Retrospective analysis of the effect of current clinical medications and clinicopathological factors on viral shedding in COVID‑19 patients

Pan,Yanfeng; Li,Qingqing; Yu,Xue; Luo,Qiankun; Qin,Tao; Xin,Ningbo; Zhang,Qian; Li,Xianyang; Du,Xinwei; Zhao,Qingxia; Sun,Li

doi:10.3892/br.2020.1375

Retrospective analysis of the effect of current clinical medications and clinicopathological factors on viral shedding in COVID‑19 patients

Authors:
- Yanfeng Pan
- Qingqing Li
- Xue Yu
- Qiankun Luo
- Tao Qin
- Ningbo Xin
- Qian Zhang
- Xianyang Li
- Xinwei Du
- Qingxia Zhao
- Li Sun
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Affiliations: Department of Infectious Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, P.R. China, Department of Hepatobiliary and Pancreatic Surgery, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan 450000, P.R. China, Department of Infectious Diseases, Zhengzhou Sixth People's Hospital, Zhengzhou, Henan 450000, P.R. China, Department of Infectious Diseases, Henan Provincial People's Hospital, Zhengzhou, Henan 450000, P.R. China, Department of Infectious Diseases, Shenqiu County People's Hospital, Zhoukou, Henan 466300, P.R. China, Department of Infectious Diseases, The People's Hospital of Suzhou New District, Suzhou, Jiangsu 205011, P.R. China, Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, P.R. China
Published online on: October 20, 2020 https://doi.org/10.3892/br.2020.1375
Article Number: 68

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Abstract

The aim of the present study was to identify the risk factors associated with prolonged shedding in patients with coronavirus disease 2019 (COVID‑19), and to evaluate the effects of current clinical and clinicopathological factors on viral shedding in patients. A total of 186 COVID‑19 inpatients were enrolled in this multicentre retrospective analysis. Detailed clinical data of each patient were collected, and the factors that affected the duration of viral shedding were retrospectively analysed. The median duration of viral shedding in the 186 COVID‑19 patients was 13 days. The median duration of viral shedding was 12 days in non‑severe patients, and 17 days in severe patients, and there was a significant difference between the two groups (P<0.001). Multi‑factor regression analysis suggested that the onset‑hospitalization interval [odds ratio (OR), 1.27; 95% confidence interval (CI), 1.15‑1.41; P<0.001] and comorbidity with a chronic disease (OR, 2.43; 95% CI, 1.14‑5.17; P=0.021) were independent risk factors for prolonged viral shedding, whereas lopinavir/ritonavir (LPV/r) was an independent protective factor (OR, 0.28; 95% CI, 0.11‑0.75; P=0.011). Spearman's rank correlation analysis showed that the onset‑drug interval was positively correlated with the duration of viral shedding (r=0.446; P<0.0001). Umifenovir, and low and short courses of glucocorticoids were not associated with prolonged viral shedding. The prolonged viral shedding was the initial causative factor of persistent aggravation of the patient's conditions. The interval between presentation of symptoms and hospitalization as well as complications with a comorbid chronic disease were independent risk factors for prolonged viral shedding. LPV/r shortened the duration of viral shedding, and the smaller the interval between presentation and LPV/r onset was, the faster viral shedding occurred.

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