The treatment and follow‐up of ‘recurrence’ with discharged <scp>COVID</scp>‐19 patients: data from Guizhou, China

Tian, Maolu; Long, Yun; Hong, Yang; Zhang, Xiangyan; Zha, Yan

doi:10.1111/1462-2920.15156

Cited by 26 publications

(38 citation statements)

References 19 publications

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“…Within the first admission, considering 1064 patients, the majority of re-positive cases ( n = 987; 92.7%) were asymptomatic or had mild to moderate symptoms [ 1 , 3 , 13 , 14 , 16 , 17 , 19 , 21–24 , 26–28 , 30–33 , 36–45 , 47 , 48 , 50–52 , 54 , 56 , 58 , 59 , 61 , 62 , 64–67 , 69–73 , 75 , 77 ], but some of them had severe or critical disease ( n = 77, 7.3%) [ 1 , 13 , 18 , 21 , 23 , 24 , 27 , 30 , 31 , 35 , 36 , 39 , 42 , 43 , 46 , 49 , 55 , 60 , 63 , 68 , 74 ]. To compare the severity of disease during the first and second courses of illness in re-positive patients, 57 studies including 858 re-positive patients, it was reported that the disease severity decreased or remained unchanged in 835 cases (97.3%) [ 13 , 15–20 , 23 , 24 , 26 , 28–31 , 33 , 36–48 , 50 , 52–54 , 58–61 , 65–68 , 70 , 71 , …”

Section: Resultsmentioning

confidence: 99%

“…Different studies observed no significant association between the recurrence susceptibility and the presence of these serum-specific antibodies [ 13 , 14 , 34 ]. Several cases with recurrence have been tested positive for the IgG test [ 31 , 34 , 49 ]. According to this evidence, it could be speculated that antibody presence does not necessarily prevent disease recurrence.…”

Section: Resultsmentioning

confidence: 99%

“…However, another study proposes that the immunity failure might cause not only the persistence of the virus but also reinfection [ 34 ]. Although most the rate of positive IgG antibodies against the SARS-CoV-2 has been reported between 52.8% and 95%, the absence of sufficient immunity in patients with re-positive SARS-CoV-2 test was observed in multiple studies [ 14 , 31 , 34 , 46 ]. Robbiani et al.…”

Section: Secondary Positive Sars-cov-2 Pcr Test: Is It a Sampling Issmentioning

confidence: 99%

“…The failure of immunity for protection may lead to the prolonged viral shedding of the non-viable virus, replication of a viable virus, or reinfection. Three studies asserted that non-strong immune response and insufficient immunity led to the persistence of shedding of the virus, but not a replication of a viable virus [ 14 , 31 , 34 ]. In this regard, a case report study on a patient with four times recurrence within 137 days assumed that the antibody levels are just sufficient for preventing transmission of disease considering negative RT-PCR tests of the patient's parents, not for full clearance of virus [ 48 ].…”

Section: Secondary Positive Sars-cov-2 Pcr Test: Is It a Sampling Issmentioning

confidence: 99%

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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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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Secondary Positive Sars-cov-2 Pcr Test: Is It a Sampling Issmentioning

confidence: 99%

Section: Secondary Positive Sars-cov-2 Pcr Test: Is It a Sampling Issmentioning

confidence: 99%

See 2 more Smart Citations

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

View full text Add to dashboard Cite

show abstract

“…One of the main purposes of follow-up is to monitor nucleic acid reactivation. Although the current evidences suggest that positivity on follow-up RT-PCR not imply infectivity [22], typical symptoms occur in a significant proportion of recurrence patients and require further treatment [23][24][25]. On the other hand, it is imperative to understand the possible outcome of discharged COVID-19 patients, especially if they have any other detrimental illnesses by longitudinal analysis to safeguard their life in future [26,27].…”

Section: Discussionmentioning

confidence: 97%

Liver function recovery of COVID-19 patients after discharge, a follow-up study

An¹,

Song²,

Li³

et al. 2021

Int. J. Med. Sci.

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Objective: The aim of this study was to observe the liver function recovery of COVID-19 patients after discharge. Patients and Methods: A total of 253 discharged COVID-19 patients in Shenzhen city, China were selected. The clinical characteristics of these patients were assessed. A 2-month follow-up and laboratory hematology test were performed to examine the status of patients' liver function. Results: Patients combined with liver diseases, especially fatty liver, are more likely to progress to severe condition (P<0.05). Patients in severe condition and those with liver diseases have higher rates of liver injuries during hospitalization, characterized by a significant increase in alanine aminotransferase (ALT) and aspartate aminotransferase (AST, P<0.01). The ALT, AST/ALT, gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), total protein (TP), albumin (ALB), and A/G levels showed significant differences in comparison with the control group (P<0.05, and P<0.001); and the outlier ratio of A/G, ALT, GGT and ALP of patients remained abnormal higher within 14 days after discharge (P<0.001). Liver injuries of COVID-19 patients may be related to the epidemiological characteristics, clinical indexes, basic diseases, symptoms, drug treatment during hospitalization and the complications. Indicators of liver function were correlated with cardiac function, renal function, thyroid function, lipid metabolism, glucose metabolism, immune index, leukocyte, erythrocyte, hemoglobin and platelet related indexes. The outlier ratio of TP, ALB and GLB remained extremely low throughout the follow-up period; the outlier ratio of ALT, AST and GGT decreased below 10% from a high level at 40 days after discharged. However, the outlier ratio of A/G, AST/ALT and ALP remained high during the follow-up period. Conclusions: Abnormal liver function might indicate worse recovery of COVID-19 patients. Changes in liver function should be emphasized during long-term follow-up of COVID-19 patients after hospital discharge; the necessity of employing appropriate interventions for liver function repair should be emphasized.

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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

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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.

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The treatment and follow‐up of ‘recurrence’ with discharged COVID‐19 patients: data from Guizhou, China

Cited by 26 publications

References 19 publications

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

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

Liver function recovery of COVID-19 patients after discharge, a follow-up study

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

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