Time to Negativity and Factors Associated with Persistent Reverse Transcription-Polymerase Chain Reaction Positivity among Asymptomatic and Mildly Symptomatic Covid-19 Patients

BACKGROUND The Covid-19 infection caused by SARS-CoV-2 has spread rapidly across the world & has become a global public health emergency. Infected patients tend to carry the virus for a longer period of time, which requires an early isolation and monitoring. Information on persistent RT-PCR posi...

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Published inJournal of evolution of medical and dental sciences Vol. 10; no. 31; pp. 2373 - 2377
Main Authors Abraham, Anitha, M.B, Adarsh, Padinjath, Kavitha, Nandakumar, Meera Mini, Pilankatta, Rajendra, Vaman, Raman Swathy
Format Journal Article
LanguageEnglish
Published Akshantala Enterprises Private Limited 02.08.2021
Subjects
Epidemiology
Health aspects
Hypertension
Infection
Medical records
Medical research
Medicine, Experimental
Polymerase chain reaction
Risk factors
China
India
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Summary:BACKGROUND The Covid-19 infection caused by SARS-CoV-2 has spread rapidly across the world & has become a global public health emergency. Infected patients tend to carry the virus for a longer period of time, which requires an early isolation and monitoring. Information on persistent RT-PCR positivity and time to negativity are lacking in our population. We wanted to assess the prevalence of persistent RT-PCR positivity, time to a negative test and factors related to it in our population. METHODS This is a retrospective medical record based observational study conducted among lab confirmed and admitted Covid-19 patients. After admission, repeat oropharyngeal swabs were taken at specific time intervals that varied from 3 - 5 days. A persistent RT-PCR positivity was defined as more than 3 repeat positive RT-PCR tests in a patient. RESULTS 118 Covid-19 positive patients were included in the study. Mean age was 40.58 yrs. (SD, 11.9 years). Median number of repeat RT-PCR tests was 3 (IQR, 2 – 4 repeats). Persistent RT-PCR positivity was seen in 15 (12.7 %) subjects. Median time taken to first negative RT-PCR test was 9 days (IQR, 6.7 - 13.25 days) and median duration of hospital stay of subjects was 14 (IQR, 10 – 18). Presence of hypertension, use of antibiotic azithromycin and use of angiotensin receptor blockers were found to be significant risk factors for persistent positivity. CONCLUSIONS Persistent RT-PCR positivity indicating prolonged viral shedding was seen in 12.7 % of patients. Hypertension and use of antibiotic azithromycin were independent risk factors of persistent RT-PCR positivity. The epidemiological burden of the finding needs to be assessed in a wider population with a larger sample size. KEY WORDS COVID-19, RT-PCR, Viral Persistence, Infectivity, Time to Negativity
ISSN:2278-4748
2278-4802
DOI:10.14260/jemds/2021/487