Post-COVID-19 syndrome. SARS-CoV-2 RNA detection in plasma, stool, and urine in patients with persistent symptoms after COVID-19, 2022, Tejerina et al

Abstract

Background
There is a paucity of knowledge on the long-term outcome in patients diagnosed with COVID-19. We describe a cohort of patients with a constellation of symptoms occurring four weeks after diagnosis causing different degrees of reduced functional capacity. Although different hypothesis have been proposed to explain this condition like persistent immune activation or immunological dysfunction, to date, no physiopathological mechanism has been identified. Consequently, there are no therapeutic options besides symptomatic treatment and rehabilitation.

Methods
We evaluated patients with symptoms that persisted for at least 4 weeks after COVID-19. Epidemiological and clinical data were collected. Blood tests, including inflammatory markers, were conducted, and imaging studies made if deemed necessary. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription polymerase chain reaction (RT-PCR) in plasma, stool, and urine were performed. Patients were offered antiviral treatment (compassionate use).

Results
We evaluated 29 patients who reported fatigue, muscle pain, dyspnea, inappropriate tachycardia, and low-grade fever. Median number of days from COVID-19 to positive RT-PCR in extra-respiratory samples was 55 (39–67). Previous COVID-19 was mild in 55% of the cases. Thirteen patients (45%) had positive plasma RT-PCR results and 51% were positive in at least one RT-PCR sample (plasma, urine, or stool). Functional status was severely reduced in 48% of the subjects. Eighteen patients (62%) received antiviral treatment. Improvement was seen in most patients (p = 0.000) and patients in the treatment group achieved better outcomes with significant differences (p = 0.01).

Conclusions
In a cohort of COVID-19 patients with persistent symptoms, 45% of them have detectable plasma SARS-CoV-2 RNA. Our results indicate possible systemic viral persistence in these patients, who may benefit of antiviral treatment strategies.

Open access: https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-022-07153-4

 

Quote:

During the 2003 epidemic of severe acute respiratory syndrome (SARS), a large number of survivors reported persistent symptoms that included muscle weakness and pain, fatigue, and dyspnea. In some patients, these symptoms remained for several years and resembled those of chronic fatigue syndrome [2,3,4]. Moreover, functional status in these subjects was reduced, and in some cases, the patient was unable to return to work [5]. The etiological cause of these symptoms remains unknown, although hypothalamic/hypophysis dysfunction inducing hypocortisolism was proposed [6].​

(...)​

In conclusion, our results suggest a pattern of persistent or recurrent/intermittent SARS-CoV-2 viremia in some patients, causing a clinical curse of non-specific symptoms associated to relevant functional limitations. Further studies in larger series are needed to confirm this hypothesis of persistent viremia in order to avoid diagnosing a great number of patients of chronic fatigue-like syndrome, a disease with poor clinical outcomes. These patients may benefit from antiviral treatment an issue that should be evaluated in randomized placebo-controlled trials.​

 

" causing a clinical curse of non-specific symptoms associated to relevant functional limitations. Further studies in larger series are needed " . this bit stands out . otherwise they seem to be reinventing the wheel .