<br>严重急性呼吸系统综合症冠状病毒的感染期为 17 名疗养院居民中的 2 人——阿肯色州，2020 年 6 月至 8 月,Open Forum Infectious Diseases

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严重急性呼吸系统综合症冠状病毒的感染期为 17 名疗养院居民中的 2 人——阿肯色州，2020 年 6 月至 8 月
Open Forum Infectious Diseases ( IF 3.8 ) Pub Date : 2021-01-30 , DOI: 10.1093/ofid/ofab048
Diya Surie ₁ , Jennifer Y Huang ₁ , Allison C Brown ₁ , Paige Gable ₁ , Caitlin Biedron ₁ , Sarah E Gilbert ₁ , Kelley Garner ₂ , Susan Bollinger ₁ , Trent Gulley ₂ , Tafarra Haney ₂ , Amanda K Lyons ₁ , Elizabeth Beshearse _{1,

3} , Christopher J Gregory ₁ , Sarah Sabour ₁ , Nakia S Clemmons ₁ , Allison E James _{2,

3} , Azaibi Tamin ₁ , Natashia Reese ₁ , K Allison Perry-Dow ₁ , Robin Brown ₂ , Jennifer L Harcourt ₁ , Davina Campbell ₁ , Hollis Houston ₁ , Rohan Chakravorty ₂ , Ashley Paulick ₁ , Brett Whitaker ₁ , Jordan Murdoch ₂ , Lori Spicer ₁ , Megan M Stumpf ₁ , Lisa Mills ₁ , Melissa M Coughlin ₁ , Pamela Higdem ₂ , Mohammad Ata Ur Rasheed ₁ , David Lonsway ₁ , Amelia Bhatnagar ₁ , Atul Kothari ₂ , Karen Anderson ₁ , Natalie J Thornburg ₁ , Erin Breaker ₁ , Michelle Adamczyk ₁ , Gillian A McAllister ₁ , Alison L Halpin ₁ , Kathryn A Seely ₂ , Naveen Patil ₂ , L Clifford McDonald ₁ , Preeta K Kutty ₁

Affiliation

背景为了估计患有基础疾病的老年人中严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 的感染期，我们评估了 2019 年冠状病毒病 (COVID-19) 症状的持续时间、逆转录聚合酶链反应 (RT-疗养院居民中 PCR）阳性和培养阳性。方法我们于 2020 年 7 月 7 日至 15 日在阿肯色州的一个设施中招募了首次 SARS-CoV-2 阳性检测（诊断）后 15 天内的居民，并在 42 天内进行了招募。我们每 3 天一次，持续 21 天，然后每周评估一次 COVID-19 症状，收集标本（口咽、前鼻孔和唾液），并查看医疗图表。在第 0、6、12、21 和 42 天收集血液进行血清学检查。感染性通过阳性培养来定义。将培养阳性持续时间与 COVID-19 症状和 RT-PCR 阳性持续时间进行比较。使用集中趋势、频率和比例的度量来总结数据。结果我们招募了 39 名符合条件的居民中的 17 名 (44%)。参与者年龄中位数为 82 岁（范围：58-97 岁）。所有人都有≥3种基础疾病。 RT-PCR 阳性的中位持续时间为诊断后 22 天（四分位距 [IQR]，8-31 天）；症状持续时间中位数为 42 天（IQR，28-49 天）。在 9 名 (53%) 具有任何培养阳性标本的参与者中，1 名 (11%) 严重免疫功能低下的参与者在诊断后 19 天仍保持培养阳性； 9 例中有 8 例 (89%) 在诊断后 8 天以内呈培养阳性。 12 名存活参与者中，有 12 名（100%）血液样本≥1 份时发生血清转化；所有参与者在血清转化前均为培养阴性。结论感染持续时间明显短于症状持续时间和 RT-PCR 阳性持续时间。严重的免疫功能低下可能会延长 SARS-CoV-2 的传染性。血清转化表明该队列不具有感染性。

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Infectious Period of Severe Acute Respiratory Syndrome Coronavirus 2 in 17 Nursing Home Residents—Arkansas, June–August 2020

Background To estimate the infectious period of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in older adults with underlying conditions, we assessed duration of coronavirus disease 2019 (COVID-19) symptoms, reverse-transcription polymerase chain reaction (RT-PCR) positivity, and culture positivity among nursing home residents. Methods We enrolled residents within 15 days of their first positive SARS-CoV-2 test (diagnosis) at an Arkansas facility from July 7 to 15, 2020 and instead them for 42 days. Every 3 days for 21 days and then weekly, we assessed COVID-19 symptoms, collected specimens (oropharyngeal, anterior nares, and saliva), and reviewed medical charts. Blood for serology was collected on days 0, 6, 12, 21, and 42. Infectivity was defined by positive culture. Duration of culture positivity was compared with duration of COVID-19 symptoms and RT-PCR positivity. Data were summarized using measures of central tendency, frequencies, and proportions. Results We enrolled 17 of 39 (44%) eligible residents. Median participant age was 82 years (range, 58–97 years). All had ≥3 underlying conditions. Median duration of RT-PCR positivity was 22 days (interquartile range [IQR], 8–31 days) from diagnosis; median duration of symptoms was 42 days (IQR, 28–49 days). Of 9 (53%) participants with any culture-positive specimens, 1 (11%) severely immunocompromised participant remained culture-positive 19 days from diagnosis; 8 of 9 (89%) were culture-positive ≤8 days from diagnosis. Seroconversion occurred in 12 of 12 (100%) surviving participants with ≥1 blood specimen; all participants were culture-negative before seroconversion. Conclusions Duration of infectivity was considerably shorter than duration of symptoms and RT-PCR positivity. Severe immunocompromise may prolong SARS-CoV-2 infectivity. Seroconversion indicated noninfectivity in this cohort.

更新日期：2021-01-30

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