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Delayed hospital admission and high-dose corticosteroids potentially prolong SARS-CoV-2 RNA detection duration of patients with COVID-19

Authors
  • Hu, Zhigang1, 2
  • Li, Sijia1, 2
  • Yang, Ailan3
  • Li, Wenxin1, 2
  • Xiong, Xiaoqi1, 2
  • Hu, Jianwu4
  • Jiang, Jun5
  • Song, Xinyu1, 2
  • 1 The First College of Clinical Medicine Science, China Three Gorges University,
  • 2 Department of Respiratory and Critical Care Medicine, Yichang Central People’s Hospital, Yichang, 443003 People’s Republic of China
  • 3 Department of Respiratory and Critical Care Medicine, Zhijiang People’s Hospital, Yichang, 443003 People’s Republic of China
  • 4 Wuhan Fourth Hospital, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology,
  • 5 Department of Respiratory and Critical Care Medicine, Yichang Third People’s Hospital, Yichang, 443003 People’s Republic of China
Type
Published Article
Journal
European Journal of Clinical Microbiology & Infectious Diseases
Publisher
Springer-Verlag
Publication Date
Oct 29, 2020
Pages
1–8
Identifiers
DOI: 10.1007/s10096-020-04085-2
PMID: 33123934
PMCID: PMC7594939
Source
PubMed Central
Keywords
License
Unknown

Abstract

Coronavirus disease 2019 (COVID-19) with the infection of SARS-CoV-2 has become a serious pandemic worldwide. However, only few studies focused on risk factors of prolonged SARS-CoV-2 RNA detection among patients with COVID-19. We included 206 adult patients with laboratory-confirmed COVID-19 from two hospitals between 23 Jan and 1 April 2020. Least absolute shrinkage and selection operator (LASSO) analysis was used to screen out independent risk factors of SARS-CoV-2 RNA detection. By multivariate binomial logistic regression analysis and Cox regression analysis, we further determined the associations between SARS-CoV-2 RNA detection and potential risk factors. All patients had two negative SARS-CoV-2 tests with 33 days of median duration of SARS-CoV-2 RNA detection (interquartile range: 25.2–39 days). LASSO and binomial logistic regression analyses suggested that delayed hospital admission (adjusted OR = 3.70, 95% CI: 1.82–7.50), hypokalemia, and subpleural lesion (adjusted OR = 4.32, 95% CI: 1.10–16.97) were associated with prolonged SARS-CoV-2 RNA detection. By LASSO and multivariate Cox regression analyses, we observed that delayed hospital admission, subpleural lesion, and high-dose corticosteroid use were independent risk factors of prolonged SARS-CoV-2 RNA detection. Early hospital admission shortened 5.73 days of mean duration of SARS-CoV-2 RNA detection than delayed hospital admission after adjusting confounding factors. Our study demonstrated that delayed hospital admission and subpleural lesion were associated with prolonged SARS-CoV-2 RNA detection among patients with COVID-19. The use of high-dose corticosteroids should be interpreted with extreme caution in treating COVID-19.

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