Drancourt M. auteur aut IRD Cortaredona Sébastien auteur aut IRD Melenotte C. auteur aut IRD Amrane S. auteur aut IRD Eldin C. auteur aut IRD La Scola B. auteur aut IRD Parola P. auteur aut IRD Million M. auteur aut IRD Lagier J. C. auteur aut IRD Raoult D. auteur aut IRD Colson P. auteur aut IRD text journalArticle eng text/pdf reformatted digital access 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. specialized SARS-CoV-2 COVID-19 viral persistence culture qRT-PCR hydroxychloroquine azithromycin 052 050 13 5 890 [12 ] 2021 https://www.documentation.ird.fr/hor/fdi:010081532 10.3390/v13050890 [F B010081532] https://www.documentation.ird.fr/hor/fdi:010081532 https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2021-07/010081532.pdf IRD - Base Horizon / Pleins textes 2021-07-02 2025-02-24 fdi:010081532 fre