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SARS-CoV-2 Persistent Viral Shedding in the Context of Hydroxychloroquine-Azithromycin Treatment

SARS-CoV-2 nasopharyngeal shedding contributes to the spread of the COVID-19 epidemic. Among 3271 COVID-19 patients treated at the Hospital University Institute Méditerranée Infection, Marseille, France from 3 March to 27 April 2020, tested at least twice by qRT-PCR, the median SARS-CoV-2 nasopharyn...

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Autores principales: Drancourt, Michel, Cortaredona, Sébastien, Melenotte, Cléa, Amrane, Sophie, Eldin, Carole, La Scola, Bernard, Parola, Philippe, Million, Matthieu, Lagier, Jean-Christophe, Raoult, Didier, Colson, Philippe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8150993/
https://www.ncbi.nlm.nih.gov/pubmed/34065871
http://dx.doi.org/10.3390/v13050890
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author Drancourt, Michel
Cortaredona, Sébastien
Melenotte, Cléa
Amrane, Sophie
Eldin, Carole
La Scola, Bernard
Parola, Philippe
Million, Matthieu
Lagier, Jean-Christophe
Raoult, Didier
Colson, Philippe
author_facet Drancourt, Michel
Cortaredona, Sébastien
Melenotte, Cléa
Amrane, Sophie
Eldin, Carole
La Scola, Bernard
Parola, Philippe
Million, Matthieu
Lagier, Jean-Christophe
Raoult, Didier
Colson, Philippe
author_sort Drancourt, Michel
collection PubMed
description SARS-CoV-2 nasopharyngeal shedding contributes to the spread of the COVID-19 epidemic. Among 3271 COVID-19 patients treated at the Hospital University Institute Méditerranée Infection, Marseille, France from 3 March to 27 April 2020, tested at least twice by qRT-PCR, the median SARS-CoV-2 nasopharyngeal shedding duration was 6 days (range 2–54 days). Compared with short shedders (qRT-PCR positivity < 10 days), 34 (1.04%) persistent shedders (qRT-PCR positivity ≥ 17 days; mean ± SD: 23.3 ± 3.8 days) were significantly older, with associated comorbidities, exhibiting lymphopenia, eosinopenia, increased D-dimer and increased troponin (p < 0.05), and were hospitalized in intensive care unit in 17.7% vs. 1.1% of cases (p < 0.0001). Viral culture was positive in six persistent shedders after day 10, including in one patient after day 17, and no viral co-pathogen was detected in 33 tested patients. Persistent shedders received azithromycin plus hydroxychloroquine ≥ 3 days in 26/34 (76.5%) patients, a figure significantly lower than in short shedders (86.6%) (p = 0.042). Accordingly, mortality was 14.7% vs. 0.5% (p < 0.0001). Persistent shedding was significantly associated with persistent dyspnea and anosmia/ageusia (p < 0.05). In the context of COVID-19 treatment, including treatment with azithromycin plus hydroxychloroquine, the persistence of SARS-CoV-2 nasopharyngeal shedding was a rare event, most frequently encountered in elderly patients with comorbidities and lacking azithromycin plus hydroxychloroquine treatment.
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spelling pubmed-81509932021-05-27 SARS-CoV-2 Persistent Viral Shedding in the Context of Hydroxychloroquine-Azithromycin Treatment Drancourt, Michel Cortaredona, Sébastien Melenotte, Cléa Amrane, Sophie Eldin, Carole La Scola, Bernard Parola, Philippe Million, Matthieu Lagier, Jean-Christophe Raoult, Didier Colson, Philippe Viruses Article SARS-CoV-2 nasopharyngeal shedding contributes to the spread of the COVID-19 epidemic. Among 3271 COVID-19 patients treated at the Hospital University Institute Méditerranée Infection, Marseille, France from 3 March to 27 April 2020, tested at least twice by qRT-PCR, the median SARS-CoV-2 nasopharyngeal shedding duration was 6 days (range 2–54 days). Compared with short shedders (qRT-PCR positivity < 10 days), 34 (1.04%) persistent shedders (qRT-PCR positivity ≥ 17 days; mean ± SD: 23.3 ± 3.8 days) were significantly older, with associated comorbidities, exhibiting lymphopenia, eosinopenia, increased D-dimer and increased troponin (p < 0.05), and were hospitalized in intensive care unit in 17.7% vs. 1.1% of cases (p < 0.0001). Viral culture was positive in six persistent shedders after day 10, including in one patient after day 17, and no viral co-pathogen was detected in 33 tested patients. Persistent shedders received azithromycin plus hydroxychloroquine ≥ 3 days in 26/34 (76.5%) patients, a figure significantly lower than in short shedders (86.6%) (p = 0.042). Accordingly, mortality was 14.7% vs. 0.5% (p < 0.0001). Persistent shedding was significantly associated with persistent dyspnea and anosmia/ageusia (p < 0.05). In the context of COVID-19 treatment, including treatment with azithromycin plus hydroxychloroquine, the persistence of SARS-CoV-2 nasopharyngeal shedding was a rare event, most frequently encountered in elderly patients with comorbidities and lacking azithromycin plus hydroxychloroquine treatment. MDPI 2021-05-12 /pmc/articles/PMC8150993/ /pubmed/34065871 http://dx.doi.org/10.3390/v13050890 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Drancourt, Michel
Cortaredona, Sébastien
Melenotte, Cléa
Amrane, Sophie
Eldin, Carole
La Scola, Bernard
Parola, Philippe
Million, Matthieu
Lagier, Jean-Christophe
Raoult, Didier
Colson, Philippe
SARS-CoV-2 Persistent Viral Shedding in the Context of Hydroxychloroquine-Azithromycin Treatment
title SARS-CoV-2 Persistent Viral Shedding in the Context of Hydroxychloroquine-Azithromycin Treatment
title_full SARS-CoV-2 Persistent Viral Shedding in the Context of Hydroxychloroquine-Azithromycin Treatment
title_fullStr SARS-CoV-2 Persistent Viral Shedding in the Context of Hydroxychloroquine-Azithromycin Treatment
title_full_unstemmed SARS-CoV-2 Persistent Viral Shedding in the Context of Hydroxychloroquine-Azithromycin Treatment
title_short SARS-CoV-2 Persistent Viral Shedding in the Context of Hydroxychloroquine-Azithromycin Treatment
title_sort sars-cov-2 persistent viral shedding in the context of hydroxychloroquine-azithromycin treatment
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8150993/
https://www.ncbi.nlm.nih.gov/pubmed/34065871
http://dx.doi.org/10.3390/v13050890
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