Background The temporal relationship between SARS-CoV-2 and antibody production and clinical progression remained obscure. The aim of this study was to describe the viral kinetics of symptomatic patients with SARS-CoV-2 infection and identify factors that might contribute to prolonged viral shedding. Methods Symptomatic COVID-19 patients were enrolled in two hospitals in Wuhan, China, from whom the respiratory samples were collected and measured for viral loads consecutively by reverse transcriptase quantitative PCR (RT-qPCR) assay. The viral shedding pattern was delineated in relate to the epidemiologic and clinical information. Results Totally 2726 respiratory samples collected from 703 patients were quantified. The SARS-CoV-2 viral loads were at the highest level during the initial stage after symptom onset, which subsequently declined with time. The median time to SARS-CoV-2 negativity of nasopharyngeal test was 28 days, significantly longer in patients with older age (> 60 years old), female gender and those having longer interval from symptom onset to hospital admission (> 10 days). The multivariate Cox regression model revealed significant effect from older age (HR 0.73, 95% CI 0.55–0.96), female gender (HR 0.72, 95% CI 0.55–0.96) and longer interval from symptom onset to admission (HR 0.44, 95% CI 0.33–0.59) on longer time to SARS-CoV-2 negativity. The IgM antibody titer was significantly higher in the low viral loads group at 41–60 days after symptom onset. At the population level, the average viral loads were higher in early than in late outbreak periods. Conclusions The prolonged viral shedding of SARS-CoV-2 was observed in COVID-19 patients, particularly in older, female and those with longer interval from symptom onset to admission. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-07002-w.
【저자키워드】 COVID-19, SARS-CoV-2, antibody, viral shedding, risk factor, 【초록키워드】 SARS-COV-2 infection, hospital, progression, RT-qPCR, Viral load, outbreak, nasopharyngeal, female, Patient, Older age, Hospital admission, viral kinetics, prolonged viral shedding, Admission, quantitative PCR, COVID-19 patients, COVID-19 patient, antibody production, symptom onset, Older, Factor, supplementary material, 95% CI, significant effect, median time, IgM antibody, SARS-CoV-2 viral load, average, multivariate Cox regression, clinical information, female gender, population level, negativity, transcriptase, respiratory sample, Wuhan, China, initial, Result, enrolled, highest, identify, collected, significantly, remained, contribute, significantly higher, quantified, declined, symptomatic patient, 【제목키워드】 Prospective Study, symptomatic, Prolonged, Factor,