Factors associated with negative conversion of viral RNA in patients hospitalized with COVID-19
Autor
Hu, Xiaowen
Xing, Yuhan
Jia, Jing
Ni, Wei
Liang, Jiwei
Zhao, Dan
Song, Xin
Gao, Ruqin
Jiang, Fachun
Institución
Resumen
Factors associated with negative conversion of SARS-CoV-2 RNA in hospitalized patients have not yet been systematically determined. We conducted a retrospective cohort study of COVID-19 patients in Qingdao, China.
Both univariate and multivariate analysis were performed to identify independent factors for time to viral RNA
negative conversion. Data on patients with re-detectable viral RNA after showing negative on RT-PCR test (intermittent negative status) were also analyzed. A total of 59 patients confirmed with COVID-19 were included in this
study, with a median duration of 1 (interquartile range, IQR: 0–2) day from symptom onset to hospital admission.
Median communicable period (from first day of positive nucleic acid test to first day of consecutive negative results) was 14 (IQR: 10–18) days, and 7 (IQR: 6–10) days for 10 patients with intermittent negative results. Age
older than 45 years (hazard ratio, HR: 0.378; 95% confidence interval, CI: 0.205–0.698) and chest tightness
(HR: 0.290; 95%CI: 0.091–0.919) were factors independently affecting negative conversion of SARS-CoV-2
RNA. Headache (odds ratio: 7.553; 95%CI: 1.011–28.253) was significantly associated with intermittent negative
status, with a predicted probability of 60%. Older age and chest tightness were independently associated with delayed clearance of SARS-CoV-2 RNA in hospitalized patients. These predictors would provide a new perspective
on early identification of patients with prolonged viral shedding and facilitate optimal isolation protocols and
treatment strategies.