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Predictors of SARS-CoV-2 RNA From Nasopharyngeal Swabs and Concordance With Other Compartments in Nonhospitalized Adults With Mild to Moderate COVID-19
BACKGROUND: Identifying characteristics associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA shedding may be useful to understand viral compartmentalization, disease pathogenesis, and risks for viral transmission. METHODS: Participants were enrolled August 2020 to Februar...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9709705/ https://www.ncbi.nlm.nih.gov/pubmed/36467293 http://dx.doi.org/10.1093/ofid/ofac618 |
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author | Moser, Carlee Li, Jonathan Z Eron, Joseph J Aga, Evgenia Daar, Eric S Wohl, David A Coombs, Robert W Javan, Arzhang Cyrus Bender Ignacio, Rachel A Jagannathan, Prasanna Ritz, Justin Sieg, Scott F Parikh, Urvi M Hughes, Michael D Currier, Judith S Smith, Davey M Chew, Kara W |
author_facet | Moser, Carlee Li, Jonathan Z Eron, Joseph J Aga, Evgenia Daar, Eric S Wohl, David A Coombs, Robert W Javan, Arzhang Cyrus Bender Ignacio, Rachel A Jagannathan, Prasanna Ritz, Justin Sieg, Scott F Parikh, Urvi M Hughes, Michael D Currier, Judith S Smith, Davey M Chew, Kara W |
author_sort | Moser, Carlee |
collection | PubMed |
description | BACKGROUND: Identifying characteristics associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA shedding may be useful to understand viral compartmentalization, disease pathogenesis, and risks for viral transmission. METHODS: Participants were enrolled August 2020 to February 2021 in ACTIV-2/A5401, a placebo-controlled platform trial evaluating investigational therapies for mild-to-moderate coronavirus disease 2019 (COVID-19), and underwent quantitative SARS-CoV-2 RNA testing on nasopharyngeal and anterior nasal swabs, oral wash/saliva, and plasma at entry (day 0, pretreatment) and days 3, 7, 14, and 28. Concordance of RNA levels (copies/mL) across compartments and predictors of nasopharyngeal RNA levels were assessed at entry (n = 537). Predictors of changes over time were evaluated among placebo recipients (n = 265) with censored linear regression models. RESULTS: Nasopharyngeal and anterior nasal RNA levels at study entry were highly correlated (r = 0.84); higher levels of both were associated with greater detection of RNA in plasma and oral wash/saliva. Older age, White non-Hispanic race/ethnicity, lower body mass index (BMI), SARS-CoV-2 immunoglobulin G seronegativity, and shorter prior symptom duration were associated with higher nasopharyngeal RNA at entry. In adjusted models, body mass index and race/ethnicity associations were attenuated, but the association with age remained (for every 10 years older, mean nasopharyngeal RNA was 0.27 log(10) copies/mL higher; P < .001). Examining longitudinal viral RNA levels among placebo recipients, women had faster declines in nasopharyngeal RNA than men (mean change, −2.0 vs −1.3 log(10) copies/mL, entry to day 3; P < .001). CONCLUSIONS: SARS-CoV-2 RNA shedding was concordant across compartments. Age was strongly associated with viral shedding, and men had slower viral clearance than women, which could explain sex differences in acute COVID-19 outcomes. |
format | Online Article Text |
id | pubmed-9709705 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-97097052022-12-01 Predictors of SARS-CoV-2 RNA From Nasopharyngeal Swabs and Concordance With Other Compartments in Nonhospitalized Adults With Mild to Moderate COVID-19 Moser, Carlee Li, Jonathan Z Eron, Joseph J Aga, Evgenia Daar, Eric S Wohl, David A Coombs, Robert W Javan, Arzhang Cyrus Bender Ignacio, Rachel A Jagannathan, Prasanna Ritz, Justin Sieg, Scott F Parikh, Urvi M Hughes, Michael D Currier, Judith S Smith, Davey M Chew, Kara W Open Forum Infect Dis Major Article BACKGROUND: Identifying characteristics associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA shedding may be useful to understand viral compartmentalization, disease pathogenesis, and risks for viral transmission. METHODS: Participants were enrolled August 2020 to February 2021 in ACTIV-2/A5401, a placebo-controlled platform trial evaluating investigational therapies for mild-to-moderate coronavirus disease 2019 (COVID-19), and underwent quantitative SARS-CoV-2 RNA testing on nasopharyngeal and anterior nasal swabs, oral wash/saliva, and plasma at entry (day 0, pretreatment) and days 3, 7, 14, and 28. Concordance of RNA levels (copies/mL) across compartments and predictors of nasopharyngeal RNA levels were assessed at entry (n = 537). Predictors of changes over time were evaluated among placebo recipients (n = 265) with censored linear regression models. RESULTS: Nasopharyngeal and anterior nasal RNA levels at study entry were highly correlated (r = 0.84); higher levels of both were associated with greater detection of RNA in plasma and oral wash/saliva. Older age, White non-Hispanic race/ethnicity, lower body mass index (BMI), SARS-CoV-2 immunoglobulin G seronegativity, and shorter prior symptom duration were associated with higher nasopharyngeal RNA at entry. In adjusted models, body mass index and race/ethnicity associations were attenuated, but the association with age remained (for every 10 years older, mean nasopharyngeal RNA was 0.27 log(10) copies/mL higher; P < .001). Examining longitudinal viral RNA levels among placebo recipients, women had faster declines in nasopharyngeal RNA than men (mean change, −2.0 vs −1.3 log(10) copies/mL, entry to day 3; P < .001). CONCLUSIONS: SARS-CoV-2 RNA shedding was concordant across compartments. Age was strongly associated with viral shedding, and men had slower viral clearance than women, which could explain sex differences in acute COVID-19 outcomes. Oxford University Press 2022-11-11 /pmc/articles/PMC9709705/ /pubmed/36467293 http://dx.doi.org/10.1093/ofid/ofac618 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Major Article Moser, Carlee Li, Jonathan Z Eron, Joseph J Aga, Evgenia Daar, Eric S Wohl, David A Coombs, Robert W Javan, Arzhang Cyrus Bender Ignacio, Rachel A Jagannathan, Prasanna Ritz, Justin Sieg, Scott F Parikh, Urvi M Hughes, Michael D Currier, Judith S Smith, Davey M Chew, Kara W Predictors of SARS-CoV-2 RNA From Nasopharyngeal Swabs and Concordance With Other Compartments in Nonhospitalized Adults With Mild to Moderate COVID-19 |
title | Predictors of SARS-CoV-2 RNA From Nasopharyngeal Swabs and Concordance With Other Compartments in Nonhospitalized Adults With Mild to Moderate COVID-19 |
title_full | Predictors of SARS-CoV-2 RNA From Nasopharyngeal Swabs and Concordance With Other Compartments in Nonhospitalized Adults With Mild to Moderate COVID-19 |
title_fullStr | Predictors of SARS-CoV-2 RNA From Nasopharyngeal Swabs and Concordance With Other Compartments in Nonhospitalized Adults With Mild to Moderate COVID-19 |
title_full_unstemmed | Predictors of SARS-CoV-2 RNA From Nasopharyngeal Swabs and Concordance With Other Compartments in Nonhospitalized Adults With Mild to Moderate COVID-19 |
title_short | Predictors of SARS-CoV-2 RNA From Nasopharyngeal Swabs and Concordance With Other Compartments in Nonhospitalized Adults With Mild to Moderate COVID-19 |
title_sort | predictors of sars-cov-2 rna from nasopharyngeal swabs and concordance with other compartments in nonhospitalized adults with mild to moderate covid-19 |
topic | Major Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9709705/ https://www.ncbi.nlm.nih.gov/pubmed/36467293 http://dx.doi.org/10.1093/ofid/ofac618 |
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