tetano
Editor, Senior Moderator
Open Forum Infect Dis
. 2022 Nov 11;9(11)
fac618.
doi: 10.1093/ofid/ofac618. eCollection 2022 Nov.
Predictors of SARS-CoV-2 RNA From Nasopharyngeal Swabs and Concordance With Other Compartments in Nonhospitalized Adults With Mild to Moderate COVID-19
Carlee Moser[SUP] 1 [/SUP], Jonathan Z Li[SUP] 2 [/SUP], Joseph J Eron[SUP] 3 [/SUP], Evgenia Aga[SUP] 1 [/SUP], Eric S Daar[SUP] 4 [/SUP], David A Wohl[SUP] 3 [/SUP], Robert W Coombs[SUP] 5 [/SUP], Arzhang Cyrus Javan[SUP] 6 [/SUP], Rachel A Bender Ignacio[SUP] 7 8 [/SUP], Prasanna Jagannathan[SUP] 9 [/SUP], Justin Ritz[SUP] 1 [/SUP], Scott F Sieg[SUP] 10 [/SUP], Urvi M Parikh[SUP] 11 [/SUP], Michael D Hughes[SUP] 12 [/SUP], Judith S Currier[SUP] 13 [/SUP], Davey M Smith[SUP] 14 [/SUP], Kara W Chew[SUP] 13 [/SUP], ACTIV-2/A5401 Study Team
Collaborators, Affiliations
Abstract
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[SUB]10[/SUB] 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[SUB]10[/SUB] 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.
Keywords: COVID-19; SARS-CoV-2 RNA; nasal swabs; nasopharyngeal swabs; predictors; serostatus; sex differences.
. 2022 Nov 11;9(11)
fac618.doi: 10.1093/ofid/ofac618. eCollection 2022 Nov.
Predictors of SARS-CoV-2 RNA From Nasopharyngeal Swabs and Concordance With Other Compartments in Nonhospitalized Adults With Mild to Moderate COVID-19
Carlee Moser[SUP] 1 [/SUP], Jonathan Z Li[SUP] 2 [/SUP], Joseph J Eron[SUP] 3 [/SUP], Evgenia Aga[SUP] 1 [/SUP], Eric S Daar[SUP] 4 [/SUP], David A Wohl[SUP] 3 [/SUP], Robert W Coombs[SUP] 5 [/SUP], Arzhang Cyrus Javan[SUP] 6 [/SUP], Rachel A Bender Ignacio[SUP] 7 8 [/SUP], Prasanna Jagannathan[SUP] 9 [/SUP], Justin Ritz[SUP] 1 [/SUP], Scott F Sieg[SUP] 10 [/SUP], Urvi M Parikh[SUP] 11 [/SUP], Michael D Hughes[SUP] 12 [/SUP], Judith S Currier[SUP] 13 [/SUP], Davey M Smith[SUP] 14 [/SUP], Kara W Chew[SUP] 13 [/SUP], ACTIV-2/A5401 Study Team
Collaborators, Affiliations
- PMID: 36467293
- PMCID: PMC9709705
- DOI: 10.1093/ofid/ofac618
Abstract
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[SUB]10[/SUB] 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[SUB]10[/SUB] 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.
Keywords: COVID-19; SARS-CoV-2 RNA; nasal swabs; nasopharyngeal swabs; predictors; serostatus; sex differences.