tetano
Editor, Senior Moderator
Open Forum Infect Dis
. 2021 Apr 16;8(6)
fab195.
doi: 10.1093/ofid/ofab195. eCollection 2021 Jun.
Delayed Rise of Oral Fluid Antibodies, Elevated BMI, and Absence of Early Fever Correlate With Longer Time to SARS-CoV-2 RNA Clearance in a Longitudinally Sampled Cohort of COVID-19 Outpatients
Annukka A R Antar[SUP] 1 [/SUP], Tong Yu[SUP] 1 [/SUP], Nora Pisanic[SUP] 2 [/SUP], Razvan Azamfirei[SUP] 1 [/SUP], Jeffrey A Tornheim[SUP] 1 [/SUP], Diane M Brown[SUP] 1 [/SUP], Kate Kruczynski[SUP] 2 [/SUP], Justin P Hardick[SUP] 1 [/SUP], Thelio Sewell[SUP] 1 [/SUP], Minyoung Jang[SUP] 1 [/SUP], Taylor Church[SUP] 1 [/SUP], Samantha N Walch[SUP] 1 [/SUP], Carolyn Reuland[SUP] 1 [/SUP], Vismaya S Bachu[SUP] 1 [/SUP], Kirsten Littlefield[SUP] 3 [/SUP], Han-Sol Park[SUP] 3 [/SUP], Rebecca L Ursin[SUP] 4 [/SUP], Abhinaya Ganesan[SUP] 3 [/SUP], Oyinkansola Kusemiju[SUP] 1 [/SUP], Brittany Barnaba[SUP] 1 [/SUP], Curtisha Charles[SUP] 1 [/SUP], Michelle Prizzi[SUP] 1 [/SUP], Jaylynn R Johnstone[SUP] 1 [/SUP], Christine Payton[SUP] 1 [/SUP], Weiwei Dai[SUP] 1 [/SUP], Joelle Fuchs[SUP] 1 [/SUP], Guido Massaccesi[SUP] 1 [/SUP], Derek T Armstrong[SUP] 5 [/SUP], Jennifer L Townsend[SUP] 1 [/SUP], Sara C Keller[SUP] 1 [/SUP], Zoe O Demko[SUP] 1 [/SUP], Chen Hu[SUP] 6 [/SUP], Mei-Cheng Wang[SUP] 7 [/SUP], Lauren M Sauer[SUP] 8 [/SUP], Heba H Mostafa[SUP] 4 [/SUP], Jeanne C Keruly[SUP] 1 [/SUP], Shruti H Mehta[SUP] 9 [/SUP], Sabra L Klein[SUP] 3 4 [/SUP], Andrea L Cox[SUP] 1 3 6 [/SUP], Andrew Pekosz[SUP] 3 [/SUP], Christopher D Heaney[SUP] 2 9 10 [/SUP], David L Thomas[SUP] 1 [/SUP], Paul W Blair[SUP] 1 [/SUP], Yukari C Manabe[SUP] 1 3 [/SUP]
Affiliations
Abstract
Background: Sustained molecular detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in the upper respiratory tract (URT) in mild to moderate coronavirus disease 2019 (COVID-19) is common. We sought to identify host and immune determinants of prolonged SARS-CoV-2 RNA detection.
Methods: Ninety-five symptomatic outpatients self-collected midturbinate nasal, oropharyngeal (OP), and gingival crevicular fluid (oral fluid) samples at home and in a research clinic a median of 6 times over 1-3 months. Samples were tested for viral RNA, virus culture, and SARS-CoV-2 and other human coronavirus antibodies, and associations were estimated using Cox proportional hazards models.
Results: Viral RNA clearance, as measured by SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR), in 507 URT samples occurred a median (interquartile range) 33.5 (17-63.5) days post-symptom onset. Sixteen nasal-OP samples collected 2-11 days post-symptom onset were virus culture positive out of 183 RT-PCR-positive samples tested. All participants but 1 with positive virus culture were negative for concomitant oral fluid anti-SARS-CoV-2 antibodies. The mean time to first antibody detection in oral fluid was 8-13 days post-symptom onset. A longer time to first detection of oral fluid anti-SARS-CoV-2 S antibodies (adjusted hazard ratio [aHR], 0.96; 95% CI, 0.92-0.99; P = .020) and body mass index (BMI) ≥25 kg/m[SUP]2[/SUP] (aHR, 0.37; 95% CI, 0.18-0.78; P = .009) were independently associated with a longer time to SARS-CoV-2 viral RNA clearance. Fever as 1 of first 3 COVID-19 symptoms correlated with shorter time to viral RNA clearance (aHR, 2.06; 95% CI, 1.02-4.18; P = .044).
Conclusions: We demonstrate that delayed rise of oral fluid SARS-CoV-2-specific antibodies, elevated BMI, and absence of early fever are independently associated with delayed URT viral RNA clearance.
Keywords: COVID-19; RT-PCR; SARS-CoV-2; antibody; viral RNA.
. 2021 Apr 16;8(6)
fab195.doi: 10.1093/ofid/ofab195. eCollection 2021 Jun.
Delayed Rise of Oral Fluid Antibodies, Elevated BMI, and Absence of Early Fever Correlate With Longer Time to SARS-CoV-2 RNA Clearance in a Longitudinally Sampled Cohort of COVID-19 Outpatients
Annukka A R Antar[SUP] 1 [/SUP], Tong Yu[SUP] 1 [/SUP], Nora Pisanic[SUP] 2 [/SUP], Razvan Azamfirei[SUP] 1 [/SUP], Jeffrey A Tornheim[SUP] 1 [/SUP], Diane M Brown[SUP] 1 [/SUP], Kate Kruczynski[SUP] 2 [/SUP], Justin P Hardick[SUP] 1 [/SUP], Thelio Sewell[SUP] 1 [/SUP], Minyoung Jang[SUP] 1 [/SUP], Taylor Church[SUP] 1 [/SUP], Samantha N Walch[SUP] 1 [/SUP], Carolyn Reuland[SUP] 1 [/SUP], Vismaya S Bachu[SUP] 1 [/SUP], Kirsten Littlefield[SUP] 3 [/SUP], Han-Sol Park[SUP] 3 [/SUP], Rebecca L Ursin[SUP] 4 [/SUP], Abhinaya Ganesan[SUP] 3 [/SUP], Oyinkansola Kusemiju[SUP] 1 [/SUP], Brittany Barnaba[SUP] 1 [/SUP], Curtisha Charles[SUP] 1 [/SUP], Michelle Prizzi[SUP] 1 [/SUP], Jaylynn R Johnstone[SUP] 1 [/SUP], Christine Payton[SUP] 1 [/SUP], Weiwei Dai[SUP] 1 [/SUP], Joelle Fuchs[SUP] 1 [/SUP], Guido Massaccesi[SUP] 1 [/SUP], Derek T Armstrong[SUP] 5 [/SUP], Jennifer L Townsend[SUP] 1 [/SUP], Sara C Keller[SUP] 1 [/SUP], Zoe O Demko[SUP] 1 [/SUP], Chen Hu[SUP] 6 [/SUP], Mei-Cheng Wang[SUP] 7 [/SUP], Lauren M Sauer[SUP] 8 [/SUP], Heba H Mostafa[SUP] 4 [/SUP], Jeanne C Keruly[SUP] 1 [/SUP], Shruti H Mehta[SUP] 9 [/SUP], Sabra L Klein[SUP] 3 4 [/SUP], Andrea L Cox[SUP] 1 3 6 [/SUP], Andrew Pekosz[SUP] 3 [/SUP], Christopher D Heaney[SUP] 2 9 10 [/SUP], David L Thomas[SUP] 1 [/SUP], Paul W Blair[SUP] 1 [/SUP], Yukari C Manabe[SUP] 1 3 [/SUP]
Affiliations
- PMID: 34095338
- PMCID: PMC8083254
- DOI: 10.1093/ofid/ofab195
Abstract
Background: Sustained molecular detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in the upper respiratory tract (URT) in mild to moderate coronavirus disease 2019 (COVID-19) is common. We sought to identify host and immune determinants of prolonged SARS-CoV-2 RNA detection.
Methods: Ninety-five symptomatic outpatients self-collected midturbinate nasal, oropharyngeal (OP), and gingival crevicular fluid (oral fluid) samples at home and in a research clinic a median of 6 times over 1-3 months. Samples were tested for viral RNA, virus culture, and SARS-CoV-2 and other human coronavirus antibodies, and associations were estimated using Cox proportional hazards models.
Results: Viral RNA clearance, as measured by SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR), in 507 URT samples occurred a median (interquartile range) 33.5 (17-63.5) days post-symptom onset. Sixteen nasal-OP samples collected 2-11 days post-symptom onset were virus culture positive out of 183 RT-PCR-positive samples tested. All participants but 1 with positive virus culture were negative for concomitant oral fluid anti-SARS-CoV-2 antibodies. The mean time to first antibody detection in oral fluid was 8-13 days post-symptom onset. A longer time to first detection of oral fluid anti-SARS-CoV-2 S antibodies (adjusted hazard ratio [aHR], 0.96; 95% CI, 0.92-0.99; P = .020) and body mass index (BMI) ≥25 kg/m[SUP]2[/SUP] (aHR, 0.37; 95% CI, 0.18-0.78; P = .009) were independently associated with a longer time to SARS-CoV-2 viral RNA clearance. Fever as 1 of first 3 COVID-19 symptoms correlated with shorter time to viral RNA clearance (aHR, 2.06; 95% CI, 1.02-4.18; P = .044).
Conclusions: We demonstrate that delayed rise of oral fluid SARS-CoV-2-specific antibodies, elevated BMI, and absence of early fever are independently associated with delayed URT viral RNA clearance.
Keywords: COVID-19; RT-PCR; SARS-CoV-2; antibody; viral RNA.