolation arrangement in the facility (single or in pairs) were collected. Clinical features and radiologic/haematologic findings were also collected. Taking day 28 as the cut-off, 187 patients who had a negative swab result up to day 28 (no prolonged DVS) were compared to 126 patients with a persistently positive result on or after day 28 (prolonged DVS). Results Of 964 consecutive patients included, 851 (88.3%) patients were symptomatic. 266 patients had a documented negative RT-PCR assay with a median DVS of 25 days (range: 13 to 96 days; interquartile range (IQR): 22 to 33 days). Patients isolated in pairs were associated with prolonged DVS (OR: 2.7; 95% CI: 1.7 to 4.5; p<0.0001) compared to those isolated individually. Among vital signs, only tachycardia was associated with prolonged DVS (OR: 2.6; 95% CI: 1.0 to 7.1; p = 0.03). Amongst investigations, only a raised CRP was associated with prolonged DVS (OR: 2.7; 95% CI: 1.1 to 6.8; p = 0.02). Conclusions In young, mildly symptomatic Covid-19 patients, prolonged DVS was associated with being isolated in pairs compared to individually. In situations where a negative RT-PCR test result is required, retesting in patients who were not isolated individually, or who had baseline tachycardia or a raised CRP, may be delayed to increase the yield of a negative result.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>34570805</pmid><doi>10.1371/journal.pone.0257565</doi><tpages>e0257565</tpages><orcidid>https://orcid.org/0000-0001-7349-2948</orcidid><orcidid>https://orcid.org/0000-0001-8894-6711</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Asthma Biology and Life Sciences Cardiac arrhythmia Coronaviruses COVID-19 COVID-19 vaccines Disease prevention Disease transmission Evaluation Fever Gastroesophageal reflux Immunization Infections Leukopenia Medicine Medicine and Health Sciences Patients Polymerase chain reaction Research and Analysis Methods Severe acute respiratory syndrome Severe acute respiratory syndrome coronavirus 2 Shedding Tachycardia Vectors Vital signs |
| title | Factors affecting duration of SARS-Cov-2 viral shedding in mildly symptomatic patients isolated in a community facility |
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