症狀消失後，某些COVID-19患者仍患有冠狀病毒 Some COVID-19 patients still have coronavirus after symptoms disappear

News Release 27-Mar-2020

American Thoracic Society

March 27, 2020– In a new study, researchers found that half of the patients they treated for mild COVID-19 infection still had coronavirus for up to eight days after symptoms disappeared. The research letter was published online in the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine.

In “Time Kinetics of Viral Clearance and Resolution of Symptoms in Novel Coronavirus Infection,” Lixin Xie, MD, Lokesh Sharma, PhD, and co-authors report on a study of 16 patients with COVID-19, who were treated and released from the Treatment Center of PLA General Hospital in Beijing between January 28 and Feb. 9, 2020. Patients studied had a median age of 35.5 years.

Researchers collected samples from throat swabs taken from all patients on alternate days and analyzed. Patients were discharged after their recovery and confirmation of negative viral status by at least two consecutive polymerase chain reaction (PCR) tests.

“The most significant finding from our study is that half of the patients kept shedding the virus even after resolution of their symptoms,” said co-lead author Dr. Sharma, instructor of medicine, Section of Pulmonary, Critical Care & Sleep Medicine, Department of Medicine, Yale School of Medicine. “More severe infections may have even longer shedding times.”

The primary symptoms in these patients included fever, cough, pain in the pharynx (pharyngalgia) and difficult or labored breathing (dyspnea). Patients were treated with a range of medications.

The time from infection to onset of symptoms (incubation period) was five days among all but one patient. The average duration of symptoms was eight days, while the length of time patients remained contagious after the end of their symptoms ranged from one to eight days. Two patients had diabetes and one had tuberculosis, neither of which affected the timing of the course of COVID-19 infection.

“If you had mild respiratory symptoms from COVID-19 and were staying at home so as not to infect people, extend your quarantine for another two weeks after recovery to ensure that you don’t infect other people,” recommended corresponding author Lixin Xie, MD, professor, College of Pulmonary and Critical Care Medicine, Chinese PLA General Hospital, Beijing.

The authors had a special message for the medical community: “COVID-19 patients can be infectious even after their symptomatic recovery, so treat the asymptomatic/recently recovered patients as carefully as symptomatic patients.”

The researchers emphasized that all of these patients had milder infections and recovered from the disease, and that the study looked at a small number of patients. They noted that it is unclear whether similar results would hold true for more vulnerable patients such as the elderly, those with suppressed immune systems and patients on immunosuppressive therapies.

“Further studies are needed to investigate if the real-time PCR-detected virus is capable of transmission in the later stages of COVID-19 infection,” Dr. Xie added.

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About the American Journal of Respiratory and Critical Care Medicine

The AJRCCM is a peer-reviewed journal published by the American Thoracic Society. The Journal takes pride in publishing the most innovative science and the highest quality reviews, practice guidelines and statements in pulmonary, critical care and sleep medicine. With an impact factor of 16.494, it is one of the highest ranked journals in pulmonology. Editor: Jadwiga Wedzicha, MD, professor of respiratory medicine at the National Heart and Lung Institute (Royal Brompton Campus), Imperial College London, UK.

About the American Thoracic Society

Founded in 1905, the American Thoracic Society is the world’s leading medical association dedicated to advancing pulmonary, critical care and sleep medicine. The Society’s 15,000 members prevent and fight respiratory disease around the globe through research, education, patient care and advocacy. The ATS publishes three journals, the American Journal of Respiratory and Critical Care Medicine, the American Journal of Respiratory Cell and Molecular Biology and the Annals of the American Thoracic Society.

新聞稿2020年3月27日
症狀消失後，某些COVID-19患者仍患有冠狀病毒

美國胸科協會

2020年3月27日-在一項新研究中，研究人員發現，症狀消失後，在接受COVID-19輕度感染治療的患者中，有多達八天仍患有冠狀病毒。該研究信已在線發表在美國胸科學會的《美國呼吸與重症監護醫學雜誌》上。

在“新型冠狀病毒感染的病毒清除和症狀緩解的時間動力學”中，醫學博士，Lokesh Sharma博士和合著者謝立新博士對16例COVID-19患者進行了研究，他們接受了治療並從中釋放出來。 2020年1月28日至2月9日，中國人民解放軍總醫院治療中心。研究的患者中位年齡為35.5歲。

研究人員每隔幾天從所有患者的咽拭子收集樣本並進行分析。患者恢復並通過至少兩次連續的聚合酶鏈反應（PCR）測試確認陰性病毒狀態後出院。

“我們的研究最重要的發現是，即使在症狀緩解後，仍有一半的患者仍在脫落病毒。”該研究的共同主要作者，衛生部重症監護和睡眠醫學科醫學講師Sharma博士說。耶魯大學醫學院醫學博士。 “更嚴重的感染可能會有更長的脫落時間。”

這些患者的主要症狀包括發燒，咳嗽，咽痛（咽痛）和呼吸困難或勞累（呼吸困難）。患者接受了一系列藥物治療。

從感染到症狀發作的時間（潛伏期），除一名患者外，其餘所有患者均為5天。症狀的平均持續時間為八天，而症狀消失後患者保持傳染性的時間為一到八天。兩名患者患有糖尿病，一名患有結核病，均未影響COVID-19感染過程的時間。

“如果您患有COVID-19引起的輕度呼吸道症狀，並且為了不感染他人而留在家裡，請在康復後將隔離期再延長兩週，以確保您不會感染他人。”通訊作者謝立新建議，醫學博士，中國人民解放軍總醫院肺病和重症醫學學院教授。

作者向醫學界傳達了一條特殊的信息：“即使有症狀的恢復，COVID-19患者也可能具有傳染性，因此，對無症狀/近期恢復的患者要與有症狀的患者一樣認真對待。”

研究人員強調，所有這些患者的感染都較輕，並且可以從疾病中康復，並且該研究僅針對少數患者。他們指出，尚不清楚類似的結果是否適用於更脆弱的患者，例如老年人，免疫系統受到抑制的患者和接受免疫抑制治療的患者。

謝博士補充說：“還需要進一步的研究來調查實時熒光定量PCR檢測到的病毒是否能夠在COVID-19感染的後期傳播。”

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