Chest CT study of fifteen COVID-19 patients with positive RT-PCR retest results after discharge

Li, Chenxi; Luo, Fengguang; Xie, Liqiu; Gao, Yueqin; Zhang, Na; Wu, Bing

doi:10.21037/qims-20-530

Cited by 18 publications

(30 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…All of them were SARS-CoV-2 antibody carriers Mild to moderate symptoms - [ 13 ] China 619 87 (14%) 45 (51.7%) 0–69 Nasopharyngeal swabs, throat swabs, and anal swabs 2–19 Serology was available in 59/87 patients. 58 (98.3%) were positive for neutralizing antibody Mild (46, 52.9%) and moderate (41, 47.1%) Asymptomatic (77, 88.5%), mild (10, 11.5%) [ 14 ] China 172 25 (14.5%) 8 (32.0%) < 12–60 Cloacal swab (14, 56%) and nasopharyngeal swab (11, 44%) 7.32 ± 3.86 - Non-severe (24, 96.0%), severe (1, 4.0%) Asymptomatic (17, 68%) and mild cough (32.0%) [ 15 ] China 66 11 (16.7%) - 16–78 Stool specimen - - - - [ 16 ] China 85 15 (17.6%) 4 (26.7%) Rang = 23–68 Respiratory swabs 9–30 - Fever (12/15, 80%), cough (11/15, 73.3%), and other symptoms including dyspnea (2/15, 13.3%), headache (2/15, 13.3%), chest pain (2/15, 13.3%), chills (2/15, 13.3%), and digestive symptoms (1/15, 6.7%) Two patients (13.3%) had cough, one (6.6%) had dyspnea, and one (6.6%) had chest pain [ 17 ] China 70 15 (21.4%) 9 (60.0%) Range = 51–73 Throat swab samples or nasal swab - - Moderate (14, 93.3%) and severe (1, 6.7%) - [ 18 ] China 13 6 (46.2%) 6 (46.2%) Range = 22–73 Fecal sample (2, 15.4%), sputum sample (4, 30.8%) 5–14 - All patients presented with common main symptoms of fever, cough, fatigue, muscle soreness, and sore throat - …”

Section: Clinical and Demographic Characteristics Of Re-positive Covimentioning

confidence: 99%

“…Li et al conducted a study on chest CT scan evaluations among COVID-19 patients with a positive RT-PCR re-test following their discharge in Sichuan, China [ 16 ]. A total of 15/85 (17.6%) recovered patients were re-detectable for SARS-CoV-2 and were included in the survey.…”

Section: Clinical and Demographic Characteristics Of Re-positive Covimentioning

confidence: 99%

“…Most of them were asymptomatic at the time of their second admission. The authors showed that no radiological features or changes were observed in these patients [ 16 ].…”

Section: Clinical and Demographic Characteristics Of Re-positive Covimentioning

confidence: 99%

“…The false-negative rate of RT-PCR varies from 3 to 41%, according to the type of clinical specimen used [ 34 , 70 ]. There are many reasons for false-negative RT-PCR results, including the sensitivity/specificity of the nucleic acid test kit, the sources of samples, and the sampling procedure itself [ 16 , 71 ]. In a retrospective analysis involving 161 COVID-19 patients, the authors showed that false-negative test results of SARS-CoV-2 viral RNA were mainly caused by poor-quality sampling and that swabs did not contain a sufficient quantity of cellular materials [ 72 ].…”

Section: Potential Cause Of Re-detectable Positive Sars-cov-2 Virus Imentioning

confidence: 99%

“…Although the virus was found, not only in the respiratory tract but also in the feces and rectal swabs from re-positive patients, no living virus was found [ 55 , 82 , 83 ]. Evidence of the lack of viral reactivation was also supported by the lack of increase in lung infections revealed by the chest CT scan [ 4 , 16 ]. In addition, the patients with COVID-19 can carry protective antibodies after recovery [ 84 ].…”

Section: Infectivity Of Re-detectable Positive Sars-cov-2 Virus In Rementioning

confidence: 99%

See 4 more Smart Citations

Recurrence of SARS-CoV-2 viral RNA in recovered COVID-19 patients: a narrative review

Dao

Hoang

Gautret

2020

Eur J Clin Microbiol Infect Dis

120

136

View full text Add to dashboard Cite

Many studies have shown that re-positive tests for SARS-CoV-2 by RT-PCR in recovered COVID-19 patients are very common. We aim to conduct this review to summarize the clinical and epidemiological characteristics of these patients and discuss the potential explanations for recurrences, the contagiousness of re-detectable positive SARS-CoV-2 virus, and the management of COVID-19 patients after discharge from hospital. The proportion of re-positive tests in discharged COVID-19 patients varied from 2.4 to 69.2% and persisted from 1 to 38 days after discharge, depending on population size, age of patients, and type of specimens. Currently, several causes of re-positive tests for SARS-CoV-2 in recovered COVID-19 patients are suggested, including false-negative, false-positive RT-PCR tests; reactivation; and re-infection with SARS-CoV-2, but the mechanism leading to these re-positive cases is still unclear. The prevention of re-positive testing in discharged patients is a fundamental measure to control the spread of the pandemic. In order to reduce the percentage of false-negative tests prior to discharge, we recommend performing more than two tests, according to the standard sampling and microbiological assay protocol. In addition, specimens should be collected from multiple body parts if possible, to identify SARS-CoV-2 viral RNA before discharge. Further studies should be conducted to develop novel assays that target a crucial region of the RNA genome in order to improve its sensitivity and specificity.

show abstract

Section: Clinical and Demographic Characteristics Of Re-positive Covimentioning

confidence: 99%

Section: Clinical and Demographic Characteristics Of Re-positive Covimentioning

confidence: 99%

“…Most of them were asymptomatic at the time of their second admission. The authors showed that no radiological features or changes were observed in these patients [ 16 ].…”

Section: Clinical and Demographic Characteristics Of Re-positive Covimentioning

confidence: 99%

Section: Potential Cause Of Re-detectable Positive Sars-cov-2 Virus Imentioning

confidence: 99%

Section: Infectivity Of Re-detectable Positive Sars-cov-2 Virus In Rementioning

confidence: 99%

See 3 more Smart Citations

Recurrence of SARS-CoV-2 viral RNA in recovered COVID-19 patients: a narrative review

Dao

Hoang

Gautret

2020

Eur J Clin Microbiol Infect Dis

120

136

View full text Add to dashboard Cite

show abstract

Epidemiologic characteristics of cases with reinfection, recurrence, and hospital readmission due to COVID‐19: A systematic review and meta‐analysis

Ghorbani

Taherpour

Bayat

et al. 2021

Journal of Medical Virology

View full text Add to dashboard Cite

Recent studies reported that some recovered COVID‐19 patients have tested positive for virus nucleic acid again. A systematic search was performed in Web of Science, PubMed, Scopus, and Google Scholar up to March 6, 2021. The pooled estimation of reinfection, recurrence, and hospital readmission among recovered COVID‐19 patients was 3, 133, and 75 per 1000 patients, respectively. The overall estimation of reinfection among males compared to females was greater. The prevalence of recurrence in females compared to males was more common. Also, hospital readmission between sex groups was the same. There is uncertainty about long‐term immunity after SARS‐Cov‐2 infection. Thus, the possibility of reinfection and recurrence after recovery is not unexpected. In addition, there is a probability of hospital readmission due to adverse events of COVID‐19 after discharge. However, with mass vaccination of people and using the principles of prevention and appropriate management of the disease, frequent occurrence of the disease can be controlled.

show abstract

Is recurrence possible in coronavirus disease 2019 (COVID-19)? Case series and systematic review of literature

Gidari

Nofri

Saccarelli

et al. 2020

Eur J Clin Microbiol Infect Dis

View full text Add to dashboard Cite

Can a patient diagnosed with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) be infected again? This question is still unsolved. We tried to analyze local and literature cases with a positive respiratory swab after recovery. We collected data from symptomatic patients diagnosed with SARS-CoV-2 infection in the Italian Umbria Region that, after recovery, were again positive for SARS-CoV-2 in respiratory tract specimens. Samples were also assessed for infectivity in vitro. A systematic review of similar cases reported in the literature was performed. The study population was composed of 9 patients during a 4-month study period. Among the new positive samples, six were inoculated in Vero-E6 cells and showed no growth and negative molecular test in culture supernatants. All patients were positive for IgG against SARS-CoV-2 nucleoprotein and/or S protein. Conducting a review of the literature, 1350 similar cases have been found. The presumptive reactivation occurred in 34.5 days on average (standard deviation, SD, 18.7 days) after COVID-19 onset, when the 5.6% of patients presented fever and the 27.6% symptoms. The outcome was favorable in 96.7% of patients, while the 1.1% of them were still hospitalized at the time of data collection and the 2.1% died. Several hypotheses have been formulated to explain new positive respiratory samples after confirmed negativity. According to this study, the phenomenon seems to be due to the prolonged detection of SARS-CoV-2 RNA traces in respiratory samples of recovered patients. The failure of the virus to replicate in vitro suggests its inability to replicate in vivo.

show abstract

Chest CT study of fifteen COVID-19 patients with positive RT-PCR retest results after discharge

Cited by 18 publications

References 13 publications

Recurrence of SARS-CoV-2 viral RNA in recovered COVID-19 patients: a narrative review

Recurrence of SARS-CoV-2 viral RNA in recovered COVID-19 patients: a narrative review

Epidemiologic characteristics of cases with reinfection, recurrence, and hospital readmission due to COVID‐19: A systematic review and meta‐analysis

Is recurrence possible in coronavirus disease 2019 (COVID-19)? Case series and systematic review of literature

Contact Info

Product

Resources

About