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      The N gene of SARS-CoV-2 was the main positive component in repositive samples from a cohort of COVID-19 patients in Wuhan, China

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          Highlights

          • there was indeed a significant proportion of re-positives in patients who have been negative for twice consecutive nucleic acid tests.

          • N gene was the main target gene that was positive in re-positive results as well as in the last positive results of all patients.

          • Re-positive were only seen in IgM single or both IgM and IgG positive patients, instead of IgG single positive patients.

          Abstract

          Background

          Repositivity of SARS-CoV-2 nucleic acid in discharged COVID-19 patients was reported recently. However, the characteristics of repositive results are still not well understood, leading to a lack of effective monitoring strategies.

          Methods

          In the present study, a total of 59 COVID-19 patients were enrolled, and the characteristics of the repositive samples were analyzed.

          Results

          The repositive rate in this cohort was 15.79%. The N gene was the main target gene that was positive in the repositive results as well as in the last positive results of all patients. The median duration from diagnosis to the last positive test was 20 days (IQR, 16–31 days), and the longest duration was 40 days. Repositivity was only observed in IgM single- or both IgM- and IgG-positive patients, instead of IgG single-positive patients.

          Conclusions

          There was a significant proportion of repositives in the recovered COVID-19 patients, and increasing the required number of negatives for consecutive nucleic acid tests may reduce the incidence of repositives. The recommended monitoring strategy for repositivity is monitoring the N gene in IgM-positive patients. This can ensure high sensitivity while reducing the time and cost of nucleic acid detection.

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          Author and article information

          Journal
          Clin Chim Acta
          Clin Chim Acta
          Clinica Chimica Acta; International Journal of Clinical Chemistry
          The Author(s). Published by Elsevier B.V.
          0009-8981
          1873-3492
          21 October 2020
          21 October 2020
          Affiliations
          [a ]Department of Hematology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, China
          [b ]Department of Neurology Intensive Care Unit, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, China
          [c ]Department of Respiratory Medicine, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, China
          [d ]Department of Respiratory Medicine, Shangyu People’s Hospital, Shangyu, 312300, China
          [e ]Department of Respiratory Medicine, Lanxi People’s Hospital, Lanxi, 321100, China
          [f ]Department of Dermatology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, China
          [g ]Department of Surgery Intensive Care Unit, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, China
          [h ]Aid Hubei Medical Team, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, China
          Author notes
          [* ]Corresponding author at: Department of Hematology, the Second Affiliated Hospital of Zhejiang University School of Medicine, No.88, Jiefang Road. Hangzhou, Zhejiang 310009, P.R. China.
          Article
          S0009-8981(20)30501-5
          10.1016/j.cca.2020.10.019
          7575424
          33096033
          a8bbc701-3415-4aa0-99cd-95f76f93283d
          © 2020 The Author(s)

          Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

          History
          : 16 July 2020
          : 15 October 2020
          : 15 October 2020
          Categories
          Article

          Clinical chemistry
          covid-19,sars-cov-2,repositive,viral nucleic acid detection,monitoring
          Clinical chemistry
          covid-19, sars-cov-2, repositive, viral nucleic acid detection, monitoring

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