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Evaluation of SARS-CoV-2 RNA shedding in clinical specimens and clinical characteristics of 10 patients with COVID-19 in Macau.
Int J Biol Sci. 2020; 16(10):1698-1707.IJ

Abstract

As a city famous for tourism, the public healthcare system of Macau SAR has been under great pressure during the outbreak of the Coronavirus Disease 2019 (COVID-19). In this study, we report clinical and microbiological features of ten COVID-19 patients enrolled in the Centro Hospitalar Conde de São Januário (CHCSJ) between January 21 to February 16, 2020. Clinical samples from all patients including nasopharyngeal swab (NPS)/sputum, urine, and feces were collected for serial virus RNA testing by standard qRT-PCR assay. In total, seven were imported cases and three were local cases. The median duration from Macau arrival to admission in imported cases was 3 days. Four patients required oxygen therapy but none of them needed machinal ventilation. No fatal cases were noted. The most common symptoms were fever (80%) and diarrhea (80%). In the "Severe" group, there was significantly more elderly patients (p=0.045), higher lactate dehydrogenase levels (p=0.002), and elevated C-Reactive protein levels compared to the "Mild to Moderate" group (p<0.001). There were positive SARS-CoV-2 RNA signals in all patients' NPS and stool specimens but negative in all urine specimens. Based on our data on SARS-CoV-2 RNA shedding in stool and the possibility of a lag in viral detection in NPS specimens, the assessment of both fecal and respiratory specimen is recommended to enhance diagnostic sensitivity, and also to aid discharge decision before the role of viral RNA shedding in stool is clarified.

Authors+Show Affiliations

Physician, Consultant, Department of respiratory medicine, Centro Hospitalar Conde de São Januário, Macau Health Bureau, Macau SAR, China.Physician, Macau Academy of Medicine, Centro Hospitalar Conde de São Januário, Macau Health Bureau, Macau SAR, China.Physician, Macau Academy of Medicine, Centro Hospitalar Conde de São Januário, Macau Health Bureau, Macau SAR, China.Physician, Chief of service, Department of medicine, Centro Hospitalar Conde de São Januário, Macau Health Bureau, Macau SAR, China.Physician, Chief of service, Department of respiratory medicine, Centro Hospitalar Conde de São Januário, Macau Health Bureau, Macau SAR, China.Physician, Consultant, Department of respiratory medicine, Centro Hospitalar Conde de São Januário, Macau Health Bureau, Macau SAR, China.Physician, Department of infectious diseases, Centro Hospitalar Conde de São Januário, Macau Health Bureau, Macau SAR, China.Physician, Macau Academy of Medicine, Centro Hospitalar Conde de São Januário, Macau Health Bureau, Macau SAR, China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32226287

Citation

Lo, Iek Long, et al. "Evaluation of SARS-CoV-2 RNA Shedding in Clinical Specimens and Clinical Characteristics of 10 Patients With COVID-19 in Macau." International Journal of Biological Sciences, vol. 16, no. 10, 2020, pp. 1698-1707.
Lo IL, Lio CF, Cheong HH, et al. Evaluation of SARS-CoV-2 RNA shedding in clinical specimens and clinical characteristics of 10 patients with COVID-19 in Macau. Int J Biol Sci. 2020;16(10):1698-1707.
Lo, I. L., Lio, C. F., Cheong, H. H., Lei, C. I., Cheong, T. H., Zhong, X., Tian, Y., & Sin, N. N. (2020). Evaluation of SARS-CoV-2 RNA shedding in clinical specimens and clinical characteristics of 10 patients with COVID-19 in Macau. International Journal of Biological Sciences, 16(10), 1698-1707. https://doi.org/10.7150/ijbs.45357
Lo IL, et al. Evaluation of SARS-CoV-2 RNA Shedding in Clinical Specimens and Clinical Characteristics of 10 Patients With COVID-19 in Macau. Int J Biol Sci. 2020;16(10):1698-1707. PubMed PMID: 32226287.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of SARS-CoV-2 RNA shedding in clinical specimens and clinical characteristics of 10 patients with COVID-19 in Macau. AU - Lo,Iek Long, AU - Lio,Chon Fu, AU - Cheong,Hou Hon, AU - Lei,Chin Ion, AU - Cheong,Tak Hong, AU - Zhong,Xu, AU - Tian,Yakun, AU - Sin,Nin Ngan, Y1 - 2020/03/15/ PY - 2020/02/26/received PY - 2020/03/03/accepted PY - 2020/4/1/entrez PY - 2020/4/1/pubmed PY - 2020/4/4/medline KW - COVID-19 KW - Macau KW - SARS-CoV-2 KW - nasopharyngeal swab KW - novel coronavirus KW - qRT-PCR KW - sputum KW - stool KW - urine SP - 1698 EP - 1707 JF - International journal of biological sciences JO - Int. J. Biol. Sci. VL - 16 IS - 10 N2 - As a city famous for tourism, the public healthcare system of Macau SAR has been under great pressure during the outbreak of the Coronavirus Disease 2019 (COVID-19). In this study, we report clinical and microbiological features of ten COVID-19 patients enrolled in the Centro Hospitalar Conde de São Januário (CHCSJ) between January 21 to February 16, 2020. Clinical samples from all patients including nasopharyngeal swab (NPS)/sputum, urine, and feces were collected for serial virus RNA testing by standard qRT-PCR assay. In total, seven were imported cases and three were local cases. The median duration from Macau arrival to admission in imported cases was 3 days. Four patients required oxygen therapy but none of them needed machinal ventilation. No fatal cases were noted. The most common symptoms were fever (80%) and diarrhea (80%). In the "Severe" group, there was significantly more elderly patients (p=0.045), higher lactate dehydrogenase levels (p=0.002), and elevated C-Reactive protein levels compared to the "Mild to Moderate" group (p<0.001). There were positive SARS-CoV-2 RNA signals in all patients' NPS and stool specimens but negative in all urine specimens. Based on our data on SARS-CoV-2 RNA shedding in stool and the possibility of a lag in viral detection in NPS specimens, the assessment of both fecal and respiratory specimen is recommended to enhance diagnostic sensitivity, and also to aid discharge decision before the role of viral RNA shedding in stool is clarified. SN - 1449-2288 UR - https://www.unboundmedicine.com/medline/citation/32226287/Evaluation_of_SARS_CoV_2_RNA_shedding_in_clinical_specimens_and_clinical_characteristics_of_10_patients_with_COVID_19_in_Macau_ L2 - http://www.ijbs.com/v16p1698.htm DB - PRIME DP - Unbound Medicine ER -