148例新型冠状病毒肺炎患者病毒核酸追踪及转阴时间延长影响因素分析

An analysis of factors associated with prolonged time of viral RNA turning negative in 148 patients with COVID-19

目的调查新型冠状病毒性肺炎(COVID-19)患者病毒核糖核酸(RNA)转阴时间,探索病毒RNA转阴时间延长的影响因素。方法回顾性分析148例确诊COVID-19患者的临床资料,分析影响病毒RNA转阴时间的相关因素。结果 148例COVID-19患者中,RNA阳性113例(76.4%),病毒RNA转阴中位时间28 d, 11例(9.7%)患者康复期随访出现复阳。病毒RNA转阴时间延长的影响因素包括年龄(≥60岁)、有基础疾病、入院延迟(≥6 d)、有发热和病情重(P<0.05)。多因素回归分析显示,起病到住院≥6 d是病毒RNA转阴时间延长的独立预测因素[OR=8.890,95%CI(3.618~21.843)]。结论 COVID-19患者病毒RNA转阴时间较长,住院延迟是转阴时间延长的主要因素。COVID-19患者出现症状后应尽早住院治疗,并在恢复期采取个性化方式慎重解除隔离,以避免疾病的传播风险。

Objective To investigate the duration of viral RNA turning negative in the patients with coronavirus disease 2019(COVID-19) and analyze the associated factors related to prolonged time of viral RNA turning negative.Methods Clinical data of 148 COVID-19 patients were analyzed retrospectively, and the related factors affecting the duration of virus RNA turning negative were analyzed.Results Of 148 patients with COVID-19,113 cases(76.4%) were with positive nucleic acid.The median duration of SARS-CoV-2 RNA detection was 28 days as counted from the illness onset.Eleven patients(9.7%) were re-positive during rehabilitation follow-up.The factors associated with prolonged time of SARS-CoV-2 RNA turning negative included old age(≥60 years old),with underlying diseases or fever, delayed admission to hospital after illness onset(≥6 days) and severe illness status at admission(P<0.05).Logistic regression analysis showed that delayed admission was an independent risk factor for prolonged time of viral RNA turning negative [OR=8.890,95%CI(3.618-21.843)].Conclusion COVID-19 patients have a prolonged time of viral RNA turning negative.Delayed admission to hospital after illness onset is a main factor associated with prolonged time of viral RNA turning negative.Attention should be paid to that admission needs to be as soon as possible in symptomatic COVID-19 patients and the removal of isolation during recovery should be carefully in a personalized manner in order to avoid the risk for disease transmission.