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Article

SARS-CoV-2 Persistent Viral Shedding in the Context of Hydroxychloroquine-Azithromycin Treatment

1
Aix Marseille University, IRD, AP-HM, MEPHI, 13005 Marseille, France
2
IHU Méditerranée Infection, 13005 Marseille, France
3
Aix Marseille University, IRD, SSA, VITROME, 13005 Marseille, France
*
Author to whom correspondence should be addressed.
Academic Editor: Oliver Schildgen
Viruses 2021, 13(5), 890; https://doi.org/10.3390/v13050890
Received: 11 March 2021 / Revised: 7 May 2021 / Accepted: 8 May 2021 / Published: 12 May 2021
(This article belongs to the Section SARS-CoV-2 and COVID-19)
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 Méditerranée 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. View Full-Text
Keywords: SARS-CoV-2; COVID-19; viral persistence; culture; qRT-PCR; hydroxychloroquine; azithromycin SARS-CoV-2; COVID-19; viral persistence; culture; qRT-PCR; hydroxychloroquine; azithromycin
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MDPI and ACS Style

Drancourt, M.; Cortaredona, S.; Melenotte, C.; Amrane, S.; Eldin, C.; La Scola, B.; Parola, P.; Million, M.; Lagier, J.-C.; Raoult, D.; Colson, P. SARS-CoV-2 Persistent Viral Shedding in the Context of Hydroxychloroquine-Azithromycin Treatment. Viruses 2021, 13, 890. https://doi.org/10.3390/v13050890

AMA Style

Drancourt M, Cortaredona S, Melenotte C, Amrane S, Eldin C, La Scola B, Parola P, Million M, Lagier J-C, Raoult D, Colson P. SARS-CoV-2 Persistent Viral Shedding in the Context of Hydroxychloroquine-Azithromycin Treatment. Viruses. 2021; 13(5):890. https://doi.org/10.3390/v13050890

Chicago/Turabian Style

Drancourt, Michel, Sébastien Cortaredona, Cléa Melenotte, Sophie Amrane, Carole Eldin, Bernard La Scola, Philippe Parola, Matthieu Million, Jean-Christophe Lagier, Didier Raoult, and Philippe Colson. 2021. "SARS-CoV-2 Persistent Viral Shedding in the Context of Hydroxychloroquine-Azithromycin Treatment" Viruses 13, no. 5: 890. https://doi.org/10.3390/v13050890

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