Predictors of SARS-CoV-2 RNA From Nasopharyngeal Swabs and Concordance With Other Compartments in Nonhospitalized Adults With Mild to Moderate COVID-19
Year: 2022
Type: article
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 log10 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 log10 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.
Source: Open Forum Infectious Diseases
DOI: 10.1093/ofid/ofac618
Authors: Carlee Moser, Jonathan Z Li, Joseph J Eron, Evgenia Aga, Eric S Daar, David A Wohl, Robert W Coombs, Arzhang Cyrus Javan, Rachel A Bender Ignacio, Prasanna Jagannathan, Justin Ritz, Scott F Sieg, Urvi M Parikh, Michael D Hughes, Judith S Currier, Davey M Smith, Kara W Chew, ACTIV-2/A5401 Study Team, Lara Hosey, Jhoanna Roa, Nilam Patel, Emily Degli-Angeli, Erin Goecker, Glenda Daza, Socorro Harb, Joan Dragavon, Grace Aldrovandi, William Murtaugh, Marlene Cooper, Howard Gutzman, Kevin Knowles, Rachel Bowman, Bill Erhardt, Stacey Adams
Institutions: Brigham and Women's Hospital, Harvard University, University of North Carolina at Chapel Hill, University of California, Los Angeles, The Lundquist Institute, Harbor–UCLA Medical Center, University of Washington, National Institutes of Health, Fred Hutch Cancer Center, Stanford University, Case Western Reserve University, University of Pittsburgh, University of California San Diego
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,676
Awards: G1050281965, G1636177350, G1819583291, G2737559749, G285461174, G336435875, G3382714297, G3810609436, G4553935269, G5076517209, G5316515788, G54768859, G5514976981, G650174051, G7105083719, G857487509, G9000039438, G9000047228, G9000182931, G9000292181, AIDS Clinical Trial Group Laboratory Center, University of North Carolina Global HIV Prevention and Treatment Clinical Trials Unit, G961682679
OpenAlex ID: W4308918282