Positive RT-PCR tests among discharged COVID-19 patients in Shenzhen, China.
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ABSTRACT:
SUBMITTER: Tang X
PROVIDER: S-EPMC7205550 | biostudies-literature | 2020 Sep
REPOSITORIES: biostudies-literature
Publications
Positive RT-PCR tests among discharged COVID-19 patients in Shenzhen, China.
Tang Xiujuan X Zhao Shi S He Daihai D Yang Lin L Wang Maggie H MH Li Yuan Y Mei Shujiang S Zou Xuan X
Infection control and hospital epidemiology 20200416 9
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Project description: Not available
| S-EPMC7330744 | biostudies-literature
Project description:BackgroundWith the increased number of patients discharged after having COVID-19, more and more studies have reported cases whose retesting was positive (RP) during the convalescent period, which brings a new public health challenge to the world.MethodsWe searched PubMed, Web of Science, The Cochrane Library, CNKI, WanFang and VIP from December 1, 2019 to December 31, 2020. The included studies were assessed using JBI critical appraisal tools and Newcastle-Ottawa Scale. The RP rate of discharge patients was analyzed by a meta-analysis. We adhered to PRISMA reporting guideline.FindingsWe have included 117 studies with 2669 RP participants after discharge. The methodological quality of 66 case reports were low to high, 42 case series and 3 cohort study were moderate to high, 3 case-control studies were moderate and 3 cross-sectional studies were low to moderate. The clinical manifestations of most RP patients were mild or asymptomatic, and CT imaging and laboratory examinations were usually normal. The existing risk factors suggest that more attention should be paid to sever patients, elderly patients, and patients with co-morbidities. The summary RP rate was 12·2% (95% CI 10·6-13·7) with high heterogeneity (I2 = 85%).InterpretationTo date, the causes and risk factors of RP result in discharged patients are not fully understood. High-quality etiological and clinical studies are needed to investigate these issues to further help us to make strategies to control and prevent its occurrence.
| S-EPMC8052132 | biostudies-literature
Project description:BackgroundThe emergency of new COVID-19 variants over the past three years posed a serious challenge to the public health. Cities in China implemented mass daily RT-PCR tests by pooling strategies. However, a random delay exists between an infection and its first positive RT-PCR test. It is valuable for disease control to know the delay pattern and daily infection incidences reconstructed from RT-PCR test observations.MethodsWe formulated the convolution model between daily incidences and positive RT-PCR test counts as a linear inverse problem with positivity restrictions. Consequently, the Richard-Lucy deconvolution algorithm was used to reconstruct COVID-19 incidences from daily PCR tests. A real-time deconvolution was further developed based on the same mathematical principle. The method was applied to an Omicron epidemic data set of a bar outbreak in Beijing and another in Wuxi in June 2022. We estimated the delay function by maximizing likelihood via an E-M algorithm.ResultsThe delay function of the bar-outbreak in 2022 differs from that reported in 2020. Its mode was shortened to 4 days by one day. A 95% confidence interval of the mean delay is [4.43,5.55] as evaluated by bootstrap. In addition, the deconvolved infection incidences successfully detected two associated infection events after the bar was closed. The application of the real-time deconvolution to the Wuxi data identified all explosive incidence increases. The results revealed the progression of the two COVID-19 outbreaks and provided new insights for prevention and control strategies, especially for the role of mass daily RT-PCR testing.ConclusionsThe proposed deconvolution method is generally applicable to other infectious diseases if the delay model can be assumed to be approximately valid. To ensure a fair reconstruction of daily infection incidences, the delay function should be estimated in a similar context in terms of virus variant and test protocol. Both the delay estimate from the E-M algorithm and the incidences resulted from deconvolution are valuable for epidemic prevention and control. The real-time feedback is particularly useful during the epidemic's acute phase because it can help the local disease control authorities modify the control measures more promptly and precisely.
| S-EPMC10568936 | biostudies-literature
Project description:The prevalence and outcomes of patients who had re-activation of coronavirus disease 2019 (COVID-19) after discharge remain poorly understood. We included 126 consecutively confirmed cases of COVID-19 with 2-month follow-up data after discharge in this retrospective study. The upper respiratory specimen using a reverse-transcription polymerase chain reaction test of three patients (71 years [60-76]) were positive within 11-20 days after their discharge, with an event rate of 19.8 (95%CI 2.60-42.1) per 1,000,000 patient-days. Moreover, all re-positive patients were asymptomatic. Our findings suggest that few recovered patients may still be virus carriers even after reaching the discharge criteria.
| S-EPMC7456660 | biostudies-literature
Project description: Not available
| S-EPMC7151314 | biostudies-literature
Project description:To analyze the clinical characteristics of re-positive discharged COVID-19 patients and find distinguishing markers. The demographic features, clinical symptoms, laboratory results, comorbidities, co-infections, treatments, illness severities and chest CT scan results of 267 patients were collected from 1st January to 15th February 2020. COVID-19 was diagnosed by RT-PCR. Clinical symptoms and nucleic acid test results were collected during the 14 days post-hospitalization quarantine. 30 out of 267 COVID-19 patients were detected re-positive during the post-hospitalization quarantine. Re-positive patients could not be distinguished by demographic features, clinical symptoms, laboratory results, comorbidities, co-infections, treatments, chest CT scan results or subsequent clinical symptoms. However, re-positive rate was found to be correlated to illness severity, according the Acute Physiology and Chronic Health Evaluation II (APACHE II) severity-of-disease classification system, and the confusion, urea, respiratory rate and blood pressure (CURB-65) score. Common clinical characteristics were not able to distinguish re-positive patients. However, severe and critical cases classified high according APACHE II and CURB-65 scores, were more likely to become re-positive after discharge.
| S-EPMC7562721 | biostudies-literature
Project description:BackgroundCOVID-19 is an infectious disease of variable severity caused by a new coronavirus. Clinical presentation ranges from asymptomatic cases to severe illness. Most cases in newborns appear to be asymptomatic or mild.ObjectiveTo conduct a systematic review of the literature on published studies of COVID-19 in newborns with a positive RT-PCR test.MethodsThe PubMed and EMBASE databases were searched for infection data in newborns from 1 December 2019-21 May 2021. The mesh terms included "SARS-CoV-2", "COVID-19", "novel coronavirus", "newborns" and "neonates". The selection criteria were as follows: original studies reporting clinical, radiological, laboratory, and outcome data in newborns with a positive RT-PCR test for SARS-CoV-2. Two independent investigators reviewed the studies.ResultsSeventy-two studies that involved 236 newborns were included. The main clinical manifestations were fever (43.2%), respiratory (46.6%), and gastrointestinal (35.2%) symptoms; 60.1% had mild/moderate disease. A total of 52.5% had a chest X-ray; 43.5% were normal, and 24.1% reported consolidation/infiltration images. The most frequent laboratory abnormalities were elevated C reactive protein and elevated procalcitonin and lymphopenia. Mortality was 1.7%.ConclusionSymptoms of SARS-CoV-2 infection were mild to moderate in most of the newborns. The prognosis was good, and mortality was mainly associated with other comorbidities.
| S-EPMC8919773 | biostudies-literature
Project description:BackgroundCOVID-19 is a multi-system infection with emerging evidence-based antiviral and anti-inflammatory therapies to improve disease prognosis. However, a subset of patients with COVID-19 signs and symptoms have repeatedly negative RT-PCR tests, leading to treatment hesitancy. We used comparative serology early in the COVID-19 pandemic when background seroprevalence was low to estimate the likelihood of COVID-19 infection among RT-PCR negative patients with clinical signs and/or symptoms compatible with COVID-19.MethodsBetween April and October 2020, we conducted serologic testing of patients with (i) signs and symptoms of COVID-19 who were repeatedly negative by RT-PCR ('Probables'; N = 20), (ii) signs and symptoms of COVID-19 but with a potential alternative diagnosis ('Suspects'; N = 15), (iii) no signs and symptoms of COVID-19 ('Non-suspects'; N = 43), (iv) RT-PCR confirmed COVID-19 patients (N = 40), and (v) pre-pandemic samples (N = 55).ResultsProbables had similar seropositivity and levels of IgG and IgM antibodies as propensity-score matched RT-PCR confirmed COVID-19 patients (60.0% vs 80.0% for IgG, p-value = 0.13; 50.0% vs 72.5% for IgM, p-value = 0.10), but multi-fold higher seropositivity rates than Suspects and matched Non-suspects (60.0% vs 13.3% and 11.6% for IgG; 50.0% vs 0% and 4.7% for IgM respectively; p-values < 0.01). However, Probables were half as likely to receive COVID-19 treatment than the RT-PCR confirmed COVID-19 patients with similar disease severity.ConclusionsFindings from this study indicate a high likelihood of acute COVID-19 among RT-PCR negative with typical signs/symptoms, but a common omission of COVID-19 therapies among these patients. Clinically diagnosed COVID-19, independent of RT-PCR positivity, thus has a potential vital role in guiding treatment decisions.
| S-EPMC8841043 | biostudies-literature
Project description:Amidst the COVID-19 pandemic, clinicians have been plagued with dilemmas related to the uncertainty about diagnostic testing for the virus. It has become commonplace for a patient under investigation (PUI) to repeatedly test negative but have imaging findings that are consistent with COVID-19. This raises the question of when the treating team should entertain alternative diagnoses. We present such a case to help provide a framework for how to weigh repeatedly negative test results in clinical decision making when there is ongoing concern for COVID-19.
| S-EPMC7434325 | biostudies-literature
Project description:BackgroundOur hospital is a designated institution for COVID-19 patients in Chengdu, China. This study aimed to analyze the clinical and chest CT features of 15 COVID-19 patients with positive reverse transcription-polymerase chain reaction (RT-PCR) retest results after discharge. Patients who met the current standards of discharge could still carry the SARS-CoV-2 virus.MethodsClinical manifestations, laboratory data, and chest CT images were retrospectively reviewed and analyzed.ResultsThe most common symptoms at Covid-19COVID-19 initial onset were fever (12/15, 80%) and cough (11/15, 73.3%). Most of the patients had a normal white blood cells (12/15, 80%), neutrophils (12/15, 80%), and lymphocytes count (13/15, 86.7%); some patients had increased C-reactive protein (CRP) (5/15, 33.3%), and increased lactate dehydrogenase (LDH) (4/15, 26.7%) during first admission. Five patients (33.3%) had a cough before their first discharge. The average interval from the first discharge to re-admission was 17 days (range, 9–30 days). At re-admission, two (13.3%) patients presented with cough, and one (6.6%) had chest pain with anxiety. At re-admission, all patients had normal clinical results except five (33.3%) patients had increased CRP compared with first discharging, two (13.3%) patients had increased neutrophils count, and one (6.6%) had increased CRP. The majority of patients had normal procalcitonin. Ground glass opacities (GGOs) and reticulation in the peripheral and subpleural areas were the most common CT manifestations, and six patients (40%) showed a transformation from reticulation to GGOs when re-admitted.ConclusionsThere may be no specific clinical characteristics to predict the re-detectability of the virus. A regular medical observation and a bi-monthly follow-up is recommended.
| S-EPMC7276372 | biostudies-literature