%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Drancourt, M.
%A Cortaredona, Sébastien
%A Melenotte, C.
%A Amrane, S.
%A Eldin, C.
%A La Scola, B.
%A Parola, P.
%A Million, M.
%A Lagier, J. C.
%A Raoult, D.
%A Colson, P.
%T SARS-CoV-2 persistent viral shedding in the context of hydroxychloroquine-azithromycin treatment
%D 2021
%L fdi:010081532
%G ENG
%J Viruses
%K SARS-CoV-2 ; COVID-19 ; viral persistence ; culture ; qRT-PCR ; hydroxychloroquine ; azithromycin
%M ISI:000654571900001
%N 5
%P 890 [12 ]
%R 10.3390/v13050890
%U https://www.documentation.ird.fr/hor/fdi:010081532
%> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2021-07/010081532.pdf
%V 13
%W Horizon (IRD)
%X SARS-CoV-2 nasopharyngeal shedding contributes to the spread of the COVID-19 epidemic. Among 3271 COVID-19 patients treated at the Hospital University Institute Mediterranee Infection, Marseille, France from 3 March to 27 April 2020, tested at least twice by qRT-PCR, the median SARS-CoV-2 nasopharyngeal shedding duration was 6 days (range 2-54 days). Compared with short shedders (qRT-PCR positivity < 10 days), 34 (1.04%) persistent shedders (qRT-PCR positivity >= 17 days; mean +/- SD: 23.3 +/- 3.8 days) were significantly older, with associated comorbidities, exhibiting lymphopenia, eosinopenia, increased D-dimer and increased troponin (p < 0.05), and were hospitalized in intensive care unit in 17.7% vs. 1.1% of cases (p < 0.0001). Viral culture was positive in six persistent shedders after day 10, including in one patient after day 17, and no viral co-pathogen was detected in 33 tested patients. Persistent shedders received azithromycin plus hydroxychloroquine >= 3 days in 26/34 (76.5%) patients, a figure significantly lower than in short shedders (86.6%) (p = 0.042). Accordingly, mortality was 14.7% vs. 0.5% (p < 0.0001). Persistent shedding was significantly associated with persistent dyspnea and anosmia/ageusia (p < 0.05). In the context of COVID-19 treatment, including treatment with azithromycin plus hydroxychloroquine, the persistence of SARS-CoV-2 nasopharyngeal shedding was a rare event, most frequently encountered in elderly patients with comorbidities and lacking azithromycin plus hydroxychloroquine treatment.
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