Diabetes mellitus is a risk factor for prolonged SARS-CoV-2 viral shedding in lower respiratory tract samples of critically ill patients
| Autor: | Marco Conti, Vera Consonni, Valentina Forni-Ogna, Alessandro Ceschi, Timothy Mazzuchelli, Enos Bernasconi, Luigia Elzi, Niccolò Buetti, Alexandra Trkola, Carlo Balmelli, Gladys Martinetti, Adam Ogna, Elia Lo Priore, Pierpaolo Trimboli |
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| Přispěvatelé: | University of Zurich, Trimboli, Pierpaolo |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
10028 Institute of Medical Virology
medicine.medical_specialty Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism 610 Medicine & health Type 2 diabetes law.invention 03 medical and health sciences 0302 clinical medicine Endocrinology law Internal medicine Diabetes mellitus Type 2 diabetes mellitus Medicine Intensive care unit 030212 general & internal medicine Risk factor Viral shedding SARS-CoV-2 business.industry Proportional hazards model Hazard ratio COVID-19 Type 2 Diabetes Mellitus medicine.disease 1310 Endocrinology 2712 Endocrinology Diabetes and Metabolism Infectivity 570 Life sciences biology Original Article business |
| Zdroj: | Endocrine |
| Popis: | Purpose The length of time a critically ill coronavirus disease 2019 (COVID-19) patient remains infectious and should therefore be isolated remains unknown. This prospective study was undertaken in critically ill patients to evaluate the reliability of single negative real-time polymerase chain reaction (RT-PCR) in lower tracheal aspirates (LTA) in predicting a second negative test and to analyze clinical factors potentially influencing the viral shedding. Methods From April 9, 2020 onwards, intubated COVID-19 patients treated in the intensive care unit were systematically evaluated for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by RT-PCR of nasopharyngeal swabs and LTA. The time to negativity was defined as the time between the onset of symptoms and the viral clearance in LTA. In order to identify risk factors for prolonged viral shedding, we used univariate and multivariate Cox proportional hazards models. Results Forty-eight intubated SARS-CoV-2 patients were enrolled. Overall, we observed that the association of the first negative RT-PCR with a second negative result was 96.7%. Median viral shedding was 25 (IQR: 21.5–28) days since symptoms’ onset. In the univariate Cox model analysis, type 2 diabetes mellitus was associated with a prolonged viral RNA shedding (hazard ratio [HR]: 0.41, 95% CI: 0.06–3.11, p = 0.04). In the multivariate Cox model analysis, type 2 diabetes was associated with a prolonged viral RNA shedding (HR: 0.31, 95% CI: 0.11–0.89, p = 0.029). Conclusion Intubated patients with type 2 diabetes mellitus may have prolonged SARS-CoV-2 shedding. In critically ill COVID-19 patients, one negative LTA should be sufficient to assess and exclude infectivity. |
| Databáze: | OpenAIRE |
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