Factors Influencing the Delay   in Negative Conversion of PCR Swab Test Results in Patients with COVID-19: Factors Influencing the Delay   in Negative Conversion of PCR Swab Test Results in Patients with COVID-19

Fathur  Nurkholis; Banteng  Hanang Wibisono; Agus  Suryanto; Thomas Handoyo; Farida Farida; Jimmy  Tanamas

doi:10.36408/mhjcm.v9i2.755

Authors

Fathur Nur Kholis Division of Pulmonology, Department of Internal Medicine, Faculty of Medicine, Diponegoro University/Dr. Kariadi General Hospital, Semarang, Indonesia
Banteng Hanang Wibisono Division of Pulmonology, Department of Internal Medicine, Faculty of Medicine, Diponegoro University/Dr. Kariadi General Hospital, Semarang, Indonesia
Agus Suryanto Division of Pulmonology, Department of Internal Medicine, Faculty of Medicine, Diponegoro University/Dr. Kariadi General Hospital, Semarang, Indonesia
Thomas Handoyo Division of Pulmonology, Department of Internal Medicine, Faculty of Medicine, Diponegoro University/Dr. Kariadi General Hospital, Semarang, Indonesia
Farida Division of Pulmonology, Department of Internal Medicine, Faculty of Medicine, Diponegoro University/Dr. Kariadi General Hospital, Semarang, Indonesia
Jimmy Tanamas Division of Pulmonology, Department of Internal Medicine, Faculty of Medicine, Diponegoro University/Dr. Kariadi General Hospital, Semarang, Indonesia

DOI:

https://doi.org/10.36408/mhjcm.v9i2.755

Keywords:

COVID-19, SARS-CoV-2, negative conversion time, RT-PCR

Abstract

Background : The negative conversion duration of SARS-CoV-2 RNA was related to disease progression, and a prolonged negative conversion could provide early warning signal for poor prognosis in patients with COVID-19. The objectives of this study was to identify the factors influencing the delay in negative conversion of PCR swab test results in patients with COVID-19 as a consideration in determining the COVID-19 prevention policy in the community

Methods : A retrospective cross-sectional study involving 68 patients diagnosed with COVID-19 that was treated in Dr. Kariadi General Hospital Medical Center Semarang from June 1st to December 30th 2020. Negative conversion was evaluated based on the results of the RT-PCR swab test on day 7, 14 and 21.

Results : Mean negative conversion time for all patients was 11.63±5.08 days. Thirty-one factors were evaluated in the initial univariate Cox and Kaplan-Meier analysis. Older age (>59 years), overweight (>25 kg/m2), fever (>38°C), shortness of breath, diabetes mellitus, neutrophilia, hypoalbuminemia, CRP and antiviral treatment showed significant association with negative conversion time. These factors were then included in a multivariate regression analysis. Hypoalbuminemia or albumin level of <3.0 g/dL was found as an independent factor associated with negative conversion time of viral RNA (HR:1.986; 95%CI:1.098–3.594), and hypoalbuminemia was presumed to cause prolonged viral clearance time in patients with COVID-19.

Conclusion : The factors influencing the prolong in negative conversion of viral RNA in patients with COVID-19 were older age, overweight, fever, shortness of breath, diabetes mellitus, neutrophilia, hypoalbuminemia, CRP and antiviral treatment. Hypoalbuminemia was an independent predictor for prolonged negative conversion of viral RNA in patients with COVID-19.

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Factors Influencing the Delay in Negative Conversion of PCR Swab Test Results in Patients with COVID-19