{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:13:35Z","timestamp":1787030015680,"version":"build-2736575974"},"reference-count":36,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2021,5,12]],"date-time":"2021-05-12T00:00:00Z","timestamp":1620777600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001665","name":"Agence Nationale de la Recherche","doi-asserted-by":"publisher","award":["M\u00e9diterran\u00e9e infection 10-IAHU-03"],"award-info":[{"award-number":["M\u00e9diterran\u00e9e infection 10-IAHU-03"]}],"id":[{"id":"10.13039\/501100001665","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>SARS-CoV-2 nasopharyngeal shedding contributes to the spread of the COVID-19 epidemic. Among 3271 COVID-19 patients treated at the Hospital University Institute M\u00e9diterran\u00e9e Infection, Marseille, France from 3 March to 27 April 2020, tested at least twice by qRT-PCR, the median SARS-CoV-2 nasopharyngeal shedding duration was 6 days (range 2\u201354 days). Compared with short shedders (qRT-PCR positivity &lt; 10 days), 34 (1.04%) persistent shedders (qRT-PCR positivity \u2265 17 days; mean \u00b1 SD: 23.3 \u00b1 3.8 days) were significantly older, with associated comorbidities, exhibiting lymphopenia, eosinopenia, increased D-dimer and increased troponin (p &lt; 0.05), and were hospitalized in intensive care unit in 17.7% vs. 1.1% of cases (p &lt; 0.0001). Viral culture was positive in six persistent shedders after day 10, including in one patient after day 17, and no viral co-pathogen was detected in 33 tested patients. Persistent shedders received azithromycin plus hydroxychloroquine \u2265 3 days in 26\/34 (76.5%) patients, a figure significantly lower than in short shedders (86.6%) (p = 0.042). Accordingly, mortality was 14.7% vs. 0.5% (p &lt; 0.0001). Persistent shedding was significantly associated with persistent dyspnea and anosmia\/ageusia (p &lt; 0.05). In the context of COVID-19 treatment, including treatment with azithromycin plus hydroxychloroquine, the persistence of SARS-CoV-2 nasopharyngeal shedding was a rare event, most frequently encountered in elderly patients with comorbidities and lacking azithromycin plus hydroxychloroquine treatment.<\/jats:p>","DOI":"10.3390\/v13050890","type":"journal-article","created":{"date-parts":[[2021,5,13]],"date-time":"2021-05-13T03:08:12Z","timestamp":1620875292000},"page":"890","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["SARS-CoV-2 Persistent Viral Shedding in the Context of Hydroxychloroquine-Azithromycin Treatment"],"prefix":"10.3390","volume":"13","author":[{"given":"Michel","family":"Drancourt","sequence":"first","affiliation":[{"name":"Aix Marseille University, IRD, AP-HM, MEPHI, 13005 Marseille, France"},{"name":"IHU M\u00e9diterran\u00e9e Infection, 13005 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3523-7158","authenticated-orcid":false,"given":"S\u00e9bastien","family":"Cortaredona","sequence":"additional","affiliation":[{"name":"IHU M\u00e9diterran\u00e9e Infection, 13005 Marseille, France"},{"name":"Aix Marseille University, IRD, SSA, VITROME, 13005 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cl\u00e9a","family":"Melenotte","sequence":"additional","affiliation":[{"name":"Aix Marseille University, IRD, AP-HM, MEPHI, 13005 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Amrane","sequence":"additional","affiliation":[{"name":"Aix Marseille University, IRD, AP-HM, MEPHI, 13005 Marseille, France"},{"name":"IHU M\u00e9diterran\u00e9e Infection, 13005 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carole","family":"Eldin","sequence":"additional","affiliation":[{"name":"IHU M\u00e9diterran\u00e9e Infection, 13005 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8006-7704","authenticated-orcid":false,"given":"Bernard","family":"La Scola","sequence":"additional","affiliation":[{"name":"Aix Marseille University, IRD, AP-HM, MEPHI, 13005 Marseille, France"},{"name":"IHU M\u00e9diterran\u00e9e Infection, 13005 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Parola","sequence":"additional","affiliation":[{"name":"IHU M\u00e9diterran\u00e9e Infection, 13005 Marseille, France"},{"name":"Aix Marseille University, IRD, SSA, VITROME, 13005 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthieu","family":"Million","sequence":"additional","affiliation":[{"name":"Aix Marseille University, IRD, AP-HM, MEPHI, 13005 Marseille, France"},{"name":"IHU M\u00e9diterran\u00e9e Infection, 13005 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Christophe","family":"Lagier","sequence":"additional","affiliation":[{"name":"Aix Marseille University, IRD, AP-HM, MEPHI, 13005 Marseille, France"},{"name":"IHU M\u00e9diterran\u00e9e Infection, 13005 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Didier","family":"Raoult","sequence":"additional","affiliation":[{"name":"Aix Marseille University, IRD, AP-HM, MEPHI, 13005 Marseille, France"},{"name":"IHU M\u00e9diterran\u00e9e Infection, 13005 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6285-0308","authenticated-orcid":false,"given":"Philippe","family":"Colson","sequence":"additional","affiliation":[{"name":"Aix Marseille University, IRD, AP-HM, MEPHI, 13005 Marseille, France"},{"name":"IHU M\u00e9diterran\u00e9e Infection, 13005 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,5,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1056\/NEJMoa2001017","article-title":"A Novel Coronavirus from Patients with Pneumonia in China, 2019","volume":"382","author":"Zhu","year":"2020","journal-title":"N. 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