ABSTRACT Since December 2019, coronavirus disease 2019 (COVID-19) caused by SARS coronavirus 2 (SARS-CoV-2) has spread and threatens public health worldwide. The recurrence of SARS-CoV-2 RNA detection in patients after discharge from hospital signals a risk of transmission from such patients to the community and challenges the current discharge criteria of COVID-19 patients. A wide range of clinical specimens has been used to detect SARS-CoV-2. However, to date, a consensus has not been reached regarding the most appropriate specimens to use for viral RNA detection in assessing COVID-19 patients for discharge. An anal swab sample was proposed as the standard because of prolonged viral detection. In this retrospective longitudinal study of viral RNA detection in 60 confirmed COVID-19 patients, we used saliva, oropharyngeal/nasopharyngeal swab (O/N swab) and anal swab procedures from admission to discharge. The conversion times of saliva and anal swab were longer than that of O/N swab. The conversion time of hyper sensitive-CRP was the shortest and correlated with that of CT scanning and viral detection. Some patients were found to be RNA-positive in saliva while RNA-negative in anal swab while the reverse was true in some other patients, which indicated that false negatives were inevitable if only the anal swab is used for evaluating suitability for discharge. These results indicated that double-checking for viral RNA using multiple and diverse specimens was essential, and saliva could be a candidate to supplement anal swabs to reduce false-negative results and facilitate pandemic control.
【저자키워드】 COVID-19, discharge, clinical specimen, recurrent of viral detection, conversion days, 【초록키워드】 coronavirus disease, public health, SARS-CoV-2, Saliva, Coronavirus disease 2019, coronavirus, pandemic, hospital, Spread, Viral, longitudinal study, false negatives, Patient, Community, Viral detection, Viral RNA, anal swab, Swab, SARS Coronavirus, false-negative results, SARS coronavirus 2, anal swabs, recurrence, Admission, false-negative, patients, COVID-19 patients, False negative, retrospective, SARS-CoV-2 RNA detection, COVID-19 patient, criteria, in some, Consensus, specimen, candidate, CT scanning, viral RNA detection, risk of transmission, detect, caused, indicated, facilitate, correlated, reached, reduce, O/N, 【제목키워드】 hospital, complement, specimen, patients with COVID-19,