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Publication Detail

Title: Infectious SARS-CoV-2 Virus in Symptomatic COVID-19 Outpatients: Host, Disease, and Viral Correlates.

Authors: Mollan, Katie R; Eron, Joseph J; Krajewski, Taylor J; Painter, Wendy; Duke, Elizabeth R; Morse, Caryn G; Goecker, Erin A; Premkumar, Lakshmanane; Wolfe, Cameron R; Szewczyk, Laura J; Alabanza, Paul L; Loftis, Amy James; Degli-Angeli, Emily J; Brown, Ariane J; Dragavon, Joan A; Won, John J; Keys, Jessica; Hudgens, Michael G; Fang, Lei; Wohl, David A; Cohen, Myron S; Baric, Ralph S; Coombs, Robert W; Sheahan, Timothy P; Fischer 2nd, William A

Published In medRxiv, (2021 Jun 25)

Abstract: BACKGROUND: While SARS-CoV-2 infectious virus isolation in outpatients with COVID-19 has been associated with viral RNA levels and symptom duration, little is known about the host, disease and viral determinants of infectious virus detection. METHODS: COVID-19 adult outpatients were enrolled within 7 days of symptom onset. Clinical symptoms were recorded via patient diary. Nasopharyngeal swabs were collected to quantitate SARS-CoV-2 RNA by reverse transcriptase polymerase chain reaction and for infectious virus isolation in Vero E6-cells. SARS-CoV-2 antibodies were measured in serum using a validated ELISA assay. RESULTS: Among 204 participants with mild-to-moderate symptomatic COVID19, the median nasopharyngeal viral RNA was 6.5 (IQR 4.7-7.6 log10 copies/mL), and 26% had detectable SARS-CoV-2 antibodies (IgA, IgM, IgG, and/or total Ig) at baseline. Infectious virus was recovered in 7% of participants with SARS-CoV-2 antibodies compared to 58% of participants without antibodies (probability ratio (PR)=0.12, 95% CI: 0.04, 0.36; p=0.00016). Infectious virus isolation was also associated with higher levels of viral RNA (mean RNA difference +2.6 log10, 95% CI: 2.2, 3.0; p<0.0001) and fewer days since symptom onset (PR=0.79, 95% CI: 0.71, 0.88 per day; p<0.0001). CONCLUSIONS: The presence of SARS-CoV-2 antibodies is strongly associated with clearance of infectious virus isolation. Seropositivity and viral RNA levels are likely more reliable markers of infectious virus clearance than subjective measure of COVID-19 symptom duration. Virus-targeted treatment and prevention strategies should be administered as early as possible and ideally before seroconversion. CLINICALTRIALSGOV IDENTIFIER: NCT04405570.

PubMed ID: 34100024 Exiting the NIEHS site

MeSH Terms: No MeSH terms associated with this publication

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