Prolonged viral RNA shedding and recurrence of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)in coronavirus disease 2019(COVID-19)patients have been reported.However,the clinical outcome and pathogenesis ...Prolonged viral RNA shedding and recurrence of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)in coronavirus disease 2019(COVID-19)patients have been reported.However,the clinical outcome and pathogenesis remain unclear.In this study,we recruited 43 laboratory-confirmed COVID-19 patients.We found that prolonged viral RNA shedding or recurrence mainly occurred in severe/critical patients(P<0.05).The average viral shedding time in severe/critical patients was more than 50 days,and up to 100 days in some patients,after symptom onset.However,chest computed tomography gradually improved and complete absorption occurred when SARS-CoV-2 RT-PCR was still positive,but specific antibodies appeared.Furthermore,the viral shedding time significantly decreased when the A1,430G or C12,473T mutation occurred(P<0.01 and FDR<0.01)and increased when G227A occurred(P<0.05 and FDR<0.05).High IL1R1,IL1R2,and TNFRSF21 expression in the host positively correlated with viral shedding time(P<0.05 and false discovery rate<0.05).Prolonged viral RNA shedding often occurs but may not increase disease damage.Prolonged viral RNA shedding is associated with viral mutations and host factors.展开更多
基金supported by the Guangzhou Institute of Respiratory Health Open Project(Funds provided by China Evergrande Group)(2020GIRHHMS14)Zhongnanshan Medical Foundation of Guangdong Province(2020B1111340004 and ZNSA-2020003)+1 种基金the Traditional Chinese Medicine Bureau of Guangdong Province(2020ZYYJ05)the funding from Guangzhou Institute of Respiratory Health。
文摘Prolonged viral RNA shedding and recurrence of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)in coronavirus disease 2019(COVID-19)patients have been reported.However,the clinical outcome and pathogenesis remain unclear.In this study,we recruited 43 laboratory-confirmed COVID-19 patients.We found that prolonged viral RNA shedding or recurrence mainly occurred in severe/critical patients(P<0.05).The average viral shedding time in severe/critical patients was more than 50 days,and up to 100 days in some patients,after symptom onset.However,chest computed tomography gradually improved and complete absorption occurred when SARS-CoV-2 RT-PCR was still positive,but specific antibodies appeared.Furthermore,the viral shedding time significantly decreased when the A1,430G or C12,473T mutation occurred(P<0.01 and FDR<0.01)and increased when G227A occurred(P<0.05 and FDR<0.05).High IL1R1,IL1R2,and TNFRSF21 expression in the host positively correlated with viral shedding time(P<0.05 and false discovery rate<0.05).Prolonged viral RNA shedding often occurs but may not increase disease damage.Prolonged viral RNA shedding is associated with viral mutations and host factors.
