Clearance and persistence of SARS‐CoV‐2 RNA in patients with COVID‐19

Carmo, Anália do; Pereira‐Vaz, João; Mota, Vanda; Mendes, A.; Morais, Catarina M.; Silva, Andreia Coelho da; Camilo, Elisabete; Pinto, Carla; Cunha, Elizabete; Pereira, Janet; Coucelo, Margarida; Martinho, Patrícia; Correia, Lurdes; Marques, Gilberto; Araújo, Lucília; Rodrigues, Fernando

doi:10.1002/jmv.26103

Cited by 94 publications

(101 citation statements)

References 18 publications

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“…Despite the observation that some COVID-19 patients initially test negative by real-time PCR (1, 2), a dichotomous observation has been the persistent detection of SARS-CoV-2 RNA in other patients (7). A number of published reports have demonstrated that SARS-CoV-2 real-time PCR assays may be positive for weeks, even following the resolution of clinical symptoms (7,8). The author is aware of a case where a patient with an underlying health condition tested positive by PCR for over 100 days (unpublished data).…”

Section: The Clinical Sensitivity Of Pcr and Its Use As A Test-of-curementioning

confidence: 99%

Challenges and Controversies to Testing for COVID-19

2020

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The coronavirus disease (COVID)-19 pandemic has placed the clinical laboratory and testing for SARS-CoV-2 front-and-center in the worldwide discussion of how to end the outbreak. Clinical laboratories have responded by developing, validating and implementing a variety of molecular and serologic assays to test for SARS-CoV-2 infection. This has played an essential role in identifying cases, informing isolation decisions and helping to curb the spread of disease. However, as the demand for COVID-19 testing has increased, laboratory professionals have faced a growing list of challenges, uncertainties and, in some situations, controversy, as they have attempted to balance the need for increasing test capacity with maintaining a high-quality laboratory operation. The emergence of this new viral pathogen has raised unique diagnostic questions for which there have not always been straightforward answers. In this commentary, the author addresses several areas of current debate, including 1) the role of molecular assays in defining the duration of isolation/quarantine, 2) whether the PCR cycle threshold value should be included on patient reports, 3) if specimen pooling and testing by research staff represent acceptable solutions to expand screening, and 4) whether testing a large percentage of the population is feasible and represents a viable strategy to end the pandemic.

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Section: The Clinical Sensitivity Of Pcr and Its Use As A Test-of-curementioning

confidence: 99%

Challenges and Controversies to Testing for COVID-19

2020

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“…Preliminary results from the RECOVERY trial showed that low-dose dexamethasone reduced deaths by one-third; however, the results were restricted to patients who needed ventilation [21,28]. Clinical outcomes are the most important endpoints; however, the duration of RNA clearance was used as an observational indicator in previous studies [14,29,30]. Studies on MERS showed that corticosteroid therapy was associated with delayed RNA clearance [14].…”

Section: Discussionmentioning

confidence: 99%

Effect of Corticosteroid Therapy on the Duration of SARS-CoV-2 Clearance in Patients with Mild COVID-19: A Retrospective Cohort Study

et al. 2020

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Introduction: In December, 2019, an outbreak of the coronavirus disease 2019 (COVID-19), which was caused by a novel coronavirus, started in Wuhan, China. So far, there is limited clinical evidence on the effect of corticosteroid therapy for this disease. This study aims to investigate the association between corticosteroid therapy and the duration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) clearance among patients with mild COVID-19. Methods: Patients with mild COVID-19 were enrolled from two medical centers in China between January 13, 2020 and February 29, 2020. Baseline characteristics and durations of RNA clearance were compared between the corticosteroid and non-corticosteroid therapy groups. The independent effects of corticosteroid therapy on the duration of RNA clearance were estimated by generalized linear models. Results: Of 82 patients with a mild infection, 40 patients were male (48.8%), with a median age of 49 years (interquartile range, IQR 36-61). Among those patients, 36 patients (43.9%) received corticosteroid therapy. The adjusted multivariate models showed that the effects of corticosteroids were non-significant on the durations of onset to first RNA clearance [b 2.48, 95% CI (95% confidence interval)-0.42 to 5.38, P = 0.0926] and to persistent RNA clearance (b 1.54, 95% CI-1.41 to 4.48, P = 0.3016), and durations of therapy to first RNA clearance (b 2.16, 95% CI-0.56 to 4.89, P = 0.1184) and to persistent RNA clearance (b 1.22, 95% CI-1.52 to 3.95, P = 0.3787). Conclusions: Corticosteroid therapy in patients with mild COVID-19 was not associated with the duration of SARS-CoV-2 clearance, suggesting that the use of corticosteroids may not be Cheng Ding and Xuewen Feng contributed equally to this work.

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“…Although there have not been any confirmed cases, blood banks should implement screening for possible SARS-CoV-2 contamination to ensure the safety of blood and blood products in the present COVID-19 pandemic situation. Nevertheless, viral particles can be detected in convalescent patients for a long time [9]. This is an important issue since interest has emerged in using donated convalescent plasma from patients recovering from COVID-19 to treat COVID-19 patients [10].…”

Section: Blood-borne Transmissionmentioning

confidence: 99%

Atypical mode of COVID-19 transmission: possibility?

Wiwanitkit

2020

Epidemiol Health

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Transmission via breast milk Infantile COVID-19 has already been recognized. How infants are infected is an interesting question, and in particular, the possibility of COVID-19 transmission via breast milk is an compelling topic in clinical neonatology. As discussed with vertical transmis-Coronavirus disease 2019 (COVID-19) is a new emerging pandemic, which has so far infected more than 20 million people throughout the world. Typically, this infection is transmitted from humans to humans via respiratory contact. However, the possibility that COVID-19 might be transmitted via atypical modes of transmission is an important public health consideration. In this short review article, the author summarizes and discusses the data on atypical modes of COVID-19 transmission. Based on the available data, it seems that there is still no evidence that COVID-19 can be transmitted via atypical modes of transmission.

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Clearance and persistence of SARS‐CoV‐2 RNA in patients with COVID‐19

Cited by 94 publications

References 18 publications

Challenges and Controversies to Testing for COVID-19

Challenges and Controversies to Testing for COVID-19

Effect of Corticosteroid Therapy on the Duration of SARS-CoV-2 Clearance in Patients with Mild COVID-19: A Retrospective Cohort Study

Atypical mode of COVID-19 transmission: possibility?

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