Delayed hospital admission and high-dose corticosteroids potentially prolong SARS-CoV-2 RNA detection duration of patien
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ORIGINAL ARTICLE
Delayed hospital admission and high-dose corticosteroids potentially prolong SARS-CoV-2 RNA detection duration of patients with COVID-19 Zhigang Hu 1,2
&
Sijia Li 1,2 & Ailan Yang 3 & Wenxin Li 1,2 & Xiaoqi Xiong 1,2 & Jianwu Hu 4 & Jun Jiang 5 & Xinyu Song 1,2
Received: 27 June 2020 / Accepted: 23 October 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Coronavirus disease 2019 (COVID-19) with the infection of SARS-CoV-2 has become a serious pandemic worldwide. However, only few studies focused on risk factors of prolonged SARS-CoV-2 RNA detection among patients with COVID-19. We included 206 adult patients with laboratory-confirmed COVID-19 from two hospitals between 23 Jan and 1 April 2020. Least absolute shrinkage and selection operator (LASSO) analysis was used to screen out independent risk factors of SARS-CoV-2 RNA detection. By multivariate binomial logistic regression analysis and Cox regression analysis, we further determined the associations between SARS-CoV-2 RNA detection and potential risk factors. All patients had two negative SARS-CoV-2 tests with 33 days of median duration of SARS-CoV-2 RNA detection (interquartile range: 25.2–39 days). LASSO and binomial logistic regression analyses suggested that delayed hospital admission (adjusted OR = 3.70, 95% CI: 1.82–7.50), hypokalemia, and subpleural lesion (adjusted OR = 4.32, 95% CI: 1.10–16.97) were associated with prolonged SARS-CoV-2 RNA detection. By LASSO and multivariate Cox regression analyses, we observed that delayed hospital admission, subpleural lesion, and high-dose corticosteroid use were independent risk factors of prolonged SARS-CoV-2 RNA detection. Early hospital admission shortened 5.73 days of mean duration of SARS-CoV-2 RNA detection than delayed hospital admission after adjusting confounding factors. Our study demonstrated that delayed hospital admission and subpleural lesion were associated with prolonged SARS-CoV-2 RNA detection among patients with COVID-19. The use of high-dose corticosteroids should be interpreted with extreme caution in treating COVID-19. Keywords Hospital admission . COVID-19 . Corticosteroids . SARS-CoV-2 Zhigang Hu, Sijia Li, and Ailan Yang contributed equally to this work. They are listed as co-first authors. Zhigang Hu and Xinyu Song are listed as co-corresponding authors. * Zhigang Hu [email protected]
1
Department of Respiratory and Critical Care Medicine, The First College of Clinical Medicine Science, China Three Gorges University, No. 183 Yiling Road, Yichang 443003, People’s Republic of China
2
Department of Respiratory and Critical Care Medicine, Yichang Central People’s Hospital, Yichang 443003, People’s Republic of China
3
Department of Respiratory and Critical Care Medicine, Zhijiang People’s Hospital, Yichang 443003, People’s Republic of China
4
Department of Respiratory and Critical Care Medicine, Wuhan Fourth Hospital, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
5
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