Dynamics of viral load and anti-SARS-CoV-2 antibodies in patients with positive RT-PCR results after recovery from COVID-19

Song, Kyoung Ho; Kim, Dong-Min; Lee, Hyunju; Ham, Sin Young; Oh, Seung-Yong; Jeong, Hyeonju; Jung, Jongtak; Kang, Chang Kyung; Park, Ji Young; Kang, Yu Min; Kim, Ji Yeon; Park, Jeong Su; Park, Kyoung Un; Kim, Eu Suk; Kim, Hong Bin

doi:10.3904/kjim.2020.325

Cited by 36 publications

(34 citation statements)

References 8 publications

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“…No close contacts or family members were infected. The first time positive Ct value upon hospitalization and second time positive Ct value after discharge, showed no significant difference Zhang et al [77] China Case report 3 1 36,54,50,55 4/- 15 d,25 d,6 d,15 d positive – – 4 IgG positive 3 IgM positive All presented with no symptoms, and the chest CT scan of three cases was normal Song et al [69] Korea Case report 3 1 73,33,31,18 month 4/- 4 d,9 d,9 d,9 d positive – – positive In 4 RP patients, the highest levels of IgG and IgM antibodies were reached after about a month of the onset of the initial symptoms. Then, the IgG titers plateaued, and the IgM titers decreased, regardless of RT-PCR results.…”

Section: Resultsmentioning

confidence: 93%

“…Nineteen studies ( n = 101) [ 16 , 18 , 22 – 25 , 32 , 35 , 36 , 49 – 51 , 59 , 73 , 76 , 97 , 104 , 107 , 115 ] showed that discharged patients had no symptoms when the nucleic acid test was positive. Among 55 studies, 1054 RP patients had symptoms, cough (19·82%) [ 20 , 26 , 29 – 31 , 34 , 38 , 42 , 44 , 49 , 52 , 60 , 62 , 63 , 66 , 67 , 69 , 71 , 74 , 78 , 81 , 83 – 85 , 88 , 89 , 91 , 94 , 95 , 98 , 101 , 103 , 106 , 108 , 110 , 119 , 121 , 125 , 127 , 130 ] and fever (14·99%) [ 20 , 28 , 29 , 41 , 44 , 46 , 49 , 52 , 67 ,…”

Section: Resultsmentioning

confidence: 99%

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A systematic review and meta-analysis of discharged COVID-19 patients retesting positive for RT-PCR

Ren

Lou

et al. 2021

EClinicalMedicine

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Background With the increased number of patients discharged after having COVID-19, more and more studies have reported cases whose retesting was positive (RP) during the convalescent period, which brings a new public health challenge to the world. Methods We searched PubMed, Web of Science, The Cochrane Library, CNKI, WanFang and VIP from December 1, 2019 to December 31, 2020. The included studies were assessed using JBI critical appraisal tools and Newcastle-Ottawa Scale. The RP rate of discharge patients was analyzed by a meta-analysis. We adhered to PRISMA reporting guideline. Findings We have included 117 studies with 2669 RP participants after discharge. The methodological quality of 66 case reports were low to high, 42 case series and 3 cohort study were moderate to high, 3 case-control studies were moderate and 3 cross-sectional studies were low to moderate. The clinical manifestations of most RP patients were mild or asymptomatic, and CT imaging and laboratory examinations were usually normal. The existing risk factors suggest that more attention should be paid to sever patients, elderly patients, and patients with co-morbidities. The summary RP rate was 12·2% (95% CI 10·6–13·7) with high heterogeneity ( I 2 = 85%). Interpretation To date, the causes and risk factors of RP result in discharged patients are not fully understood. High-quality etiological and clinical studies are needed to investigate these issues to further help us to make strategies to control and prevent its occurrence.

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Section: Resultsmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 99%

A systematic review and meta-analysis of discharged COVID-19 patients retesting positive for RT-PCR

Ren

Lou

et al. 2021

EClinicalMedicine

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“…On the other hand, some patients with recurrence may produce lower specific antibody titres in comparison to those without recurrence, suggesting that the virus may not confer immunity sufficiently due to limited antibody levels and after that causes recurrence [ 46 , 48 ]. In a case series study, a 33-year old man who experienced recurrence two times did not develop IgM ever during the follow-up period [ 45 ].…”

Section: Resultsmentioning

confidence: 99%

A systematic review on the recurrence of SARS-CoV-2 virus: frequency, risk factors, and possible explanations

Piri

Edalatfar

Shool

et al. 2021

Infectious Diseases

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Background Since late 2019, SARS-CoV-2 which leads to coronavirus disease 2019 (COVID-19), has caused thousands of deaths. There are some pieces of evidence that SARS-CoV-2 genome could be re-detectable in recovered patients. Methods We performed a systematic review in the PubMed/Medline database to address the risk of SARS-CoV-2 recurrence. The last update was for 20 November 2020. Among the 1178 initially found articles, 66 met the inclusion criteria and were considered. Findings In total, 1128 patients with at least one-time recurrence of SARS-CoV-2 were included. Recurrence rate has been reported between 2.3% and 21.4% in cohort studies, within a mean of 20 (ranged 1–98) days after discharge; younger patients are being affected more. Following the second course of disease, the disease severity decreased or remained unchanged in 97.3% while it increased in 2.6%. Anti-SARS-CoV-2 IgG and IgM were positive in 11–95% and 58.8–100%, respectively. Based on the literature, three possibilities include reactivation of previous disease, reinfection with the same virus, and false negative, which have been discussed in details. Conclusion There is a relatively notable risk of disease recurrence in previously recovered patients, even those who are immunised against the virus. More studies are required to clarify the underlying cause of this phenomenon.

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“…In this context, RT-PCR assay was useful for the detection of SARS-CoV-2 in these decomposed samples while other methods including histopathology, and high-resolution computed tomography (HRCT), blood examination etc., have limitations. However, RT-PCR, being a very sensitive and genome-based technique can show positive with the mere presence of traces of fragmented genome, which is observed in samples of asymptomatic and recovered subjects[26]. Additionally, findings from this assay might not reveal if the virus was viable or dead in the decomposed tissue but demonstrate the stability of the SARS-CoV-2 genome in the decomposed tissue.…”

Section: Resultsmentioning

confidence: 99%

The detection of SARS-CoV-2 in autolysed samples from an exhumed decomposed body: Implications to virus survival, genome stability and spatial distribution in tissues

Prasad

Nachappa

Anand

et al. 2021

Preprint

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Here we report for the first time the SARS-CoV-2 detection in autolysed samples from an exhumed decomposed body post-thirty six days after death. Both naso-oropharyngeal swabs and visceral samples from the lung, intestine, liver, and kidney were collected from the body exhumed post-fifteen days after burial, stored in viral transport medium and in saturated salt solution respectively. Naso-oropharyngeal swabs showed the presence of the SARS-CoV-2 genome as identified by the amplification of viral E, N, RdRP, or ORF1ab genes by RT-PCR. Subsequent examination of tissues reveal the detection of the virus genome in the intestine and liver, while no detection in the kidney and lung. These results signify the genome stability and implicate the virus survival in decomposed swab samples and in tissues and thereafter in storage solution. Further results also indicate spatial distribution of the virus in tissues during the early stage of infection in the subject with no respiratory distress. Considering the presence of cool, humid, and moist location surrounded by the paddy fields, the presence of virus genome might also indicate that SARS-CoV-2 can persist for more than seven days on the surface of dead bodies similar to the Ebola virus, confirming that transmission from deceased subjects is possible for an extended period after death. These results further reaffirm the robustness of the RT-PCR aiding in the detection of viruses or their genome in decomposed samples when other methods of detection could not be useful. Key Words: SARS-CoV-2, Virus survival, Genome stability, Autolysis, RT-PCR.

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Dynamics of viral load and anti-SARS-CoV-2 antibodies in patients with positive RT-PCR results after recovery from COVID-19

Cited by 36 publications

References 8 publications

A systematic review and meta-analysis of discharged COVID-19 patients retesting positive for RT-PCR

A systematic review and meta-analysis of discharged COVID-19 patients retesting positive for RT-PCR

A systematic review on the recurrence of SARS-CoV-2 virus: frequency, risk factors, and possible explanations

The detection of SARS-CoV-2 in autolysed samples from an exhumed decomposed body: Implications to virus survival, genome stability and spatial distribution in tissues

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