Factors associated with prolonged viral shedding in older patients infected with Omicron BA.2.2

Front Public Health. 2023 Jan 12:10:1087800. doi: 10.3389/fpubh.2022.1087800. eCollection 2022.

Abstract

Background: This study explores the risk factors associated with viral shedding time in elderly Chinese patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) omicron.

Methods: Participants infected with SARS-CoV-2 omicron were enrolled in a retrospective study, and divided into two groups according to shedding time (≥10 days, "late clearance group" and <10 days, "early clearance group").

Results: A total of 180 patients were enrolled in the study (88 early, 92 late), with a median viral shedding time of 10 days and a mean age of 77.02 years. Prolonged SARS-CoV-2 omicron shedding was associated with old age (p = 0.007), lack of vaccination (p = 0.001), delayed admission to hospital after onset of diagnosis (p = 0.001), D-dimer (p = 0.003), and methylprednisolone treatment (p = 0.048). In multivariate analysis, vaccination (OR, 0.319, 95% CI, 0.130-0.786, p = 0.013), Paxlovid (OR, 0.259, 95% CI, 0.104-0.643, p = 0.004), and time from onset of diagnosis to admission (OR, 1.802, 95% CI, 1.391-2.355, p = 0.000) were significantly associated with viral clearance.

Conclusions: Time from onset of diagnosis to hospitalization, lack of treatment with Paxlovid, and lack of vaccination were independent risk factors in elderly Chinese patients infected with SARS-CoV-2 omicron for prolonged viral shedding.

Keywords: SARS-CoV-2; corticosteroid; omicron; vaccination; viral shedding time.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • COVID-19* / pathology
  • COVID-19* / therapy
  • COVID-19* / virology
  • Humans
  • Retrospective Studies
  • SARS-CoV-2*
  • Virus Shedding

Substances

  • nirmatrelvir and ritonavir drug combination

Supplementary concepts

  • SARS-CoV-2 variants

Grants and funding

We respectfully thank all patients enrolled in this study. This work was supported by the Fund for talent construction and scientific research of the Ninth People's Hospital Affiliated with Shanghai Jiao Tong University School of Medicine. None of the individuals received compensation for their contribution.