Abstract
Coronavirus disease 2019 (COVID-19) with the infection of SARS-CoV-2 has become a serious pandemic worldwide. However, only few studies focused on risk factors of prolonged SARS-CoV-2 RNA detection among patients with COVID-19. We included 206 adult patients with laboratory-confirmed COVID-19 from two hospitals between 23 Jan and 1 April 2020. Least absolute shrinkage and selection operator (LASSO) analysis was used to screen out independent risk factors of SARS-CoV-2 RNA detection. By multivariate binomial logistic regression analysis and Cox regression analysis, we further determined the associations between SARS-CoV-2 RNA detection and potential risk factors. All patients had two negative SARS-CoV-2 tests with 33 days of median duration of SARS-CoV-2 RNA detection (interquartile range: 25.2-39 days). LASSO and binomial logistic regression analyses suggested that delayed hospital admission (adjusted OR = 3.70, 95% CI: 1.82-7.50), hypokalemia, and subpleural lesion (adjusted OR = 4.32, 95% CI: 1.10-16.97) were associated with prolonged SARS-CoV-2 RNA detection. By LASSO and multivariate Cox regression analyses, we observed that delayed hospital admission, subpleural lesion, and high-dose corticosteroid use were independent risk factors of prolonged SARS-CoV-2 RNA detection. Early hospital admission shortened 5.73 days of mean duration of SARS-CoV-2 RNA detection than delayed hospital admission after adjusting confounding factors. Our study demonstrated that delayed hospital admission and subpleural lesion were associated with prolonged SARS-CoV-2 RNA detection among patients with COVID-19. The use of high-dose corticosteroids should be interpreted with extreme caution in treating COVID-19.
Keywords: COVID-19; Corticosteroids; Hospital admission; SARS-CoV-2.
【저자키워드】 COVID-19, SARS-CoV-2, Corticosteroids, Hospital admission, 【초록키워드】 Corticosteroid, coronavirus disease, SARS-CoV-2, Coronavirus disease 2019, Corticosteroids, pandemic, Risk factors, hospital, Infection, risk factor, Patient, Factors, Logistic regression, Hospital admission, association, hypokalemia, SARS-CoV-2 RNA detection, Analysis, High-dose, interquartile range, Logistic regression analysis, 95% CI, Laboratory-confirmed COVID-19, independent risk factors, potential risk, Cox regression analysis, multivariate Cox regression, multivariate, confounding factors, independent risk factor, treating COVID-19, LASSO, operator, SARS-CoV-2 test, laboratory-confirmed, extreme, was used, median, adjusted, demonstrated, suggested, analyses, interquartile, patients with COVID-19, subpleural, 【제목키워드】 Corticosteroids, High-dose, Delayed, patients with COVID-19,