• Tingting Liao, Zhengrong Yin, Juanjuan Xu, Zhilei Lv, Sufei Wang, Limin Duan, Jinshuo Fan, and Yang Jin.
• Department of Respiratory and Critical Care Medicine, NHC Key Laboratory of Pulmonary Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
• Open Forum Infect Dis. 2020 Aug 1; 7 (8): ofaa331.

BackgroundPatients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can shed virus, thereby causing human-to-human transmission, and the viral RNA shedding is commonly used as a proxy measure for infectivity.MethodsWe retrospectively reviewed confirmed cases of COVID-19 who attended the fever clinic of Wuhan Union Hospital from January 14 to February 24. In terms of the viral RNA shedding (median values) at first visit, patients were divided into a high-viral RNA shedding group and a low-viral RNA shedding group. Univariate and multivariate logistic regression analysis were performed to investigate the correlation between viral RNA shedding and clinical features.ResultsA total of 918 consecutive COVID-19 patients were enrolled, and severe patients made up 26.1%. After univariate and multivariate logistic regression, advanced age (odds ratio [OR], 1.02; 95% CI, 1.01-1.03; P = .001), having severe chronic diseases (OR, 1.44; 95% CI, 1.03-2.01; P = .04), and severe illness (OR, 1.60; 95% CI, 1.12-2.28; P = .01) were independent risk factors for high viral RNA shedding. Shorter time interval from symptom onset to viral detection was a protective factor for viral RNA shedding (OR, 0.97; 95% CI, 0.94-0.99; P = .01). Compared with mild patients, severe patients have higher virus shedding over a long period of time after symptom onset (P = .01).ConclusionsOutpatients who were old, had severe illness, and had severe underlying diseases had high viral RNA shedding.© The Author(s) 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

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