Exhaled Breath Aerosol Shedding of Highly Transmissible Versus Prior Severe Acute Respiratory Syndrome Coronavirus 2 Variants.

Autor:	Lai J; Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, USA., Coleman KK; Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, USA., Tai SHS; Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, USA., German J; Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, USA., Hong F; Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, USA., Albert B; Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, USA., Esparza Y; Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, USA., Srikakulapu AK; Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, USA., Schanz M; Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, USA., Maldonado IS; Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, USA., Oertel M; Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, USA., Fadul N; Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, USA., Gold TL; Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, USA., Weston S; Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, Maryland, USA., Mullins K; Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA., McPhaul KM; Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, USA., Frieman M; Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, Maryland, USA., Milton DK; Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, USA.
Jazyk:	angličtina
Zdroj:	Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2023 Mar 04; Vol. 76 (5), pp. 786-794.
DOI:	10.1093/cid/ciac846
Abstrakt:	Background: Aerosol inhalation is recognized as the dominant mode of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission. Three highly transmissible lineages evolved during the pandemic. One hypothesis to explain increased transmissibility is that natural selection favors variants with higher rates of viral aerosol shedding. However, the extent of aerosol shedding of successive SARS-CoV-2 variants is unknown. We aimed to measure the infectivity and rate of SARS-CoV-2 shedding into exhaled breath aerosol (EBA) by individuals during the Delta and Omicron waves and compared those rates with those of prior SARS-CoV-2 variants from our previously published work. Methods: Individuals with coronavirus disease 2019 (COVID-19) (n = 93; 32 vaccinated and 20 boosted) were recruited to give samples, including 30-minute breath samples into a Gesundheit-II EBA sampler. Samples were quantified for viral RNA using reverse-transcription polymerase chain reaction and cultured for virus. Results: Alpha (n = 4), Delta (n = 3), and Omicron (n = 29) cases shed significantly more viral RNA copies into EBAs than cases infected with ancestral strains and variants not associated with increased transmissibility (n = 57). All Delta and Omicron cases were fully vaccinated and most Omicron cases were boosted. We cultured virus from the EBA of 1 boosted and 3 fully vaccinated cases. Conclusions: Alpha, Delta, and Omicron independently evolved high viral aerosol shedding phenotypes, demonstrating convergent evolution. Vaccinated and boosted cases can shed infectious SARS-CoV-2 via EBA. These findings support a dominant role of infectious aerosols in transmission of SARS-CoV-2. Monitoring aerosol shedding from new variants and emerging pathogens can be an important component of future threat assessments and guide interventions to prevent transmission. Competing Interests: Potential conflicts of interest. S. W. and M. F. received payments to their institution from NIAID, the Biomedical Advanced Research and Development Authority, DARPA, the Gates Foundation, Aikido Pharma, Emergent, AstraZeneca, Novavax, Regeneron, and the CDC, outside the submitted work. M. F. received royalties/licenses from Aikido Pharma for antiviral drug patent licensing, consulting fees from Aikido Pharma, Observatory Group, for consulting for COVID-19, and participation on scientific advisory board for Aikido Pharma, outside the submitted work. K. M. reports roles as board member and president of the Association of Occupational and Environmental Clinics (unpaid), member of the University of Connecticut, Storrs National Institute for Occupational Safety and Health Center for New England Workplace external advisory board (unpaid); and Editor-in-Chief of Workplace Health and Safety journal via the American Association of Occupational Health Nurses (paid). D. M. reports support for attending meetings and/or travel from The Flu Lab (gift from charitable foundation) and receipt of upper-room germicidal UV fixture (GUV) from Aeromed Inc and Far UV-C GUV fixtures from FarUV Inc. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. (© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
Databáze:	MEDLINE
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