Clinical characteristics of re-positive COVID-19 patients in Huangshi, China: A retrospective cohort study

Zhou, Ji; Zhang, Jingying; Zhou, Juan; Yi, Honggang; Lin, Zichen; Liu, Yu; Zhu, Min; Wang, Hongyu; Zhang, Wei; Xu, Hai; Jiang, Hangping; Xiang, Zhengzhong; Qu, Ze; Yang, Yuemei; Lu, Linjuan; Guo, Shuai; Fu, Heng; Adcock, Ian M.; Wei, Yu; Yao, Xin

A cluster of patients with coronavirus disease 2019 (COVID-19) underwent repeated positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA tests after they were discharged from the hospital. We referred to them as re-positive (RP) patients in this study. We aimed to describe the clinical characteristics of these patients in a retrospective cohort study. After being treated for COVID-19, the patients underwent 14 days of quarantine following their discharge from the Huangshi Hospital of Traditional Chinese Medicine and the Huangshi Hospital of Youse. Two additional sequential SARS-CoV-2 RNA tests were performed at the end of quarantine. The median age of the 368 patients was 51 years, and 184 (50%) patients were female. A total of 23 RP patients were observed at follow-up. Using multivariate Cox regression analysis, risk factors associated with RP included a higher ratio of lymphocyte/white blood cell on admission (adjusted HR 7.038; 95% CI, 1.911–25.932; P = 0.0034), lower peak temperature during hospitalization (adjusted HR, 0.203; 95% CI, 0.093–0.443; P<0.0001), and the presence of comorbidities, particularly hypertension or chronic diseases in the respiratory system (adjusted HR, 3.883; 95% CI, 1.468–10.273; P = 0.0063). Antivirus treatment with arbidol was associated with a lower likelihood of re-positive outcomes (adjusted HR, 0.178; 95% CI, 0.045–0.709; P = 0.0144).