Introduction
Since December 2019, severe acute respiratory syndrome coronavirus 2
(SARS-Coronavirus-2 (SARS-CoV-2)), which causes coronavirus disease 2019
(COVID-19) has been the focus of global attention. This severe
respiratory illness originated in Wuhan City in the Hubei province in
China and is capable of rapid community transmission. Thus far, the most
efficient effort at limiting disease spread has been by minimizing
person-to-person contact and by isolating infected
patients1. The clinical spectrum of COVID-19 includes
asymptomatic infection, mild upper respiratory tract illness, severe
viral pneumonia with respiratory failure, and death2.
In previous studies of seasonal influenza, it has been shown that the
longer duration of viral RNA shedding (among other factors such as the
use of corticosteroids, the delay of antiviral treatment, and other
comorbidities) is correlated with worse patient
prognosis3). Furthermore, our previous studies have
revealed that viral RNA clearance is associated with prognosis in
patients infected with influenza A(H7N9)4.
Although observational studies have shown that viral RNA concentration
is independently associated with risk of complications and respiratory
insufficiency in influenza 3-6, it has yet to be
determined if a longer duration of viral RNA shedding in SARS-CoV-2 is
also associated with worse patient prognosis and disease progression
(including severe viral pneumonia with respiratory failure and/or
death). Additionally, a previous study reported that the median duration
of viral shedding in patients who recovered from COVID-19 was 20 days,
although this study did not test if there was an association of viral
shedding with patient recovery2. In this retrospective
study, we explore the correlation between the viral RNA shedding
duration of SARS-CoV-2 and patient prognosis to determine if viral
shedding duration time could be used to assess patient risk of
transmission and to help guide clinical decisions for patients infected
with COVID-19.