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Delayed hospital admission and high-dose corticosteroids potentially prolong SARS-CoV-2 RNA detection duration of patients with COVID-19.
Eur J Clin Microbiol Infect Dis. 2021 Apr; 40(4):841-848.EJ

Abstract

Coronavirus disease 2019 (COVID-19) with the infection of SARS-CoV-2 has become a serious pandemic worldwide. However, only few studies focused on risk factors of prolonged SARS-CoV-2 RNA detection among patients with COVID-19. We included 206 adult patients with laboratory-confirmed COVID-19 from two hospitals between 23 Jan and 1 April 2020. Least absolute shrinkage and selection operator (LASSO) analysis was used to screen out independent risk factors of SARS-CoV-2 RNA detection. By multivariate binomial logistic regression analysis and Cox regression analysis, we further determined the associations between SARS-CoV-2 RNA detection and potential risk factors. All patients had two negative SARS-CoV-2 tests with 33 days of median duration of SARS-CoV-2 RNA detection (interquartile range: 25.2-39 days). LASSO and binomial logistic regression analyses suggested that delayed hospital admission (adjusted OR = 3.70, 95% CI: 1.82-7.50), hypokalemia, and subpleural lesion (adjusted OR = 4.32, 95% CI: 1.10-16.97) were associated with prolonged SARS-CoV-2 RNA detection. By LASSO and multivariate Cox regression analyses, we observed that delayed hospital admission, subpleural lesion, and high-dose corticosteroid use were independent risk factors of prolonged SARS-CoV-2 RNA detection. Early hospital admission shortened 5.73 days of mean duration of SARS-CoV-2 RNA detection than delayed hospital admission after adjusting confounding factors. Our study demonstrated that delayed hospital admission and subpleural lesion were associated with prolonged SARS-CoV-2 RNA detection among patients with COVID-19. The use of high-dose corticosteroids should be interpreted with extreme caution in treating COVID-19.

Authors+Show Affiliations

Department of Respiratory and Critical Care Medicine, The First College of Clinical Medicine Science, China Three Gorges University, No. 183 Yiling Road, Yichang, 443003, People's Republic of China. hxq910813@163.com. Department of Respiratory and Critical Care Medicine, Yichang Central People's Hospital, Yichang, 443003, People's Republic of China. hxq910813@163.com.Department of Respiratory and Critical Care Medicine, The First College of Clinical Medicine Science, China Three Gorges University, No. 183 Yiling Road, Yichang, 443003, People's Republic of China. Department of Respiratory and Critical Care Medicine, Yichang Central People's Hospital, Yichang, 443003, People's Republic of China.Department of Respiratory and Critical Care Medicine, Zhijiang People's Hospital, Yichang, 443003, People's Republic of China.Department of Respiratory and Critical Care Medicine, The First College of Clinical Medicine Science, China Three Gorges University, No. 183 Yiling Road, Yichang, 443003, People's Republic of China. Department of Respiratory and Critical Care Medicine, Yichang Central People's Hospital, Yichang, 443003, People's Republic of China.Department of Respiratory and Critical Care Medicine, The First College of Clinical Medicine Science, China Three Gorges University, No. 183 Yiling Road, Yichang, 443003, People's Republic of China. Department of Respiratory and Critical Care Medicine, Yichang Central People's Hospital, Yichang, 443003, People's Republic of China.Department of Respiratory and Critical Care Medicine, Wuhan Fourth Hospital, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.Department of Respiratory and Critical Care Medicine, Yichang Third People's Hospital, Yichang, 443003, People's Republic of China.Department of Respiratory and Critical Care Medicine, The First College of Clinical Medicine Science, China Three Gorges University, No. 183 Yiling Road, Yichang, 443003, People's Republic of China. songxinyu@ctgu.edu.cn. Department of Respiratory and Critical Care Medicine, Yichang Central People's Hospital, Yichang, 443003, People's Republic of China. songxinyu@ctgu.edu.cn.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33123934

Citation

Hu, Zhigang, et al. "Delayed Hospital Admission and High-dose Corticosteroids Potentially Prolong SARS-CoV-2 RNA Detection Duration of Patients With COVID-19." European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology, vol. 40, no. 4, 2021, pp. 841-848.
Hu Z, Li S, Yang A, et al. Delayed hospital admission and high-dose corticosteroids potentially prolong SARS-CoV-2 RNA detection duration of patients with COVID-19. Eur J Clin Microbiol Infect Dis. 2021;40(4):841-848.
Hu, Z., Li, S., Yang, A., Li, W., Xiong, X., Hu, J., Jiang, J., & Song, X. (2021). Delayed hospital admission and high-dose corticosteroids potentially prolong SARS-CoV-2 RNA detection duration of patients with COVID-19. European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology, 40(4), 841-848. https://doi.org/10.1007/s10096-020-04085-2
Hu Z, et al. Delayed Hospital Admission and High-dose Corticosteroids Potentially Prolong SARS-CoV-2 RNA Detection Duration of Patients With COVID-19. Eur J Clin Microbiol Infect Dis. 2021;40(4):841-848. PubMed PMID: 33123934.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Delayed hospital admission and high-dose corticosteroids potentially prolong SARS-CoV-2 RNA detection duration of patients with COVID-19. AU - Hu,Zhigang, AU - Li,Sijia, AU - Yang,Ailan, AU - Li,Wenxin, AU - Xiong,Xiaoqi, AU - Hu,Jianwu, AU - Jiang,Jun, AU - Song,Xinyu, Y1 - 2020/10/29/ PY - 2020/06/27/received PY - 2020/10/23/accepted PY - 2020/10/31/pubmed PY - 2021/3/30/medline PY - 2020/10/30/entrez KW - COVID-19 KW - Corticosteroids KW - Hospital admission KW - SARS-CoV-2 SP - 841 EP - 848 JF - European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology JO - Eur J Clin Microbiol Infect Dis VL - 40 IS - 4 N2 - Coronavirus disease 2019 (COVID-19) with the infection of SARS-CoV-2 has become a serious pandemic worldwide. However, only few studies focused on risk factors of prolonged SARS-CoV-2 RNA detection among patients with COVID-19. We included 206 adult patients with laboratory-confirmed COVID-19 from two hospitals between 23 Jan and 1 April 2020. Least absolute shrinkage and selection operator (LASSO) analysis was used to screen out independent risk factors of SARS-CoV-2 RNA detection. By multivariate binomial logistic regression analysis and Cox regression analysis, we further determined the associations between SARS-CoV-2 RNA detection and potential risk factors. All patients had two negative SARS-CoV-2 tests with 33 days of median duration of SARS-CoV-2 RNA detection (interquartile range: 25.2-39 days). LASSO and binomial logistic regression analyses suggested that delayed hospital admission (adjusted OR = 3.70, 95% CI: 1.82-7.50), hypokalemia, and subpleural lesion (adjusted OR = 4.32, 95% CI: 1.10-16.97) were associated with prolonged SARS-CoV-2 RNA detection. By LASSO and multivariate Cox regression analyses, we observed that delayed hospital admission, subpleural lesion, and high-dose corticosteroid use were independent risk factors of prolonged SARS-CoV-2 RNA detection. Early hospital admission shortened 5.73 days of mean duration of SARS-CoV-2 RNA detection than delayed hospital admission after adjusting confounding factors. Our study demonstrated that delayed hospital admission and subpleural lesion were associated with prolonged SARS-CoV-2 RNA detection among patients with COVID-19. The use of high-dose corticosteroids should be interpreted with extreme caution in treating COVID-19. SN - 1435-4373 UR - https://www.unboundmedicine.com/medline/citation/33123934/Delayed_hospital_admission_and_high_dose_corticosteroids_potentially_prolong_SARS_CoV_2_RNA_detection_duration_of_patients_with_COVID_19_ L2 - https://dx.doi.org/10.1007/s10096-020-04085-2 DB - PRIME DP - Unbound Medicine ER -