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The results come from the publication of Chinese scientists in the British magazine “The BMJ” (previously known as “The British Medical Journal”), one of the most prestigious in the field of health.
Patients who have had the most severe form of Covid-19, a disease caused by Sars-Cov-2, remain with the virus in the body for a longer period than those who have had mild infections.
In the samples taken from the respiratory tract (phlegm and saliva) from patients with more serious diseases in China, the virus was found for an average of 21 days. In some cases, this period has been extended by 30 days. The average duration of virus presence in uncomplicated patients was 14 days.
The results come from a study published by Chinese scientists on Tuesday (21), in the British scientific journal “The BMJ” (formerly known as “The British Medical Journal”), one of the most prestigious publications in the field of health.
The survey was conducted with more than 3,400 samples of respiratory tract secretions, urine, blood and feces from 96 patients treated at a hospital in Zhejiang, eastern China province. All study participants had Covid-19 confirmed by molecular testing (RT-PCR). Scientists classified 22 of the cases as moderate and 74 as severe.
Analysis of the samples indicated that, in patients with mild cases of the disease, the maximum viral load occurs in the second week of infection. In patients with more severe cases, the amounts of the virus in the body were still high in the third week of illness.
“Everything indicates that the higher the viral load, the greater the chances that the patient will develop the disease in a more severe way. The possibility of transmitting the virus also increases,” says Fabrizio Romano, otorhinolaryngologist and president of the Brazilian Academy of Rhinology (ABR).
“This is one of the reasons why we see so many health professionals with Covid-19 complications, because they deal more closely with more seriously ill patients,” says the doctor.
In the most critical cases, the body cannot fight the infection, and therefore the virus can multiply in the infected person’s body for a longer time, Romano explains.
“When this patient is discharged and goes home, this does not mean that he has stopped transmitting the disease. He must remain isolated until the test indicates the absence of the virus,” he says.
The virus was also detected in stool samples from 59% of patients over an average period of 22 days, that is, longer than the virus present in the respiratory system. Only one research participant detected the virus in a urine sample.
According to Marco Aurélio Sáfadi, an infectologist at the Santa Casa de São Paulo Faculty of Medical Sciences, the scenario is especially delicate when it comes to children or the elderly who need diaper changes, for example.
The article does not provide certainty of transmission through contact with excretions, since the molecular test, carried out to detect the disease in the patients who participated in the research, detects parts of the virus in the person, but does not say if it is still active for cause infection However, the study result indicates that there is the possibility of transmission by this route, according to Safadi.
In the Chinese study, samples were taken from adult patients between January and March this year. Safadi is conducting a study with children infected with the new coronavirus, and the virus was also found in the stool samples of the little ones. The results have not yet been published.
“We cannot assume that there is infectivity, but it is possible that it is. This brings the need for more attention,” says the infectologist.
According to ABR’s Romano, the study in China had a reliable methodology, but would have even more precise results with the inclusion of a larger number of patients. The combination of medications used by research participants is another limitation noted by the physician.
In the study, patients received corticosteroids, antibiotics, or a combination of these medications. All were treated with some antiviral. “We must be cautious before extrapolating these results to other populations receiving other medications,” says Romano.
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