Abstract
BackgroundVarious factors may determine the duration of viral shedding (the time from infection to viral RNA-negative conversion or recovery) in COVID-19 patients. Understanding the average duration of recovery and its predictors is crucial in formulating preventive measures and optimizing treatment options. Therefore, evidence showing the duration of recovery from COVID-19 in different contexts and settings is necessary for tailoring appropriate treatment and prevention measures. This study aimed to investigate the average duration and the predictors of recovery from Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection among COVID-19 patients.MethodA hospital-based prospective cohort study was conducted at Eka Kotebe General Hospital, COVID-19 Isolation and Treatment Center from March 18 to June 27, 2020. The Center was the first hospital designated to manage COVID-19 cases in Ethiopia. The study participants were all COVID-19 adult patients who were admitted to the center during the study period. Follow up was done for the participants from the first date of diagnosis to the date of recovery (negative Real-time Reverse Transcriptase Polymerase Chain Reaction (rRT-PCT) test of throat swab).ResultA total of 306 COVID-19 cases were followed up to observe the duration of viral clearance by rRT-PCR. Participants’ mean age was 34 years (18–84 years) and 69% were male. The median duration of viral clearance from each participant’s body was 19 days, but the range was wide: 2 to 71 days. Cough followed by headache was the leading sign of illness among the 67 symptomatic COVID-19 patients; and nearly half of those with comorbidities were known cancer and HIV/AIDS patients on clinical follow up. The median duration of recovery from COVID-19 was different for those with and without previous medical conditions or comorbidities. The rate of recovery from SARS-CoV-2 infection was 36% higher in males than in females (p = 0.043, CI: 1.01, 1.85). The rate of recovery was 93% higher in those with at least one comorbidity than in those without any comorbidity. The risk of delayed recovery was not influenced by blood type, BMI and presence of signs or symptoms. The findings showed that study participants without comorbidities recovered more quickly than those with at least one comorbidity. Therefore, isolation and treatment centers should be prepared to manage the delayed stay of patients having comorbidity.
Highlights
Understanding the factors associated with the duration of viral ribonucleic acid (RNA) shedding, the time from infection to viral RNA-negative conversion in patients with Coronavirus disease 2019 (COVID-19), is crucial in formulating preventive measures and optimizing treatment options [1]
Immunoglobulin use, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and lymphocyte count were independent factors associated with a prolonged duration of SARS-CoV-2 shedding in a study conducted among hospitalized patients with COVID-19 in Zhejiang Province, China [8]
A study by Xu revealed that severe illness requiring invasive mechanical ventilation was an independent factor for prolonged SARS-CoV-2 RNA shedding [11], while another study reported no correlation between severity and viral shedding [4]
Summary
Understanding the factors associated with the duration of viral ribonucleic acid (RNA) shedding, the time from infection to viral RNA-negative conversion in patients with Coronavirus disease 2019 (COVID-19), is crucial in formulating preventive measures and optimizing treatment options [1]. Factors that are associated with prolonged duration of viral RNA shedding in COVID-19 patients include older age, a time lag from illness onset to hospital admission, diarrhea, corticosteroid treatment and lopinavir/ritonavir use [1]. Immunoglobulin use, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and lymphocyte count were independent factors associated with a prolonged duration of SARS-CoV-2 shedding in a study conducted among hospitalized patients with COVID-19 in Zhejiang Province, China [8]. This study aimed to investigate the average duration and the predictors of recovery from Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection among COVID-19 patients
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