Work

Viral dynamics of omicron variants in older patients

Year: 2023

Type: letter

Abstract: Yang Yang and colleagues1Yang Y Guo L Yuan J et al.Viral and antibody dynamics of acute infection with SARS-CoV-2 omicron variant (B.1.1.529): a prospective cohort study from Shenzhen, China.Lancet Microbe. 2023; 4: e632-e641Summary Full Text Full Text PDF PubMed Google Scholar presented a detailed summary of the viral dynamics of several SARS-CoV-2 variants in infected individuals. They focused on young and middle-aged adults, with a median age of 33·0 years (IQR 21·0–47·5), who were infected with the omicron (B.1.1.529) variant. However, in reality, hospitalisation and disease burden resulting from omicron variant infection are primarily observed among older people. Therefore, understanding viral dynamics in this older population (age >60 years) is essential to inform future diagnosis and treatment strategies. We collected data from all patients admitted to our hospital because of SARS-CoV-2 infection from Nov 1, 2022, to June 30, 2023. We excluded patients who received antivirals against SARS-CoV-2 and collected demographic and clinical data from the remaining patients who had at least one SARS-CoV-2 nucleic acid test result (appendix pp 1–2). The variants prevalent in China during the study period were BA.5/BF.7 and XBB. We divided the included patients into two groups on the basis of age (≤60 and >60 years) and analysed viral dynamics by measuring cycle threshold (Ct) values after admission using a method similar to the one used in our previous study.2Gao Y Luo Z Ren S et al.Antiviral effect of azvudine and nirmatrelvir-ritonavir among hospitalized patients with COVID-19.J Infect. 2023; 86: e158-e160Summary Full Text Full Text PDF PubMed Scopus (0) Google Scholar We found that the slope of the Ct value decline after SARS-CoV-2 infection was less steep in older individuals than that in younger adults. The viral clearance time was 8·6 days (95% CI 7·8–9·4) for older individuals and 7·4 days (6·9–7·8) for younger adults (appendix p 3). The mean Ct value was lower in older patients at admission, and this result could be attributed to the slightly delayed hospital admission after symptom onset, resulting in a leftward shift in the fitted curve and failure to obtain the peak Ct value. Our findings suggest a decreased viral clearance ability in the older population and provide a reference for future clinical studies on SARS-CoV-2 antivirals.See Online for appendix See Online for appendix We declare no competing interests. YG, YunG, and ZG contributed equally. YM and ZH contributed equally. This work is supported by the National Key Research and Development Program of China (2019YFC0121704) and High-Level Public Health Technology Talent Project (Academic Leader-01-05). The funders of the study had no role in writing this Correspondence. Download .docx (.13 MB) Help with docx files Supplementary appendix

Source: The Lancet Microbe

DOI: 10.1016/s2666-5247(23)00341-5

Authors: Yuan Gao, Yunyi Gao, Ziwen Gao, Yingmin Ma, Zhongjie Hu

Institutions: Qingdao University, Capital Medical University, Beijing YouAn Hospital, Chinese Academy of Sciences, Academy of Mathematics and Systems Science

Language: English

Topic: SARS-CoV-2 and COVID-19 Research

Subfield: Infectious Diseases

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $6,300