Positive RT-PCR Test Results in 420 Patients Recovered From COVID-19 in Wuhan: An Observational Study.

Si He ,Yi Lv,Jia Ke,Ping Song,Xiaodong Li,Zijun Zhang,Xiaolin Tong,Xiuyang Li,Zhaoyuan Jiang,De Jin,Ying Zhang,Juexian Song,Xiaojun Min,Jiaxing Tian,Qiyou Ding,Han Wang,Yujiao Zheng,Jiaran Lin,Mingzhong Xiao,Qingwei Li,Fengmei Lian,Qing Zhang,Yue Zhou ,Tao Jiang ,Shuāng Táng

doi:10.3389/fphar.2020.549117

Abstract

ObjectiveDuring the follow-up of patients recovered from coronavirus disease 2019 (COVID-19) in the quarantine and observation period, some of the cured patients showed positive results again. The recurrent positive RT-PCR test results drew widespread concern. We observed a certain number of cured COVID-19 patients with positive RT-PCR test results and try to analyze the factors that caused the phenomenon.MethodsWe conducted an observational study in COVID-19 patients discharged from 6 rehabilitation stations in Wuhan, China. All observed subjects met the criteria for hospital discharge and were in quarantine. Data regarding age, sex, body mass index (BMI), course of disease, comorbidity, smoking status and alcohol consumption, symptoms in and out of quarantine, and intervention were collected from the subjects’ medical records and descriptively analyzed. The main outcome of this study was the RT-PCR test result of the observed subjects at the end of quarantine (negative or positive). Logistic regression analysis was used to identify the influencing factors related to recurrent positive RT-PCR test results.ResultsIn this observational study, 420 observed subjects recovered from COVID-19 were included. The median age was 56 years, 63.6% of the subjects were above 50 years old, and 50.7% (213/420) were female. The most common comorbidities were hypertension [26.4% (111/420)], hyperlipidemia [10.7% (45/420)], and diabetes [10.5% (44/420)]. 54.8% (230/420) manifested one or more symptoms at the beginning of the observation period, the most common symptoms were cough [27.6% (116/420)], shortness of breath 23.8% (100/420)], and fatigue [16.2% (68/420)], with fever rare [2.6% (11/420)]. A total of 325 subjects were exposed to comprehensive intervention; 95 subjects were absence of intervention. The recurrence rate of positive RT-PCR test results with comprehensive intervention was 2.8% (9/325), and that with no intervention was 15.8% (15/95). The results of logistic regression analysis showed that after adjusted for factors such as age, sex, and comorbidity and found out that comprehensive intervention was correlated with the recurrent positive RT-PCR test results. There was appreciably less recurrence in the comprehensive intervention group.ConclusionsThe factors related to positive RT-PCR test results in observed subjects recovered from COVID-19 were age, comorbidity, and comprehensive intervention, among which comprehensive intervention might be a protective factor.Clinical Trial Registration Chictr.org.cn, identifier ChiCTR2000030747.

Highlights

By March 11th, 2020, 121,133 cases were diagnosed as coronavirus disease 2019 (COVID-19) globally
It was reported that some COVID-19 patients who had met the criteria for hospital discharge showed positive RT-PCR test results for COVID-19 nucleic acid later (Lan et al, 2020)
In 420 observed subjects, the median age was 56 years, 63.6% of the subjects were above 50 years old, 50.7% (213/420; 95% CI: 45.9–55.5%) were female. 52.2% (219/420; 95% CI:47.4–56.9%) of the subjects were overweight or obese (BMI≥24), and 41.0% (172/ 420; 95% CI: 36.2–45.7%) had one or more comorbidities

Summary

Introduction

By March 11th, 2020, 121,133 cases were diagnosed as coronavirus disease 2019 (COVID-19) globally. In China, 80,967 cases have been diagnosed, among which 61661 have been cured and discharged from the hospital (Chinese Center for Disease Control and Prevention). It was reported that some COVID-19 patients who had met the criteria for hospital discharge (absence of clinical symptoms and radiological abnormalities with 2 consecutive negative RT-PCR test results) showed positive RT-PCR test results for COVID-19 nucleic acid later (Lan et al, 2020). The patients usually had no or mild clinical symptoms; their health status and infectivity were unclear, which caused widespread concern to the key points which affected the control of the disease, including the complexity of COVID-19, discharge criteria, reinfection after discharge, infectivity of discharged patients with positive RT-PCR test results, quality of nucleic acid kit and specimen sampling, and obstructed to epidemic prevention and control.

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