Viral Clearance Course of COVID-19 Outbreaks

• Published in: Journal of multidisciplinary healthcare Vol. 14; pp. 555 - 565
• Main Authors: Samrah, Shaher M, Al-Mistarehi, Abdel-Hameed, Kewan, Tariq, Al-Khatib, Sohaib M, Ibnian, Ali M, Samrah, Randa S, Khassawneh, Basheer Y
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01-01-2021; Taylor & Francis Ltd; Dove; Dove Medical Press
• Subjects: Asymptomatic; cdc; China; Contraindications; coronavirus; Coronaviruses; COVID-19; Electronic health records; Epidemics; Health aspects; Hospital patients; incubation period; Infections; Medical laboratories; Medical records; Original Research; Outbreaks; pandemic; Patients; Severe acute respiratory syndrome coronavirus 2; viral clearance; viral shedding; China; COVID-19; CDC; viral clearance; incubation period; viral shedding; coronavirus; pandemic
• ISSN: 1178-2390; 1178-2390
• DOI: 10.2147/JMDH.S302891

Coronavirus disease 2019 (COVID-19) viral course and behavior remain unpredictable. This study describes incubation time and viral clearance of COVID-19 hospitalized cases in Northern Jordan.
All COVID-19 confirmed cases hospitalized from March 15 to June 09, 2020, were included. Nasopharyngeal swabs were collected, and COVID-19 reverse transcription-polymerase chain reaction (RT-PCR) was performed every two days in all cases. The viral cure was defined when two negative RT-PCR tests were obtained ≥ 24 hours apart. Viral clearance time (VCT) reflects the time from the first positive nasopharyngeal swab to the first of two consecutive negative tests.
In this cohort, a total of 157 patients were included. Most cases resulted from two major outbreaks. The median incubation period was 6 days (IQR, 3-10) and ranged from 1 to 17 days. The median VCT was 13 days (IQR, 7-2) and ranged from 1 to 40 days. Symptomatic presentation and abnormal chest radiograph were predictors for a prolonged VCT (
=0.015 and
=0.014, respectively). The median time of resolution of symptoms was 7 days (IQR, 3-10 days). Most symptomatic cases (91.7%) remained RT-PCR positive for up to 20 days after symptoms resolution, with a median of 13.5 days. VCT significantly correlated with the incubation period (
=0.013).
Viral cure lagged for as long as 20 days after resolution of symptoms. Continuing with social-distancing, frequent hand hygiene, and wearing facial mask remains essential and is recommended even after clinical resolution of symptoms.