Factors associated with prolonged duration of viral clearance in non-severe SARS-CoV-2 patients in Osaka, Japan

Emma Nakagawa Hoffman,Rumiko Asada,Haruna Kawachi,Jun Masui,Yasushi Mori,Toshitake Ohara,Takanori Hirayama,Ayumi Murayama,Atsushi Hirayama,Satomi Fujita,Hiroyasu Iso,Jingwen Zhang

doi:10.1186/s12199-021-01035-y

Emma Nakagawa Hoffman, Rumiko Asada + Show 10 more

Open Access

https://doi.org/10.1186/s12199-021-01035-y

Copy DOI

Abstract

BackgroundWe investigated factors associated with prolonged viral clearance of SARS-CoV-2 among non-severe adult patients in Osaka, Japan. A total of 706 laboratory-confirmed COVID-19 patients were enrolled in this longitudinal observational study between 29 January 2020 and 31 May 2020, across 62 hospitals and three non-hospital recuperation facilities.MethodsLogistic regression analysis was performed to investigate the factors associated with prolonged (29 days: upper 25% in duration) viral clearance of SARS-CoV-2. Linear regression analysis was conducted to assess these factors 14 days after symptom onset.ResultsThe median duration of viral clearance was 22 days from symptom onset. After adjustment for sex, age, symptoms, comorbidity, and location of recuperation, comorbidities were associated with prolonged duration: (OR, 1.77 [95% CI, 1.11–2.82]) for one, (OR, 2.47 [95% CI, 1.32–4.61]) for two or more comorbidities. Viral clearance 14 days after symptom onset was 3 days longer for one comorbidity and 4 days longer for two or more comorbidities compared to clearance when there was no comorbidity.ConclusionThe presence of comorbidity was a robust factor associated with a longer duration of viral clearance, extending by 3 to 4 days compared to patients with no comorbidity.

Highlights

The outbreak of the coronavirus disease 2019 (COVID19), induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and first discovered in Wuhan City, Hubei Province, China, has rapidly become a globalWhile knowledge has accumulated on the clinical course and outcomes of critically ill patients with COVID-19, research on the viral clearance patterns of non-severe patients is scarce
Baseline characteristics This report describes a cohort of 1783 laboratory-confirmed cases of COVID-19 in Osaka
We observed that comorbidities were associated with prolonged duration: for one, for two or more comorbidities

Summary

Introduction

The outbreak of the coronavirus disease 2019 (COVID19), induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and first discovered in Wuhan City, Hubei Province, China, has rapidly become a globalWhile knowledge has accumulated on the clinical course and outcomes of critically ill patients with COVID-19, research on the viral clearance patterns of non-severe patients is scarce. Patients are admitted depending on severity of disease; data analysis to uncover other indicators to adjust patient admission has not been conducted. We retrospectively analyzed data relating to 706 patients with non-severe, laboratory-confirmed COVID19 in Osaka and the duration from the onset of disease until consecutive negative detection on reverse transcription polymerase chain reaction (RT-PCR) test of SARSCoV-2. We examined the duration of viral clearance in mild cases of COVID-19 in order to find out what factors are associated with prolonged viral clearance. These findings can be used as supplementary data when coordinating patients for admission and discharge. We investigated factors associated with prolonged viral clearance of SARS-CoV-2 among non-severe adult patients in Osaka, Japan. A total of 706 laboratory-confirmed COVID-19 patients were enrolled in this longitudinal observational study between 29 January 2020 and 31 May 2020, across 62 hospitals and three non-hospital recuperation facilities

Methods

Results

Discussion

Conclusion