tetano
Editor, Senior Moderator
Diagn Microbiol Infect Dis
. 2021 Nov 28;102(3):115612.
doi: 10.1016/j.diagmicrobio.2021.115612. Online ahead of print.
Inflammatory but not respiratory symptoms are associated with ongoing upper airway viral shedding in outpatients with uncomplicated COVID-19
Karen B Jacobson[SUP] 1 [/SUP], Natasha Purington[SUP] 2 [/SUP], Julie Parsonnet[SUP] 3 [/SUP], Jason Andrews[SUP] 3 [/SUP], Vidhya Balasubramanian[SUP] 2 [/SUP], Hector Bonilla[SUP] 3 [/SUP], Karlie Edwards[SUP] 3 [/SUP], Manisha Desai[SUP] 2 [/SUP], Upinder Singh[SUP] 4 [/SUP], Haley Hedlin[SUP] 2 [/SUP], Prasanna Jagannathan[SUP] 5 [/SUP]
Affiliations
Abstract
Although the vast majority of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infections are uncomplicated, our understanding of predictors of symptom resolution and viral shedding cessation remains limited. We characterized symptom trajectories and oropharyngeal viral shedding among 120 outpatients with uncomplicated Coronavirus Disease of 2019 (COVID-19) enrolled in a clinical trial of Peginterferon Lambda, which demonstrated no clinical or virologic benefit compared with placebo. In the combined trial cohort, objective fever was uncommon, inflammatory symptoms (myalgias, fatigue) peaked at 4 to 5 days postsymptom onset, and cough peaked at 9 days. The median time to symptom resolution from earliest symptom onset was 17 days (95% confidence interval 14-18). SARS-CoV-2 IgG seropositivity at enrollment was associated with hastened resolution of viral shedding (hazard ratio 1.80, 95% confidence interval 1.05-3.1, P = 0.03), but not with symptom resolution. Inflammatory symptoms were associated with a significantly greater odds of oropharyngeal SARS-CoV-2 RNA detection; respiratory symptoms were not. These findings have important implications for COVID-19 screening approaches and trial design.
Keywords: COVID-19; SARS-CoV-2; symptom clustering; symptom progression; viral shedding.
. 2021 Nov 28;102(3):115612.
doi: 10.1016/j.diagmicrobio.2021.115612. Online ahead of print.
Inflammatory but not respiratory symptoms are associated with ongoing upper airway viral shedding in outpatients with uncomplicated COVID-19
Karen B Jacobson[SUP] 1 [/SUP], Natasha Purington[SUP] 2 [/SUP], Julie Parsonnet[SUP] 3 [/SUP], Jason Andrews[SUP] 3 [/SUP], Vidhya Balasubramanian[SUP] 2 [/SUP], Hector Bonilla[SUP] 3 [/SUP], Karlie Edwards[SUP] 3 [/SUP], Manisha Desai[SUP] 2 [/SUP], Upinder Singh[SUP] 4 [/SUP], Haley Hedlin[SUP] 2 [/SUP], Prasanna Jagannathan[SUP] 5 [/SUP]
Affiliations
- PMID: 34974350
- DOI: 10.1016/j.diagmicrobio.2021.115612
Abstract
Although the vast majority of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infections are uncomplicated, our understanding of predictors of symptom resolution and viral shedding cessation remains limited. We characterized symptom trajectories and oropharyngeal viral shedding among 120 outpatients with uncomplicated Coronavirus Disease of 2019 (COVID-19) enrolled in a clinical trial of Peginterferon Lambda, which demonstrated no clinical or virologic benefit compared with placebo. In the combined trial cohort, objective fever was uncommon, inflammatory symptoms (myalgias, fatigue) peaked at 4 to 5 days postsymptom onset, and cough peaked at 9 days. The median time to symptom resolution from earliest symptom onset was 17 days (95% confidence interval 14-18). SARS-CoV-2 IgG seropositivity at enrollment was associated with hastened resolution of viral shedding (hazard ratio 1.80, 95% confidence interval 1.05-3.1, P = 0.03), but not with symptom resolution. Inflammatory symptoms were associated with a significantly greater odds of oropharyngeal SARS-CoV-2 RNA detection; respiratory symptoms were not. These findings have important implications for COVID-19 screening approaches and trial design.
Keywords: COVID-19; SARS-CoV-2; symptom clustering; symptom progression; viral shedding.