key: cord-305092-q4tlj1jd authors: Lu, Jingjing; Yin, Qi; Li, Quan; Fu, Gang; Hu, Xueping; Huang, Jianhao; Chen, Lin; Li, Qiang; Guo, Zhongliang title: Clinical characteristics and factors affecting the duration of positive nucleic acid test for patients of COVID‐19 in XinYu, China date: 2020-08-29 journal: J Clin Lab Anal DOI: 10.1002/jcla.23534 sha: doc_id: 305092 cord_uid: q4tlj1jd BACKGROUND: The outbreak of a new coronavirus, COVID‐19, which was earliest reported in Wuhan, China, is now transmitting throughout the world. The aim of this study was to articulate the clinical characteristics of COVID‐19 and to reveal possible factors that may affect the persistent time of positive SARS‐CoV‐2 nucleic acid test, so as to identify which patients may deteriorate or have poor prognoses as early as possible. METHODS: Retrospective cohort study was carried out on 47 patients with confirmed COVID‐19 infection admitted to XinYu People's Hospital of JiangXi Province. Epidemiological, demographic, clinical, laboratorial, management, treatment, and outcome data were also collected and analyzed. RESULTS: In this study, patients were divided into two groups based on whether their SARS‐CoV‐2 nucleic acid tests in respiratory specimens turn negative within (Group Rapid or Group R) or over (Group Slow or Group S) a week. There was no significant difference in age, sex, travel or exposure history, and smoking history between the two groups. Forty‐two patients had been observed with comorbidities. Similar clinical manifestations, for instance fever, cough, sputum, and fatigue, have been observed among patients in both groups, except that patients in Group S were obviously more likely to get fatigue than patients in Group R. Both groups had shown decrease in white blood cell or lymphocyte counts. Chest X‐ray or computed tomography scan showed unilateral or bilateral infiltrates. High proportion in both groups has used nasal cannula (89.47% vs. 85.71%) to inhale oxygen. 10.53% of Group S have applied high‐flow nasal cannula, while Group R used none. The current treatment is mainly antibiotics, antiviral, and traditional Chinese medicine, while a couple of patients has used methylprednisolone. Only 1 patient out of both groups got even worse despite this active treatment. CONCLUSION: Clinical characteristics of COVID‐19 include the exposure history and typical systemic symptoms such as fever, cough, fatigue, decreased WBC and lymphocyte counts, and infiltration in both lower lobes on CT imaging. Among them, fatigue appears to be an important factor that affects the duration of positive SARS‐CoV‐2 nucleic acid test in respiratory specimens. In December 2019, a group of pneumonia patients with unknown pathogeny was found in Wuhan, Hubei Province, China. The clinical manifestation of such pneumonia is very similar to that of viral pneumonia, 1 NATs in respiratory specimens were taken after 48-72 hours of treatment. Clinical data were sampled only on patients whose NATs show negative in at least two successive tests between which the time interval is at least over one day. Written informed consent was waived for the retrospective case series, and this study has involved no potential risk to any patient. Descriptive analyses of the variables were expressed as median (interquartile range [IQR]) or number (%). Differences in distributions of patient characteristics by subgroups are reported using differences with 95% CIs. All analyses were performed with SPSS version 23.0, and P value <.05 was considered statistically significant. A total of 47 patients, among which 26 (55.32%) were female, were involved in this study (Table 1) . Aged from 13 to 70, the median age of the patients is 45 years old. Epidemiological data showed that 1 patient had been traveling to Hubei province, and 30 patients had been exposed to positive infections of COVID-19 (63.8%), including family members and colleagues. Forty-two patients had comorbidities, including hypertension (n = 10, 21.28%), diabetes (n = 9, 19.15%), coronary heart disease (n = 6, 12.77%), and chronic obstructive lung disease (n = 10, 21.28%). The proportion of patients having underlying diseases seems to be higher in Group S than in Group R. In addition, in both groups most patients were non-smokers. used methylprednisolone. Only 1 patient out of both groups got even worse despite this active treatment. Clinical characteristics of COVID-19 include the exposure history and typical systemic symptoms such as fever, cough, fatigue, decreased WBC and lymphocyte counts, and infiltration in both lower lobes on CT imaging. Among them, fatigue appears to be an important factor that affects the duration of positive SARS-CoV-2 nucleic acid test in respiratory specimens. clinical characteristics, Coronavirus disease, COVID-19, fatigue, SARS-CoV-2 In this study, patients were divided into two groups based on whether their SARS-CoV-2 NATs in respiratory specimens turns negative within (Group Rapid, or Group R) or over (Group Slow, or Group S) one week. There were no significant differences in age, gender, travel or exposure history, or smoking history between the two groups of patients ( Note: Except where indicated, data = n/N (%), n is number of patients, where N is the total number of patients with available data. *P < .05. In order to detect COVID-19, SARS-CoV-2 nucleic acid assay played a vital role in testing oropharyngeal swabs samples and provided a standard and critical condition for confirming recovering and approving discharge. Negative SARS-CoV-2 NAT in respiratory specimens has been believed to indicate viral shedding in respiratory specimens, which allows shorter hospital stay and implies better prognosis. In this study, patients were divided into two groups based on whether or not the NAT turns negative within one week. We thank Dr Gang Fu from XinYu People's Hospital for supporting the clinical data of the patients. The authors declared that they have no conflicts of interest to this work. We declare that we do not have any commercial or associative interest that represents a conflict of interest in connection with the work submitted. All the data supporting used in this work were publicly available. 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