학술논문
Risk and predictive factors of prolonged viral RNA shedding in upper respiratory specimens in a large cohort of COVID-19 patients admitted to an Italian reference hospital
Document Type
article
Author
Annalisa Mondi; Patrizia Lorenzini; Concetta Castilletti; Roberta Gagliardini; Eleonora Lalle; Angela Corpolongo; Maria Beatrice Valli; Fabrizio Taglietti; Stefania Cicalini; Laura Loiacono; Francesco Di Gennaro; Gianpiero D’Offizi; Fabrizio Palmieri; Emanuele Nicastri; Chiara Agrati; Nicola Petrosillo; Giuseppe Ippolito; Francesco Vaia; Enrico Girardi; Maria Rosaria Capobianchi; Andrea Antinori; Sara Zito; Maria Alessandra Abbonizio; Amina Abdeddaim; Elisabetta Agostini; Fabrizio Albarello; Gioia Amadei; Alessandra Amendola; Maria Assunta Antonica; Mario Antonini; Tommaso Ascoli Bartoli; Francesco Baldini; Raffaella Barbaro; Barbara Bartolini; Rita Bellagamba; Martina Benigni; Nazario Bevilacqua; Gianluigi Biava; Michele Bibas; Licia Bordi; Veronica Bordoni; Evangelo Boumis; Marta Branca; Rosanna Buonomo; Donatella Busso; Marta Camici; Paolo Campioni; Flaminia Canichella; Alessandro Capone; Cinzia Caporale; Emanuela Caraffa; Ilaria Caravella; Fabrizio Carletti; Adriana Cataldo; Stefano Cerilli; Carlotta Cerva; Roberta Chiappini; Pierangelo Chinello; Maria Assunta Cianfarani; Carmine Ciaralli; Claudia Cimaglia; Nicola Cinicola; Veronica Ciotti; Francesca Colavita; Massimo Cristofaro; Salvatore Curiale; Alessandra D’Abramo; Cristina Dantimi; Alessia De Angelis; Giada De Angelis; Maria Grazia De Palo; Federico De Zottis; Virginia Di Bari; Rachele Di Lorenzo; Federica Di Stefano; Davide Donno; Francesca Evangelista; Francesca Faraglia; Anna Farina; Federica Ferraro; Lorena Fiorentini; Andrea Frustaci; Matteo Fusetti; Vincenzo Galati; Paola Gallì; Gabriele Garotto; Ilaria Gaviano; Saba Gebremeskel Tekle; Maria Letizia Giancola; Filippo Giansante; Emanuela Giombini; Guido Granata; Maria Cristina Greci; Elisabetta Grilli; Susanna Grisetti; Gina Gualano; Fabio Iacomi; Marta Iaconi; Giuseppina Iannicelli; Carlo Inversi; Maria Elena Lamanna; Simone Lanini; Daniele Lapa; Luciana Lepore; Raffaella Libertone; Raffaella Lionetti; Giuseppina Liuzzi; Andrea Lucia; Franco Lufrani; Manuela Macchione; Gaetano Maffongelli; Alessandra Marani; Luisa Marchioni; Andrea Mariano; Maria Cristina Marini; Micaela Maritti; Annelisa Mastrobattista; Ilaria Mastrorosa; Giulia Matusali; Valentina Mazzotta; Paola Mencarini; Silvia Meschi; Francesco Messina; Sibiana Micarelli; Giulia Mogavero; Marzia Montalbano; Chiara Montaldo; Silvia Mosti; Silvia Murachelli; Maria Musso; Michela Nardi; Assunta Navarra; Martina Nocioni; Pasquale Noto; Roberto Noto; Alessandra Oliva; Ilaria Onnis; Sandrine Ottou; Claudia Palazzolo; Emanuele Pallini; Giulio Palombi; Carlo Pareo; Virgilio Passeri; Federico Pelliccioni; Giovanna Penna; Antonella Petrecchia; Ada Petrone; Elisa Pianura; Carmela Pinnetti; Maria Pisciotta; Pierluca Piselli; Silvia Pittalis; Agostina Pontarelli; Costanza Proietti; Vincenzo Puro; Paolo Migliorisi Ramazzini; Alessia Rianda; Gabriele Rinonapoli; Silvia Rosati; Dorotea Rubino; Martina Rueca; Alberto Ruggeri; Alessandra Sacchi; Alessandro Sampaolesi; Francesco Sanasi; Carmen Santagata; Alessandra Scarabello; Silvana Scarcia; Vincenzo Schininà; Paola Scognamiglio; Laura Scorzolini; Giulia Stazi; Giacomo Strano; Chiara Taibi; Giorgia Taloni; Tetaj Nardi; Roberto Tonnarini; Simone Topino; Martina Tozzi; Francesco Vairo; Alessandra Vergori; Laura Vincenzi; Ubaldo Visco-Comandini; Serena Vita; Pietro Vittozzi; Mauro Zaccarelli; Antonella Zanetti
Source
International Journal of Infectious Diseases, Vol 105, Iss , Pp 532-539 (2021)
Subject
Language
English
ISSN
1201-9712
Abstract
Background: Limited data are available about the predictors and outcomes associated with prolonged SARS-CoV-2 RNA shedding (VS). Methods: A retrospective study including COVID-19 patients admitted to an Italian hospital between March 1 and July 1, 2020. Predictors of viral clearance (VC) and prolonged VS from the upper respiratory tract were assessed by Poisson regression and logistic regression analyses. The causal relation between VS and clinical outcomes was evaluated through an inverse probability weighted Cox model. Results: The study included 536 subjects. The median duration of VS from symptoms onset was 18 days. The estimated 30-day probability of VC was 70.2%. Patients with comorbidities, lymphopenia at hospital admission, or moderate/severe respiratory disease had a lower chance of VC. The development of moderate/severe respiratory failure, delayed hospital admission after symptoms onset, baseline comorbidities, or D-dimer >1000 ng/mL at admission independently predicted prolonged VS. The achievement of VC doubled the chance of clinical recovery and reduced the probability of death/mechanical ventilation. Conclusions: Respiratory disease severity, comorbidities, delayed hospital admission and inflammatory markers negatively predicted VC, which resulted to be associated with better clinical outcomes. These findings highlight the importance of prompt hospitalization of symptomatic patients, especially where signs of severity or comorbidities are present.