- Intubated patients with type 2 diabetes (T2D) may have prolonged SARS-CoV-2 shedding.
- In critically ill patients with COVID-19, 1 negative lower tracheal aspirate (LTA) should suffice to assess and exclude infectivity.
Why this matters
- Critically ill patients with COVID-19 must be strictly isolated to limit transmission, but duration of infectivity remains unknown.
- Beginning April 9, 2020, 48 intubated patients with COVID-19 underwent 2-8 PCR reaction tests of nasopharyngeal swabs and LTA.
- Funding: Swiss National Science Foundation; Bangerter-Rhyner Foundation.
- At screening, swab and LTA results corresponded in 31 patients (65%), whereas in 15 (31%), LTA samples were positive and swabs were negative.
- During follow-up, 31 patients had 1 negative PCR in LTA and 28 (90.3%) had a second negative test within 3 days.
- Association of first negative PCR with second negative result was 96.7%.
- Median viral shedding: 25 (interquartile range, 21.5-28) days since symptom onset.
- In multivariate analysis, T2D was associated with prolonged viral RNA shedding (HR, 0.31; P=.029).
- Similar results with negativity defined as 2 negative LTA samples (HR, 0.23; P=.0089).
- Observational design.
- LTA samples were not collected daily or after 2 negative results.
- Viral cell cultures were not routinely performed.
- Small sample size.