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Persistent viral RNA shedding of SARS-CoV-2 is associated with delirium incidence and six-month mortality in hospitalized COVID-19 patients
GeroScience ( IF 5.6 ) Pub Date : 2022-05-11 , DOI: 10.1007/s11357-022-00561-z
Ayush Batra 1, 2 , Jeffrey R Clark 1 , Anthony K Kang 1 , Sareen Ali 1 , Tulsi R Patel 1 , Nathan A Shlobin 1 , Steven C Hoffman 1 , Patrick H Lim 1 , Zachary S Orban 1 , Lavanya Visvabharathy 1 , Edith L Graham 1 , David P Sullivan 2 , William A Muller 2 , Sherry H-Y Chou 1 , Zoltán Ungvári 3, 4, 5, 6 , Igor J Koralnik 1 , Eric M Liotta 1
Affiliation  

Background

Persistent viral RNA shedding of SARS-CoV-2 following COVID-19 has increasingly been recognized, with limited understanding of its implications on outcomes in hospitalized COVID-19 patients.

Methods

We retrospectively assessed for persistent viral shedding across Northwestern Medicine Healthcare (NMHC) patients between March and August 2020. We assessed for predictors of persistent viral shedding, in-hospital delirium, and six-month mortality using binary logistic regression.

Results

Of the 2,518 hospitalized patients with an RT-PCR-confirmed diagnosis of COVID-19, 959 underwent repeat SARS-CoV-2 RT-PCR at least fourteen days from initial positive testing. Of those, 405 (42.2%) patients were found to have persistent viral shedding. Persistent viral shedding was associated with male sex, increased BMI, diabetes mellitus, chronic kidney disease, and exposure to corticosteroids during initial COVID-19 hospitalization. Persistent viral shedding was independently associated with incidence of in-hospital delirium after adjusting for factors including severity of respiratory dysfunction (OR 2.45; 95% CI 1.75, 3.45). Even after adjusting for age, severity of respiratory dysfunction, and occurrence of in-hospital delirium, persistent viral shedding remained significantly associated with increased six-month mortality (OR 2.43; 95% CI 1.42, 4.29).

Conclusions

Persistent viral shedding occurs frequently in hospitalized COVID-19 patients and is associated with in-hospital delirium and increased six-month mortality.



中文翻译:

SARS-CoV-2 的持续病毒 RNA 脱落与住院 COVID-19 患者的谵妄发生率和 6 个月死亡率相关

背景

COVID-19 后 SARS-CoV-2 的持续病毒 RNA 脱落已越来越得到认可,但对其对住院 COVID-19 患者预后的影响了解有限。

方法

我们回顾性评估了 2020 年 3 月至 2020 年 8 月期间西北医学医疗保健 (NMHC) 患者的持续病毒脱落情况。我们使用二元逻辑回归评估了持续病毒脱落、院内谵妄和六个月死亡率的预测因子。

结果

在经 RT-PCR 确诊为 COVID-19 的 2,518 名住院患者中,959 名在最初的阳性检测后至少 14 天接受了重复 SARS-CoV-2 RT-PCR。其中,405 名 (42.2%) 患者被发现有持续的病毒脱落。持续的病毒脱落与男性、体重指数增加、糖尿病、慢性肾病和在最初的 COVID-19 住院期间接触皮质类固醇有关。在调整包括呼吸功能障碍严重程度在内的因素后,持续的病毒脱落与院内谵妄的发生率独立相关(OR 2.45;95% CI 1.75, 3.45)。即使在调整了年龄、呼吸功能障碍的严重程度和院内谵妄的发生后,持续的病毒脱落仍然与 6 个月死亡率增加显着相关(OR 2.43;95% CI 1.

结论

持续的病毒脱落经常发生在住院的 COVID-19 患者中,并与院内谵妄和六个月死亡率增加有关。

更新日期:2022-05-11
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