Analysis of the Factors Associated with Negative Conversion of Severe Acute Respiratory Syndrome Coronavirus 2 RNA of Coronavirus Disease 2019

Nan Jiang; Yang Liu; Bo  Yang; Zhijun Li; Daoyuan  Si; Piyong  Ma; Jinnan  Zhang; Tianji  Liu; Qiong Yu

doi:10.3889/oamjms.2020.5488

Authors

Nan Jiang Department of Emergency, China-Japan Union Hospital, Jilin University, Changchun, China
Yang Liu Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
Bo Yang Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Zhijun Li Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
Daoyuan Si Department of Cardiology, China-Japan Union Hospital, Jilin University, Changchun, China
Piyong Ma Department of Critical Care Unit, China-Japan Union Hospital, Jilin University, Changchun, China
Jinnan Zhang Department of Neurosurgery, China-Japan Union Hospital, Jilin University, Changchun, China
Tianji Liu Department of Emergency, China-Japan Union Hospital, Jilin University, Changchun, China
Qiong Yu Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China http://orcid.org/0000-0003-1143-1749

DOI:

https://doi.org/10.3889/oamjms.2020.5488

Keywords:

SARS-CoV-2，Risk Factor, Cox Regression, Negative Conversion

Abstract

AIM: To understand the factors associated with negative conversion of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA, targeted surveillance and control measures can be taken to provide scientific basis for the treatment of the disease and to improve the prognosis of the disease.

METHODS: Using the method of retrospective cohort study, we collected the data of Coronavirus Disease 2019 (COVID-19) patients in Tongji Hospital of Wuhan, China from 10 January to 25 March, 2020. Among the data of 282 cases, 271 patients, according to whether the negative conversion happened, were divided into negative conversion group and control group. We made the quantitative variables into classification; Chi-square test single-factor and Cox regression were used in univariate analysis and extracted 30 meaningful variables, then through the collinearity diagnosis, excluded the existence of collinear variables. Finally, 22 variables were included in Cox regression analysis.

RESULTS: The gender distribution was statistically significant between two groups (p < 0.05). While in the negative conversion group, the patients of non-severe group occupied a large proportion (p < 0.001). The median time for the negative conversion group was 17 days, and at the end of the observation period, the virus duration in control group was 24 days (p < 0.05). A total of 55 variables were included in univariate analysis, among which 30 variables were statistically different between the two groups. After screening variables through collinearity diagnosis, 22 variables were included in the Cox regression analysis. Last, lactate dehydrogenase (LDH), age, fibrinogen (FIB), and disease severity were associated with negative conversion of SARS-CoV-2 RNA.

CONCLUSION: Our results suggest that in the treatment of COVID-19, focus on the age of more than 65 years old, severe, high level of LDH, FIB patients, and take some targeted treatment, such as controlling of inflammation, reducing organ damage, so as to provide good conditions for virus clearance in the body.

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