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. 2021 Sep 13;41(6):1096–1104. doi: 10.1007/s11596-021-2434-y

Prolonged SARS-CoV-2 Viral Shedding in Patients with COVID-19 was Associated with Delayed Initiation of Arbidol Treatment and Consulting Doctor Later: A Retrospective Cohort Study

Xin-liang He 1, Ya-ya Zhou 1, Wei Fu 1, Yu-e Xue 1, Meng-yuan Liang 1, Bo-han Yang 1, Wan-li Ma 1, Qiong Zhou 1, Long Chen 1, Jian-chu Zhang 1,✉, Xiao-rong Wang 1,✉
PMCID: PMC8436017  PMID: 34515914

Abstract

Objective

To study data about SARS-CoV-2 virus shedding and clarify the risk factors for prolonged virus shedding.

Methods

Data were retrospectively collected from adults hospitalized with laboratory-confirmed coronavirus disease-19 (COVID-19) in Wuhan Union Hospital. We compared clinical features among patients with prolonged (a positive SARS-CoV-2 RNA on day 23 after illness onset) and short virus shedding and evaluated risk factors associated with prolonged virus shedding by multivariate regression analysis.

Results

Among 238 patients, the median age was 55.5 years, 57.1% were female, 92.9% (221/238) were administered with arbidol, 58.4% (139/238) were given arbidol in combination with interferon. The median duration of SARS-CoV-2 virus shedding was 23 days (IQR, 17.8–30 days) with a longest one of 51 days. The patients with prolonged virus shedding had higher value of D-dimer (P=0.002), IL-6 (P<0.001), CRP (P=0.005) and more lobes lung lesion (P=0.014) on admission, as well as older age (P=0.017) and more patients with hypertension (P=0.044) than in those the virus shedding less than 23 days. Multivariate regression analysis revealed that prolonged viral shedding was significantly associated with initiation arbidol >8 days after symptom onset [OR: 2.447, 95% CI (1.351–4.431)], ≥3 days from onset of symptoms to first medical visitation [OR: 1.880, 95% CI (1.035–3.416)], illness onset before Jan. 31, 2020 [OR: 3.289, 95% CI (1.474–7.337)]. Arbidol in combination with interferon was also significantly associated with shorter virus shedding [OR: 0.363, 95% CI (0.191–0.690)].

Conclusion

Duration of SARS-CoV-2 virus shedding was long. Early initiation of arbidol and arbidol in combination with interferon as well as consulting doctor timely after illness onset were helpful for SARS-CoV-2 clearance.

Electronic Supplementary Material

Supplementary material is available for this article at 10.1007/s11596-021-2434-y and is accessible for authorized users.

Key words: SARS-CoV-2, viral shedding, risk factors, antiviral treatment, arbidol

Electronic supplementary material

Appendix (238.8KB, pdf)

Footnotes

This project was supported by Fundamental Research Funds for the Central Universities (No. 2020kfyXGYJ034, No. 2020kfyXGYJ009).

Conflict of Interest Statement

The authors declare there are no conflicts of interest. Author Xiao-rong WANG is a young member and Wanli MA is a member of the Editorial Board for Current Medical Science. The paper was handled by the other editors and has undergone rigrous peer review process. Authors Xiao-rong WANG and Wan-li MA were not involved in the journal’s review of, or decisions related to, this manuscript.

Contributor Information

Xin-liang He, Email: herbert1111@163.com.

Jian-chu Zhang, Email: zsn0928@163.com.

Xiao-rong Wang, Email: rong-100@163.com.

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Supplementary Materials

Appendix (238.8KB, pdf)

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