Factors associated with negative conversion of viral RNA in hospitalized
children infected with SARS-CoV-2 Omicron Variant in Shanghai, China
Abstract
Abstract Objectives: This study aimed to identify the related risk
factors and potential predictors of SARS-CoV-2 RNA negative conversion
by describing the dynamics of viral shedding in infected children
admitted to two hospitals from Shanghai during Omicron variant outbreak.
Methods: This retrospective cohort included laboratory-confirmed cases
of SARS-CoV-2 infection from Shanghai between March 28 and May 31, 2022.
Clinical characteristics, personal vaccination, household vaccination
rates were collected through electronic health records and telephone
interviews. Results: The total of 603 pediatric cases confirmed with
COVID-19 was included in this study. Both Univariate and multivariate
analysis were performed to filter independent factors for the duration
to viral RNA negative conversion. Data on cases re-detected SARS-CoV-2
after showing negative results on RT-PCR test (intermittent negative
status) were also analyzed. The median duration of virus shedding was
12(Interquartile Qange,IQR: 10-14) days. The severity of clinical
outcome, personal vaccination-2doses, household vaccination rates,
abnormal defecation were factors indecently affecting negative
conversion of SARS-CoV-2 RNA, suggesting that patient who had abnormal
defecation or with more severe condition would delay virological
clearance, while patient accepted 2 doses vaccination or with higher
household vaccination rates would accelerate virological clearance. Loss
of appetite (Odds Ratio (OR) :5.343; 95%CI: 3.307-8.632) and abnormal
defecation (OR:2.840; 95%CI: 1.736-4.645) were significantly associated
with intermittent negative status. Conclusion: These findings could
provide clues for early identification of pediatric patients with
prolonged viral shedding, enriching the evidence for development of
prevention and control strategies especially the vaccination policies
for children and adolescents.