Evaluation of SARS-CoV-2 Viral Shedding Duration in the Upper Respiratory Specimens and Factors That Predict Prolonged Positivity in Children

Aim: This study evaluated pediatric patient clinical and epidemiological features to identify factors associated with prolonged severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) polymerase chain reaction (PCR) positivity in children. Methods: This retrospective cohort study consecutively enrolled SARS-CoV-2-positive cases admitted to the University of Health Sciences Turkey, Istanbul Haseki Training and Research Hospital between March 31 and July 1, 2020. Their PCR results were retrieved from the system, and the time to a negative PCR result was calculated. Demographics, clinical disease severity, and laboratory and radiologic findings of patients with a SARS-CoV-2 PCR negative result within the first 14 days (Group 1) and after 14 days (Group 2) were compared. Results: We evaluated 258 patients with a median age of 132.6 months, of whom 134 were female. The median C-reactive protein (CRP) level was significantly higher in group 1 than in group 2. A multivariate logistic regression model including age, sex, fever complaints, D-dimer value >0.55 mg/L, high CRP, and lymphocyte <1500/uL at admission showed that lymphopenia was an independent predictor of prolonged SARS-CoV-2 PCR test positivity. Conclusion: Our findings indicate that children with fever, high CRP levels, and lymphopenia are particularly associated with prolonged SARS-CoV-2 PCR positivity.