Elsevier

Clinical Immunology

Volume 221, December 2020, 108611
Clinical Immunology

Full Length Article
Proinflammatory cytokines are associated with prolonged viral RNA shedding in COVID-19 patients

https://doi.org/10.1016/j.clim.2020.108611Get rights and content
Under a Creative Commons license
open access

Highlights

  • Prolonged viral clearance is common in COVID-19 patients.

  • Elevated CRP and IL-2R were risk factors for prolonged viral clearance.

  • Monitor proinflammatory cytokines is necessary in COVID-19 patients.

Abstract

Since December 2019, Coronavirus Disease 2019 (COVID-19) has emerged as a global pandemic. We aimed to investigate the clinical characteristics and analyzed the risk factors for prolonged viral RNA shedding. We retrospectively collected data from 112 hospitalized COVID-19 patients in a single center in Wuhan, China. Factors associated with prolonged viral RNA shedding (≥28 days) were investigated. Forty-nine (43.8%) patients had prolonged viral RNA shedding. Patients with prolonged viral shedding were older and had a higher rate of hypertension. Proinflammatory cytokines, including interleukin-2R (IL-2R) and tumor necrosis factor-α (TNF-α), were significantly elevated in patients with prolonged viral shedding. Multivariate analysis revealed that hypertension, older age, lymphopenia and elevated serum IL-2R were independent risk factors for prolonged viral shedding. This comprehensive investigation revealed the distinct characteristics between patients with or without prolonged viral RNA shedding. Hypertension, older age, lymphopenia and high levels of proinflammatory cytokines may be correlated with prolonged viral shedding.

Keywords

Coronavirus disease 2019
SARS-CoV-2
Prolonged viral RNA shedding
Proinflammatory cytokines
Lymphopenia

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