Clinical characteristics of hospitalized mild/moderate COVID-19 patients with a prolonged negative conversion time of SARS-CoV-2 nucleic acid detection

BMC Infect Dis. 2021 Feb 3;21(1):141. doi: 10.1186/s12879-021-05851-z.

Abstract

Background: The impact of COVID-19 has been devastating on a global scale. The negative conversion time (NCT) of SARS-CoV-2 RNA is closely related to clinical manifestation and disease progression in COVID-19 patients. Our study aimed to predict factors associated with prolonged NCT of SARS-CoV-2 RNA in mild/moderate COVID-19 patients.

Methods: The clinical features, laboratory data and treatment outcomes of COVID-19 patients were retrospectively analyzed. Then univariate and multivariate analysis were used to screen out risk factors of influencing prolonged NCT of SARS-CoV-2 RNA.

Results: Thirty-two hospitalized mild/moderate COVID-19 patients were enrolled. The general clinical symptoms were cough (78.1%), fever (75%), diarrhea (68.8%), expectoration (56.3%), and nausea (37.5%). More than 40% of the patients had decreased erythrocyte, hemoglobin and leucocyte and 93.8% patients were detected in abnormalities of chest CT. The median NCT of SARS-CoV-2 RNA was 19.5 days (IQR: 14.25-25). Univariate analysis found fever, nausea, diarrhea and abnormalities in chest CTs were positively associated with prolonged NCT of viral RNA (P< 0.05). The multivariate Cox proportional hazard model revealed that fever [Exp (B), 0.284; 95% CI, 0.114-0.707; P<0.05] and nausea [Exp (B), 0.257; 95%CI, 0.096-0.689; P<0.05] were two significant independent factors.

Conclusions: Fever and nausea were two significant independent factors in prolonged NCT of viral RNA in mild/moderate COVID-19 patients, which provided a useful references for disease progression and treatment of COVID-19.

Keywords: COVID-19; Clinical characteristics; Negative conversion time; SARS-CoV-2.

MeSH terms

  • Adult
  • COVID-19 / complications
  • COVID-19 / diagnosis*
  • COVID-19 / pathology
  • COVID-19 / virology
  • COVID-19 Nucleic Acid Testing
  • Cough / etiology
  • Diarrhea / etiology
  • Female
  • Fever / etiology
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Proportional Hazards Models
  • RNA, Viral / metabolism*
  • Retrospective Studies
  • Risk Factors
  • SARS-CoV-2 / genetics*
  • SARS-CoV-2 / isolation & purification
  • Severity of Illness Index
  • Thorax / diagnostic imaging
  • Time Factors

Substances

  • RNA, Viral