Abstract
Prolonged viral RNA shedding and recurrence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in coronavirus disease 2019 (COVID-19) patients have been reported. However, the clinical outcome and pathogenesis remain unclear. In this study, we recruited 43 laboratory-confirmed COVID-19 patients. We found that prolonged viral RNA shedding or recurrence mainly occurred in severe/critical patients (P<0.05). The average viral shedding time in severe/critical patients was more than 50 days, and up to 100 days in some patients, after symptom onset. However, chest computed tomography gradually improved and complete absorption occurred when SARS-CoV-2 RT-PCR was still positive, but specific antibodies appeared. Furthermore, the viral shedding time significantly decreased when the A1,430G or C12,473T mutation occurred (P<0.01 and FDR<0.01) and increased when G227A occurred (P<0.05 and FDR<0.05). High IL1R1, IL1R2, and TNFRSF21 expression in the host positively correlated with viral shedding time (P<0.05 and false discovery rate <0.05). Prolonged viral RNA shedding often occurs but may not increase disease damage. Prolonged viral RNA shedding is associated with viral mutations and host factors.
Keywords: SRAS-CoV-2; host gene expression; longitudinal virological changes; viral genome.
【저자키워드】 SRAS-CoV-2, host gene expression, longitudinal virological changes, viral genome, 【초록키워드】 COVID-19, coronavirus disease, SARS-CoV-2, Coronavirus disease 2019, coronavirus, Mutation, Pathogenesis, viral shedding, severe acute respiratory syndrome Coronavirus, RT-PCR, Clinical outcome, Computed tomography, Chest computed tomography, Viral, Patient, Factors, Viral RNA, SARS-CoV-2 RT-PCR, respiratory, recurrence, disease, Viral mutations, expression, patients, COVID-19 patients, specific antibodies, host gene expression, Prolonged, viral genome, in some, symptom onset, false discovery rate, acute respiratory syndrome, Virological, Viral RNA shedding, acute respiratory syndrome coronavirus, acute respiratory syndrome coronavirus 2, average, TNFRSF21, positive, laboratory-confirmed, viral mutation, IL1R1, Host, Complete, IL1R2, occurred, significantly, recruited, reported, specific antibody, occur, host gene, positively correlated, 【제목키워드】 longitudinal, change, hospitalized COVID-19 patient, Virological, Guangzhou, China,