The factors contributing to delayed viral clearance in COVID-19 are still unclear.
•The author investigated these factors in a study of a multiethnic population.
•Advanced age, cardiovascular comorbidity, and severe COVID-19 all led to delayed viral clearance.
•This early recognition enables for a detailed strategy to optimize the outcome.
AbstractBackgroundSARS-CoV-2 virus is the causing agent of COVID-19. The factors contributing to delayed viral clearance are still unclear.
MethodsWe investigated the factors influencing the time to viral clearance in COVID-19 patients using medical records from 1785 adult patients of various ethnicities treated at NMC Royal Hospital in Abu Dhabi, UAE. The Cox-proportional Hazard Model was utilized to identify risk variables for delayed viral clearance, and the Kaplan-Meier plot was used to measure the time to viral clearance among different groups.
Resultsseveral factors have been associated with an increased risk of delayed viral clearance, including advanced age (p = 0.006), presence of cardiovascular diseases (p = 0.016), presentation with upper respiratory tract infection (URTI) (p = 0.043), and combined gastrointestinal (GIT) and symptoms (URTI) (p = 0.012). ICU admission and severity of COVID-19 also increased the risk for delayed viral clearance (p = 0.006, p < 0.001, respectively). ’The overall median viral clearance time was 24 days. It was 32 days among patients over 60, 21 among those with URTI, GIT symptoms, and asymptomatic, 24 among diabetics, and 46.5 days among cardiovascular patients. The median time till viral clearance was 30 days among severe COVID-19 patients and 39 days among ICU-admitted patients.
ConclusionsWe concluded that advanced age, cardiovascular comorbidities, disease presentation, and severe COVID-19 outcomes increased the risk of delayed viral clearance. Identifying these factors allow decision makers to implement an early and comprehensive management strategy to improve the outcome.
KeywordsSARS-CoV-2
COVID-19
Viral clearance
Asymptomatic
Severity
Multi-ethnicity
United Arab Emirates
© 2022 The Author. Published by Elsevier B.V.
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