A comparative study of virus nucleic acid re-positive and non-re-positive patients infected with SARS-CoV-2 Delta variant strain in the Ningxia Hui Autonomous Region

ObjectiveThis study aimed to provide a basis for epidemic prevention and control measures as well as the management of re-positive personnel by analyzing and summarizing the characteristics of re-positive patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant infect...

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Main Authors: Jing Wang, Shu-Xiang Zhang, Jian-Rong Na, Li-Ling Zhang, Yin-Hao Zhang, Jiao-Jiao Chu, Lei Guo, Mei Yan, Yu-Ting Li, Wei Zhou
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-12-01
Series:Frontiers in Public Health
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2022.1023797/full
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author Jing Wang
Shu-Xiang Zhang
Jian-Rong Na
Li-Ling Zhang
Yin-Hao Zhang
Jiao-Jiao Chu
Lei Guo
Mei Yan
Yu-Ting Li
Wei Zhou
author_facet Jing Wang
Shu-Xiang Zhang
Jian-Rong Na
Li-Ling Zhang
Yin-Hao Zhang
Jiao-Jiao Chu
Lei Guo
Mei Yan
Yu-Ting Li
Wei Zhou
author_sort Jing Wang
collection DOAJ
description ObjectiveThis study aimed to provide a basis for epidemic prevention and control measures as well as the management of re-positive personnel by analyzing and summarizing the characteristics of re-positive patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant infections discharged from a hospital in the Ningxia Hui Autonomous Region in 2021.MethodsThis case-control study included a total of 45 patients with Delta variant infections diagnosed in the Fourth People's Hospital of the Ningxia Hui Autonomous Region between October 17 and November 28, 2021. Based on the nucleic acid test results post-discharge, the patients were dichotomized into re-positive and non-re-positive groups. Based on the time of the first re-positive test, the re-positive group was further divided into <7 and ≥7 days groups to compare their clinical characteristics and explore the possible influencing factors of this re-positivity.ResultsOf the 45 total patients, 16 were re-positive (re-positivity rate: 35.6%), including four patients who were re-positive after 2 weeks (re-positivity rate: 8.8%). The median time of the first re-positive after discharge was 7 days (IQR: 14-3). The re-positive group was younger than the non-re-positive group (35 vs. 53, P < 0.05), had a higher proportion of patients who were not receiving antiviral therapy (56.2 vs. 17.2%, P < 0.05). The median CT value of nucleic acid in the re-positive group was considerably greater than that at admission (36.7 vs. 22.6 P < 0.05). The findings demonstrated that neutralizing antibody treatment significantly raised the average IgG antibody level in patients, particularly in those who had not received COVID-19 vaccine (P < 0.05). The median lowest nucleic acid CT value of the ≥7 days group during the re-positive period and the immunoglobulin G (IgG) antibody level at discharge were lower than those in the <7 days group (P < 0.05). When compared to the non-positive group, patients in the ≥7 days group had a higher median virus nucleic acid CT value (27.1 vs. 19.2, P < 0.05) and absolute number of lymphocytes at admission (1,360 vs. 952, P < 0.05), and a lower IgG antibody level at discharge (P < 0.05).ConclusionsIn conclusion, this study found that: (1) The re-positivity rate of SARS-CoV-2 Delta variant infection in this group was 35.6%, while the re-positivity rate was the same as that of the original strain 2 weeks after discharge (8.0%). (2) Young people, patients who did not use antiviral therapy or had low IgG antibody levels at discharge were more likely to have re-positive. And the CT value of nucleic acid at the time of initial infection was higher in re-positive group. We speculated that the higher the CT value of nucleic acid at the time of initial infection, the longer the intermittent shedding time of the virus. (3) Re-positive patients were asymptomatic. The median CT value of nucleic acid was > 35 at the re-positive time, and the close contacts were not detected as positive. The overall transmission risk of re-positive patients is low.
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spelling doaj.art-75eb206d511e434ab4cd111c137ca20e2022-12-22T03:01:14ZengFrontiers Media S.A.Frontiers in Public Health2296-25652022-12-011010.3389/fpubh.2022.10237971023797A comparative study of virus nucleic acid re-positive and non-re-positive patients infected with SARS-CoV-2 Delta variant strain in the Ningxia Hui Autonomous RegionJing Wang0Shu-Xiang Zhang1Jian-Rong Na2Li-Ling Zhang3Yin-Hao Zhang4Jiao-Jiao Chu5Lei Guo6Mei Yan7Yu-Ting Li8Wei Zhou9Clinical Medical College, Ningxia Medical University, Yinchuan, ChinaDepartment of Respiratory and Critical Care Medicine, Ningxia Medical University General Hospital, Yinchuan, ChinaDepartment of Respiratory and Critical Care Medicine, Ningxia Medical University General Hospital, Yinchuan, ChinaDepartment of Medical Education, Fourth People's Hospital of the Ningxia Hui Autonomous Region, Yinchuan, ChinaNingxia Center for Disease Control, Yinchuan, ChinaDepartment of Respiratory and Critical Care Medicine, Ningxia Medical University General Hospital, Yinchuan, ChinaDepartment of Comprehensive Internal Medicine, Fourth People's Hospital of the Ningxia Hui Autonomous Region, Yinchuan, ChinaDepartment of Respiratory and Critical Care Medicine, Ningxia Medical University General Hospital, Yinchuan, ChinaClinical Medical College, Ningxia Medical University, Yinchuan, ChinaDepartment of Respiratory and Critical Care Medicine, Ningxia Medical University General Hospital, Yinchuan, ChinaObjectiveThis study aimed to provide a basis for epidemic prevention and control measures as well as the management of re-positive personnel by analyzing and summarizing the characteristics of re-positive patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant infections discharged from a hospital in the Ningxia Hui Autonomous Region in 2021.MethodsThis case-control study included a total of 45 patients with Delta variant infections diagnosed in the Fourth People's Hospital of the Ningxia Hui Autonomous Region between October 17 and November 28, 2021. Based on the nucleic acid test results post-discharge, the patients were dichotomized into re-positive and non-re-positive groups. Based on the time of the first re-positive test, the re-positive group was further divided into <7 and ≥7 days groups to compare their clinical characteristics and explore the possible influencing factors of this re-positivity.ResultsOf the 45 total patients, 16 were re-positive (re-positivity rate: 35.6%), including four patients who were re-positive after 2 weeks (re-positivity rate: 8.8%). The median time of the first re-positive after discharge was 7 days (IQR: 14-3). The re-positive group was younger than the non-re-positive group (35 vs. 53, P < 0.05), had a higher proportion of patients who were not receiving antiviral therapy (56.2 vs. 17.2%, P < 0.05). The median CT value of nucleic acid in the re-positive group was considerably greater than that at admission (36.7 vs. 22.6 P < 0.05). The findings demonstrated that neutralizing antibody treatment significantly raised the average IgG antibody level in patients, particularly in those who had not received COVID-19 vaccine (P < 0.05). The median lowest nucleic acid CT value of the ≥7 days group during the re-positive period and the immunoglobulin G (IgG) antibody level at discharge were lower than those in the <7 days group (P < 0.05). When compared to the non-positive group, patients in the ≥7 days group had a higher median virus nucleic acid CT value (27.1 vs. 19.2, P < 0.05) and absolute number of lymphocytes at admission (1,360 vs. 952, P < 0.05), and a lower IgG antibody level at discharge (P < 0.05).ConclusionsIn conclusion, this study found that: (1) The re-positivity rate of SARS-CoV-2 Delta variant infection in this group was 35.6%, while the re-positivity rate was the same as that of the original strain 2 weeks after discharge (8.0%). (2) Young people, patients who did not use antiviral therapy or had low IgG antibody levels at discharge were more likely to have re-positive. And the CT value of nucleic acid at the time of initial infection was higher in re-positive group. We speculated that the higher the CT value of nucleic acid at the time of initial infection, the longer the intermittent shedding time of the virus. (3) Re-positive patients were asymptomatic. The median CT value of nucleic acid was > 35 at the re-positive time, and the close contacts were not detected as positive. The overall transmission risk of re-positive patients is low.https://www.frontiersin.org/articles/10.3389/fpubh.2022.1023797/fullDelta variant infectionvirus nucleic acid re-positiveantibody levelvirus nucleic acid CT valueCOVID-19 vaccine
spellingShingle Jing Wang
Shu-Xiang Zhang
Jian-Rong Na
Li-Ling Zhang
Yin-Hao Zhang
Jiao-Jiao Chu
Lei Guo
Mei Yan
Yu-Ting Li
Wei Zhou
A comparative study of virus nucleic acid re-positive and non-re-positive patients infected with SARS-CoV-2 Delta variant strain in the Ningxia Hui Autonomous Region
Frontiers in Public Health
Delta variant infection
virus nucleic acid re-positive
antibody level
virus nucleic acid CT value
COVID-19 vaccine
title A comparative study of virus nucleic acid re-positive and non-re-positive patients infected with SARS-CoV-2 Delta variant strain in the Ningxia Hui Autonomous Region
title_full A comparative study of virus nucleic acid re-positive and non-re-positive patients infected with SARS-CoV-2 Delta variant strain in the Ningxia Hui Autonomous Region
title_fullStr A comparative study of virus nucleic acid re-positive and non-re-positive patients infected with SARS-CoV-2 Delta variant strain in the Ningxia Hui Autonomous Region
title_full_unstemmed A comparative study of virus nucleic acid re-positive and non-re-positive patients infected with SARS-CoV-2 Delta variant strain in the Ningxia Hui Autonomous Region
title_short A comparative study of virus nucleic acid re-positive and non-re-positive patients infected with SARS-CoV-2 Delta variant strain in the Ningxia Hui Autonomous Region
title_sort comparative study of virus nucleic acid re positive and non re positive patients infected with sars cov 2 delta variant strain in the ningxia hui autonomous region
topic Delta variant infection
virus nucleic acid re-positive
antibody level
virus nucleic acid CT value
COVID-19 vaccine
url https://www.frontiersin.org/articles/10.3389/fpubh.2022.1023797/full
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