key: cord-0815038-9l9zp6gm
authors: Zhou, Bo; She, Jianqing; Wang, Yadan; Ma, Xiancang
title: The duration of viral shedding of discharged patients with severe COVID-19
date: 2020-04-17
journal: Clin Infect Dis
DOI: 10.1093/cid/ciaa451
sha: ea68001972fb4f511fad96366e2bc8d9d30ffcb1
doc_id: 815038
cord_uid: 9l9zp6gm

The 2019 coronavirus disease (COVID-19) has drawn global intensive attention(1-3). Most of studies paid attention to epidemiological, clinical, and radiological features of inpatients with COVID-19(1-3). However, little studies have focused on clinical characteristics of discharged patients with severe COVID-19, especially the duration of viral shedding.

M a n u s c r i p t

We enrolled 41 discharged patients with severe COVID-19 on the 7 th floor ward in the west district, Union Hospital of Tongji Medical College from February 5 th to March 16 th , 2020. The patients were evaluated with real-time reverse transcriptase-polymerase chain reaction (RT-PCR) tests for COVID-19 nucleic acid. The RT-PCR tests were performed on throat swabs following a previously described method 3 Moreover, another study displayed that four patients with COVID-19 who met the criteria for hospital discharge in China had positive RT-PCR test results 5 to 13 days later 6 , suggesting that recovered patients might still be virus carriers. Thus, it is plausible that the patients with severe COVID-19 might need longer duration of symptomatic and supportive treatments due to prolonged duration of viral shedding.

Additionally, there was no significant difference with viral shedding time and the total time from illness onset to discharge between male and female, and between <65 yrs and ≥65 yrs.

Based on the results, we did not observe shortening of viral shedding time in the above groups, so it implied that all patients with severe COVID-19 should complete adequate course of treatment, regardless of sex and age.

Previously, increased age has been reported as an important independent predictor of mortality in COVID-19 5 . The current study also found that the number of discharged patients with severe COVID-19 in the group (<65 yrs) was more than in the group (≥65 yrs), indicating that the elder patients with severe COVID-19 may have poor outcome, and we A c c e p t e d M a n u s c r i p t should pay attention to the patients with severe COVID-19, especially ≥65 yrs.

The study was limited to a small number of discharged patients with severe COVID-19, not including mild or moderate infection, because we enrolled patients from the designated hospital for severe COVID-19. Besides, the estimated duration of viral shedding is limited by the frequency of respiratory specimen collection and relatively low positive rate of SARS-CoV-2 RNA detection in throat swab. It is advisable to continue follow-up discharged patients even after discontinuing quarantine for further viral shedding information. In addition, further studies based on larger cohorts would help to understand the prognosis and the duration of the disease. M a n u s c r i p t A c c e p t e d M a n u s c r i p t 

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A c c e p t e d M a n u s c r i p t