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...
| 發表在: | Viruses |
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| Main Authors: | , , , , , , , , , , |
| 格式: | Article |
| 語言: | 英语 |
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MDPI AG
2021-05-01
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| 在線閱讀: | https://www.mdpi.com/1999-4915/13/5/890 |
| _version_ | 1850089775779807232 |
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| author | Michel Drancourt Sébastien Cortaredona Cléa Melenotte Sophie Amrane Carole Eldin Bernard La Scola Philippe Parola Matthieu Million Jean-Christophe Lagier Didier Raoult Philippe Colson |
| author_facet | Michel Drancourt Sébastien Cortaredona Cléa Melenotte Sophie Amrane Carole Eldin Bernard La Scola Philippe Parola Matthieu Million Jean-Christophe Lagier Didier Raoult Philippe Colson |
| author_sort | Michel Drancourt |
| collection | DOAJ |
| container_title | Viruses |
| 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 (<i>p</i> < 0.05), and were hospitalized in intensive care unit in 17.7% vs. 1.1% of cases (<i>p</i> < 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%) (<i>p</i> = 0.042). Accordingly, mortality was 14.7% vs. 0.5% (<i>p</i> < 0.0001). Persistent shedding was significantly associated with persistent dyspnea and anosmia/ageusia (<i>p</i> < 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. |
| format | Article |
| id | doaj-art-2fd0243981ed40fc8b1c7367f86da8a1 |
| institution | Directory of Open Access Journals |
| issn | 1999-4915 |
| language | English |
| publishDate | 2021-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| spelling | doaj-art-2fd0243981ed40fc8b1c7367f86da8a12025-08-20T00:09:27ZengMDPI AGViruses1999-49152021-05-0113589010.3390/v13050890SARS-CoV-2 Persistent Viral Shedding in the Context of Hydroxychloroquine-Azithromycin TreatmentMichel Drancourt0Sébastien Cortaredona1Cléa Melenotte2Sophie Amrane3Carole Eldin4Bernard La Scola5Philippe Parola6Matthieu Million7Jean-Christophe Lagier8Didier Raoult9Philippe Colson10Aix Marseille University, IRD, AP-HM, MEPHI, 13005 Marseille, FranceIHU Méditerranée Infection, 13005 Marseille, FranceAix Marseille University, IRD, AP-HM, MEPHI, 13005 Marseille, FranceAix Marseille University, IRD, AP-HM, MEPHI, 13005 Marseille, FranceIHU Méditerranée Infection, 13005 Marseille, FranceAix Marseille University, IRD, AP-HM, MEPHI, 13005 Marseille, FranceIHU Méditerranée Infection, 13005 Marseille, FranceAix Marseille University, IRD, AP-HM, MEPHI, 13005 Marseille, FranceAix Marseille University, IRD, AP-HM, MEPHI, 13005 Marseille, FranceAix Marseille University, IRD, AP-HM, MEPHI, 13005 Marseille, FranceAix Marseille University, IRD, AP-HM, MEPHI, 13005 Marseille, FranceSARS-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 (<i>p</i> < 0.05), and were hospitalized in intensive care unit in 17.7% vs. 1.1% of cases (<i>p</i> < 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%) (<i>p</i> = 0.042). Accordingly, mortality was 14.7% vs. 0.5% (<i>p</i> < 0.0001). Persistent shedding was significantly associated with persistent dyspnea and anosmia/ageusia (<i>p</i> < 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.https://www.mdpi.com/1999-4915/13/5/890SARS-CoV-2COVID-19viral persistencecultureqRT-PCRhydroxychloroquine |
| spellingShingle | Michel Drancourt Sébastien Cortaredona Cléa Melenotte Sophie Amrane Carole Eldin Bernard La Scola Philippe Parola Matthieu Million Jean-Christophe Lagier Didier Raoult Philippe Colson SARS-CoV-2 Persistent Viral Shedding in the Context of Hydroxychloroquine-Azithromycin Treatment SARS-CoV-2 COVID-19 viral persistence culture qRT-PCR hydroxychloroquine |
| 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 | SARS-CoV-2 COVID-19 viral persistence culture qRT-PCR hydroxychloroquine |
| url | https://www.mdpi.com/1999-4915/13/5/890 |
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