Retrospective analysis of the effect of current clinical medications and clinicopathological factors on viral shedding in COVID‑19 patients
Professor Yanfeng Pan, Qingqing Li, Xue Yu, Qiankun Luo, Professor Tao Qin, Ningbo Xin, Qian Zhang, Xianyang Li, Xinwei Du, Qingxia Zhao, Li Sun
Biomedical Reports, doi:10.3892/br.2020.1375
The aim of the present study was to identify the risk factors associated with prolonged shedding in patients with coronavirus disease 2019 , and to evaluate the effects of current clinical and clinicopathological factors on viral shedding in patients. A total of 186 COVID-19 inpatients were enrolled in this multicentre retrospective analysis. Detailed clinical data of each patient were collected, and the factors that affected the duration of viral shedding were retrospectively analysed. The median duration of viral shedding in the 186 COVID-19 patients was 13 days. The median duration of viral shedding was 12 days in non-severe patients, and 17 days in severe patients, and there was a significant difference between the two groups (P<0.001). Multi-factor regression analysis suggested that the onset-hospitalization interval [odds ratio (OR), 1.27; 95% confidence interval (CI), 1.15-1.41; P<0.001] and comorbidity with a chronic disease (OR, 2.43; 95% CI, 1.14-5.17; P=0.021) were independent risk factors for prolonged viral shedding, whereas lopinavir/ritonavir (LPV/r) was an independent protective factor (OR, 0.28; 95% CI, 0.11-0.75; P=0.011). Spearman's rank correlation analysis showed that the onset-drug interval was positively correlated with the duration of viral shedding (r=0.446; P<0.0001). Umifenovir, and low and short courses of glucocorticoids were not associated with prolonged viral shedding. The prolonged viral shedding was the initial causative factor of persistent aggravation of the patient's conditions. The interval between presentation of symptoms and hospitalization as well as complications with a comorbid chronic disease were independent risk factors for prolonged viral shedding. LPV/r shortened the duration of viral shedding, and the smaller the interval between presentation and LPV/r onset was, the faster viral shedding occurred.
Authors' contributions YP contributed to the conception and design of study and the analysis and interpretation of data. QLi contributed to the acquisition, analysis and interpretation of data and manuscript review. XY contributed to the acquisition, analysis and interpretation of data. QLuo contributed to the interpretation of data and manuscript review. TQ, NX, QZhang, XL, XD, QZhao and LS contributed to the acquisition of data. All authors read and approved the final manuscript.
Ethics approval and consent to participate This study was exempt from the need to obtain patient consent due to the retrospective nature of the study, and was approved by the Medical Ethics Committee of Zhengzhou University (approval no. 2020-KY-162).
Patient consent for publication Not applicable.
Competing interests The authors declare that they have no competing interests.
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