Associations of clinical characteristics and antiviral drugs with viral RNA clearance in patients with COVID-19 in Guangzhou, China: a retrospective cohort study

  1. Xudan Chen
  2. Yuying Zhang
  3. Baoyi Zhu
  4. Jianwen Zeng
  5. Wenxin Hong
  6. Xi He
  7. Jingfeng Chen
  8. Haipeng Zheng
  9. Shuang Qiu
  10. Ying Deng
  11. Juliana CN Chan
  12. Jian Wang
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Abstract

Background

The novel coronavirus disease 2019 (COVID-19) characterized by respiratory symptoms has become a global pandemic although factors influencing viral RNA clearance remained unclear to inform optimal isolation period and treatment strategies.

Methods

In this retrospective study, we included patients with confirmed COVID-19 admitted to Guangzhou Eighth People’s Hospital from 20 th January 2020 to 15 th March 2020. The associations of clinical characteristics and treatment regimens on time to viral RNA clearance were analyzed.

Results

We examined 284 consecutive COVID-19 cases, accounting for 82% of confirmed cases in Guangzhou during this period. At the time of reporting (20 th March 2020), 276 (97.2%) had recovered and were discharged from hospital with a median hospital stay of 18 days (interquartile range [IQR]:13-24). Overall, 280 patients achieved viral RNA clearance with a median length of 12 days (IQR: 8-16) after onset of illness. Amongst them, 66.1% had viral RNA cleared within 14 days, and 89.3% within 21 days. Older age, severity of disease, time lag from illness onset to hospital admission, high body temperature, and corticosteroid use were associated with delayed clearance of viral RNA. None of the antiviral regimens (chloroquine, oseltamivir, arbidol, and lopinavir/ritonavir) improved viral RNA clearance. The use of lopinavir/ritonavir was associated with delayed clearance of viral RNA after adjusting for confounders.

Conclusion

In patients with COVID-19, isolation for a minimum of 21 days after onset of illness may be warranted, while the use of antiviral drugs does not enhance viral RNA clearance.

Brief Summary

Viral RNA was cleared in 89% of the COVID-19 patients within 21 days after illness onset. The use of antiviral drugs (chloroquine, oseltamivir, arbidol, and lopinavir/ritonavir) did not shorten viral RNA clearance, especially in non-serious cases.

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