Comorbidities prolonged viral shedding of patients infected with SARS-CoV-2 omicron variant in Shanghai: A multi-center, retrospective, observational study

J Infect Public Health. 2023 Feb;16(2):182-189. doi: 10.1016/j.jiph.2022.12.003. Epub 2022 Dec 6.

Abstract

Background: As the omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) surges amid the coronavirus disease 2019 (COVID-19) pandemic, there is limited comorbidities data associated with viral shedding time (VST). We aimed to investigate the effect of comorbidities on VST in asymptomatic and mild patients with omicron.

Methods: A multi-center, retrospective, observational study was conducted from March 12, 2022 to May 24, 2022 in Shanghai. The analysis was adjusted for patients' baseline demographic, using log-rank test and logistic regression model.

Results: The study enrolled 198,262 subjects. The median duration of viral shedding time (VST) was 8.29 days. The number of cumulative viral shedding events was significantly lower in the chronic obstructive pulmonary disease (COPD), hyperlipidemia, diabetes, urinary system disease, and cardiocerebrovascular disease than in the no corresponding comorbidities group. Patients with comorbidities had a lower incidence of viral shedding, and the most significant independent risk factor is COPD (aOR 1.78, 95% CI: 1.53-2.08, p < 0.001). Across different age ranges, the comorbidities affecting viral shedding also differ, with the greatest risk factors for viral shedding being hyperlipidemia (aOR 2.23, 95% CI: 1.50-3.31, p < 0.001) and COPD (aOR 1.85, 95% CI: 1.50-2.28, p < 0.001) between ages of 18-39 and 40-64, and thyroid dysfunction (aOR 2.36, 95% CI: 1.60-3.47, p < 0.001) above age 64.

Conclusions: Omicron-infected patients with comorbidities might prolong the VST. The independent risk factors also differ across age ranges, suggesting that providing targeted effective prevention and control guidance and allocating appropriate resources to different populations should be a crucial strategy.

Keywords: COVID-19; Comorbidity; Omicron; SARS-CoV-2; Viral shedding time.

Publication types

  • Observational Study
  • Multicenter Study

MeSH terms

  • COVID-19* / epidemiology
  • China / epidemiology
  • Humans
  • Middle Aged
  • Pulmonary Disease, Chronic Obstructive* / epidemiology
  • Retrospective Studies
  • SARS-CoV-2
  • Virus Shedding

Supplementary concepts

  • SARS-CoV-2 variants