Other studies in mildly to moderately sick patients have not included serial RT-PCR assessments [9, 11C14]. This study has both strengths and limitations. of six symptoms per patient. Symptoms persisted for 6C67 days (median duration 18 days). In all 25 patients, blood samples collected a median of 13 days after symptom onset were positive for SARS-CoV-2 antibodies in 15 (60%). After a median of 28 days following symptom onset, 23/23 patients with available samples tested positive for antibodies. The longest duration of positive RT-PCR test was 49 days from first positive PCR test (Mean = 27.4, SD = 12.5, Median = 24). Initial Ct was significantly associated with longer duration ( = -1.3, SE = 0.3, p 0.01 per 1 cycle higher) of RT-PCR positivity. Conclusions In mildly or moderately ill COVID-19 outpatients, RT-PCT tests remained positive for as long as 49 days and test positivity and symptom period correlated with initial viral weight. Introduction COVID-19, caused by SARS-CoV-2, has resulted in severe illness and hospitalization in a relatively small proportion of patients. Most patients remain asymptomatic or develop symptoms that do not require hospitalization. However, studies of outpatients with moderate or moderate COVID-19 are uncommon. There is limited information in the published literature about the time period of resolution of symptoms in outpatients and the association of symptoms with GBR 12783 dihydrochloride viral weight, as estimated by the initial reverse transcription polymerase chain reaction (RT-PCR) test results. A meta-analysis of 77 studies on viral shedding in hospitalized SARS-CoV-2 patients summarized that RT-PCR assessments in this relatively ill group of patients remained positive for up to 63 days . To our knowledge, no previous studies of patients whose symptoms remained moderate or moderate have been reported that followed patients with multiple repeated oropharyngeal or nasopharyngeal samples and attempted to determine the duration of computer virus viability after onset of symptoms. To address gaps related to viral weight and association of symptoms with viral weight in outpatients with mild-to-moderate disease, we conducted a cohort study with the following is designed: 1) to determine the association of symptoms with RT-PCR test results; 2) to study the association of initial PCR cycle threshold (Ct) in relation to period of RT-PCR positivity in outpatients with mild-to-moderate COVID-19 who did not require hospital admission. Methods The study was IRB-approved by NorthShore University or college HealthSystem (NSUHS), Evanston, Illinois. Since the beginning of the pandemic in 2020, NSUHS has operated immediate care facilities that offered clinical evaluation and RT-PCR screening to outpatients, with results usually available within 24 hours. At the time of this study, patients reporting at least one symptom consistent with possible COVID-19 contamination were eligible for RT-PCR screening. NSUHS protocols followed Centers for Disease Control (CDC) guidelines to identify symptoms consistent with COVID-19 contamination, which included: fever, chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea, vomiting, or diarrhea . Eligible patients received a nasopharyngeal or oropharyngeal swab collection for COVID-19 RT-PCR screening. Patients for the study were recruited between June 30, 2020 and October 5, 2020. According to GBR 12783 dihydrochloride NSUHS protocols at the time of this study, all patients with a positive COVID-19 RT-PCR result received a phone call with the test result from a member of the contamination control team or a healthcare provider in the immediate care division. During this call, patients were asked about their willingness to be contacted about COVID-19 research studies for which they might qualify. If they agreed to be contacted, a CITI-trained  study team member examined the electronic medical record for eligibility. Only patients who reported moderate or moderate symptoms were recruited for the current Rabbit Polyclonal to Synapsin (phospho-Ser9) study. The National Institutes of Health (USA) GBR 12783 dihydrochloride classifies moderate illness as including any sign or symptom consistent with COVID-19 but without shortness of breath, dyspnea, or abnormal chest imaging. Moderate illness is defined in patients who report evidence of lower respiratory disease, such as shortness of breath or abnormal chest imaging, but who have a SpO2 of at least 94% . We excluded individuals who presented with severe symptoms or indicators such as SpO2 94%, or who required emergency department evaluation or hospitalization at any point during.