A systematic review and meta-analysis of discharged COVID-19 patients retesting positive for RT-PCR

Xiangying Ren; Xiangge Ren; Jiaao Lou; Yongbo Wang; Qiao Huang; Yuexian Shi; Yuqing Deng; Xiaoyan Li; Liye Lu; Siyu Yan; Yunyun Wang; Lisha Luo; Xiantao Zeng; Xiaomei Yao; Yinghui Jin

doi:10.1016/j.eclinm.2021.100839

A systematic review and meta-analysis of discharged COVID-19 patients retesting positive for RT-PCR

EClinicalMedicine. 2021 Apr:34:100839. doi: 10.1016/j.eclinm.2021.100839. Epub 2021 Apr 17.

Authors

Xiangying Ren^{1

2}, Xiangge Ren^{1

3}, Jiaao Lou^{1

4}, Yongbo Wang¹, Qiao Huang¹, Yuexian Shi⁵, Yuqing Deng^{1

6}, Xiaoyan Li^{1

7}, Liye Lu⁸, Siyu Yan¹, Yunyun Wang¹, Lisha Luo¹, Xiantao Zeng¹, Xiaomei Yao^{9

10}, Yinghui Jin¹

Affiliations

¹ Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.
² College of Nursing and Health, Henan University, Kaifeng, Henan, China.
³ Henan University of Chinese Medicine, Zhengzhou, Henan, China.
⁴ College of Medicine, Wuhan University of Science and Technology, Wuhan, Hubei, China.
⁵ School of Nursing, Peking University, Beijing, China.
⁶ Department of Thyroid Breast Surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
⁷ Department of Nephrology, the Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
⁸ Yongnian District maternity and childcare hospital, Xinming Road No.28. Yongnian District, HanDan, Hebei, China.
⁹ Center for clinical practice guideline conduction and evaluation, Children's Hospital of Fudan University, Shanghai, China.
¹⁰ Department of Health Research, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.

Abstract

Background: With the increased number of patients discharged after having COVID-19, more and more studies have reported cases whose retesting was positive (RP) during the convalescent period, which brings a new public health challenge to the world.

Methods: We searched PubMed, Web of Science, The Cochrane Library, CNKI, WanFang and VIP from December 1, 2019 to December 31, 2020. The included studies were assessed using JBI critical appraisal tools and Newcastle-Ottawa Scale. The RP rate of discharge patients was analyzed by a meta-analysis. We adhered to PRISMA reporting guideline.

Findings: We have included 117 studies with 2669 RP participants after discharge. The methodological quality of 66 case reports were low to high, 42 case series and 3 cohort study were moderate to high, 3 case-control studies were moderate and 3 cross-sectional studies were low to moderate. The clinical manifestations of most RP patients were mild or asymptomatic, and CT imaging and laboratory examinations were usually normal. The existing risk factors suggest that more attention should be paid to sever patients, elderly patients, and patients with co-morbidities. The summary RP rate was 12·2% (95% CI 10·6-13·7) with high heterogeneity (I² = 85%).

Interpretation: To date, the causes and risk factors of RP result in discharged patients are not fully understood. High-quality etiological and clinical studies are needed to investigate these issues to further help us to make strategies to control and prevent its occurrence.