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Duration of SARS-CoV-2 RNA Shedding Is Significantly Influenced by Disease Severity, Bilateral Pulmonary Infiltrates, Antibiotic Treatment, and Diabetic Status: Consideration for Isolation Period

Arfijanto et al., Pathophysiology, doi:10.3390/pathophysiology30020016
May 2023  
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Delayed viral clearance 51% Improvement Relative Risk Favipiravir  Arfijanto et al.  LATE TREATMENT Is late treatment with favipiravir beneficial for COVID-19? Retrospective 162 patients in Indonesia (June - December 2021) Improved viral clearance with favipiravir (p=0.02) c19early.org Arfijanto et al., Pathophysiology, May 2023 Favorsfavipiravir Favorscontrol 0 0.5 1 1.5 2+
Retrospective 162 hospitalized COVID-19 patients in Indonesia, showing lower incidence of delayed viral clearance with favipiravir treatment in unadjusted results.
This study is excluded in the after exclusion results of meta analysis: unadjusted results with no group details.
Study covers remdesivir and favipiravir.
delayed viral clearance, 50.9% lower, RR 0.49, p = 0.02, treatment 8 of 37 (21.6%), control 55 of 125 (44.0%), NNT 4.5.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Arfijanto et al., 4 May 2023, retrospective, Indonesia, peer-reviewed, 8 authors, study period June 2021 - December 2021. Contact: tpasmarawati@fk.unair.ac.id (corresponding author).
This PaperFavipiravirAll
Duration of SARS-CoV-2 RNA Shedding Is Significantly Influenced by Disease Severity, Bilateral Pulmonary Infiltrates, Antibiotic Treatment, and Diabetic Status: Consideration for Isolation Period
Muhammad Vitanata Arfijanto, Tri Pudy Asmarawati, Bramantono Bramantono, Musofa Rusli, Brian Eka Rachman, Bagus Aulia Mahdi, Nasronudin Nasronudin, Usman Hadi
Pathophysiology, doi:10.3390/pathophysiology30020016
Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) ribonucleic acid (RNA) shedding is an important parameter for determining the optimal length of isolation period required for coronavirus disease 2019 (COVID-19) patients. However, the clinical (i.e., patient and disease) characteristics that could influence this parameter have yet to be determined. In this study, we aim to explore the potential associations between several clinical features and the duration of SARS-CoV-2 RNA shedding in patients hospitalized with COVID-19. A retrospective cohort study involving 162 patients hospitalized for COVID-19 in a tertiary referral teaching hospital in Indonesia was performed from June to December 2021. Patients were grouped based on the mean duration of viral shedding and were compared based on several clinical characteristics (e.g., age, sex, comorbidities, COVID-19 symptoms, severity, and therapies). Subsequently, clinical factors potentially associated with the duration of SARS-CoV-2 RNA shedding were further assessed using multivariate logistic regression analysis. As a result, the mean duration of SARS-CoV-2 RNA shedding was found to be 13 ± 8.44 days. In patients with diabetes mellitus (without chronic complications) or hypertension, the duration of viral shedding was significantly prolonged (≥13 days; p = 0.001 and p = 0.029, respectively). Furthermore, patients with dyspnea displayed viral shedding for longer durations (p = 0.011). The multivariate logistic regression analysis reveals that independent risk factors associated with the duration of SARS-CoV-2 RNA shedding include disease severity (adjusted odds ratio [aOR] = 2.94; 95% CI = 1.36-6.44), bilateral lung infiltrates (aOR = 2.79; 95% CI = 1.14-6.84), diabetes mellitus (aOR = 2.17; 95% CI = 1.02-4.63), and antibiotic treatment (aOR = 3.66; 95% CI = 1.74-7.71). In summary, several clinical factors are linked with the duration of SARS-CoV-2 RNA shedding. Disease severity is positively associated with the duration of viral shedding, while bilateral lung infiltrates, diabetes mellitus, and antibiotic treatment are negatively linked with the duration of viral shedding. Overall, our findings suggest the need to consider different isolation period estimations for specific clinical characteristics of patients with COVID-19 that affect the duration of SARS-CoV-2 RNA shedding.
Conflicts of Interest: The authors declare no conflict of interest.
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Viruses'}, { 'key': 'ref_36', 'doi-asserted-by': 'crossref', 'first-page': '1622', 'DOI': '10.1016/j.cmi.2020.07.016', 'article-title': 'Bacterial co-infection and secondary infection in patients with ' 'COVID-19: A living rapid review and meta-analysis', 'volume': '26', 'author': 'Langford', 'year': '2020', 'journal-title': 'Clin. Microbiol. Infect.'}], 'container-title': 'Pathophysiology', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://www.mdpi.com/1873-149X/30/2/16/pdf', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2023, 5, 5]], 'date-time': '2023-05-05T09:45:35Z', 'timestamp': 1683279935000}, 'score': 1, 'resource': {'primary': {'URL': 'https://www.mdpi.com/1873-149X/30/2/16'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2023, 5, 4]]}, 'references-count': 36, 'journal-issue': {'issue': '2', 'published-online': {'date-parts': [[2023, 6]]}}, 'alternative-id': ['pathophysiology30020016'], 'URL': 'http://dx.doi.org/10.3390/pathophysiology30020016', 'relation': {}, 'ISSN': ['1873-149X'], 'subject': ['General Medicine'], 'container-title-short': 'Pathophysiology', 'published': {'date-parts': [[2023, 5, 4]]}}
Late treatment
is less effective
Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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