Abstract
BackgroundConsecutive negative SARS-CoV-2 PCR test results are being considered to estimate viral clearance in COVID-19 patients. However, there are anecdotal reports of hospitalization from protracted COVID-19 complications despite such confirmed viral clearance, presenting a clinical conundrum.MethodsWe conducted a retrospective analysis of 222 hospitalized COVID-19 patients to compare those that were readmitted post-viral clearance (hospitalized post-clearance cohort, n = 49) with those that were not re-admitted post-viral clearance (non-hospitalized post-clearance cohort, n = 173) between February and October 2020. In order to differentiate these two cohorts, we used neural network models for the ‘augmented curation’ of comorbidities and complications with positive sentiment in the Electronic Hosptial Records physician notes.FindingsIn the year preceding COVID-19 onset, anemia (n = 13 [26.5%], p-value: 0.007), cardiac arrhythmias (n = 14 [28.6%], p-value: 0.015), and acute kidney injury (n = 7 [14.3%], p-value: 0.030) were significantly enriched in the physician notes of the hospitalized post-clearance cohort.InterpretationOverall, this retrospective study highlights specific pre-existing conditions that are associated with higher hospitalization rates in COVID-19 patients despite viral clearance and motivates follow-up prospective research into the associated risk factors.FundingThis work was supported by Nference, inc.
Highlights
To date, over 103 million people worldwide have been infected with SARS-CoV-2, with nearly 2.23 million deaths as of December 2020 [1]
We find that in the year preceding COVID-19, acute kidney injury, anemia, and cardiac arrhythmia were significantly enriched in the physician notes of the hospitalized post-clearance cohort
This study shows that hospitalized COVID-19 patients who were re-admitted to the hospital following confirmed viral clearance of SARS-CoV-2 had higher rates of pre-existing conditions including: acute kidney injury, anemia, and cardiac arrhythmias
Summary
Over 103 million people worldwide have been infected with SARS-CoV-2, with nearly 2.23 million deaths as of December 2020 [1] At this point in the pandemic, there are reports that some patients who have cleared the virus have tested positive after documented negative tests or have developed new symptoms requiring hospitalization after documented negative tests [2À6]. A recent case series [7] reported four patients with apparent SARS-CoV-2 reinfection after an index hospitalization, despite resolution of symptoms and radiographic abnormalities and two consecutive negative tests separated by a day. Interpretation: Overall, this retrospective study highlights specific pre-existing conditions that are associated with higher hospitalization rates in COVID-19 patients despite viral clearance and motivates follow-up prospective research into the associated risk factors.
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