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The correlation between viral shedding duration and blood biomarkers in COVID-19-infected patients
Somayeh Sadeghi1, Peiman Nasri2, Elahe Nasri3, Hamid Solgi4, Maryam Nasirian5, Samaneh Pourajam6, Hamed Fakhim3, Hossein Mirhendi7, Behrooz Ataei3, Shadi Reisizadeh Mobarakeh6
1 Acquired Immunodeficiency Research Center, Al-Zahra Hospital; Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
2 Metabolic Liver Disease Research Center; Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
3 Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
4 Department of Laboratory Medicine, Division of Clinical Microbiology, Amin Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
5 Infectious Diseases and Tropical Medicine Research Center; Department of Epidemiology and Biostatistics, Health School, Isfahan University of Medical Sciences, Isfahan, Iran
6 Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
7 Department of Medical Parasitology and Mycology, School of Medicine; Core Facilities Laboratory (CFL), Mycology Reference Laboratory, Isfahan University of Medical Sciences, Isfahan, Iran
Correspondence Address:
Dr. Shadi Reisizadeh Mobarakeh
Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan
Iran
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/jrms.jrms_401_21
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Background: Since December 2019, the world is struggling with an outbreak of coronavirus disease-2019 (COVID-19) infection mostly represented as an acute respiratory distress syndrome and has turned into the most critical health issue worldwide. Limited information is available about the association between dynamic changes in the naso/oropharyngeal viral shedding in infected patients and biomarkers, aiming to be assessed in the current study. Materials and Methods: This quasi-cohort study was conducted on 31 patients with moderate severity of COVID-19 manifestations, whose real-time polymerase chain reaction (RT-PCR) test was positive for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) RNA at baseline. RT-PCR was rechecked for patients every 3–4 days until achieving two negative ones. In parallel, biomarkers, including lymphocyte count, lactate dehydrogenase (LDH), and C-reactive protein (CRP), were assessed every other day, as well. Viral shedding also was assessed. Results: Spearman's correlation test revealed a significant direct correlation between the viral shedding from the symptom onset and the time, in which CRP (P = 0.0015, r = 0.54) and LDH (P = 0.001, r = 0.6207) return to normal levels after symptom onset, but not for lymphocyte count (P = 0.068, r = 0.34). Conclusion: Based on the current study's findings, the duration of SARS-CoV-2 RNA shedding was directly correlated with the required time for LDH and CRP return to normal levels. Therefore, these factors can be considered the determinants for patients' discharge, isolation, and return to social activities; however, further investigations are required to generalize the outcomes.
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