Predictors of SARS-CoV-2 RNA From Nasopharyngeal Swabs and Concordance With Other Compartments in Nonhospitalized Adults With Mild to Moderate COVID-19.

Autor: Moser C; Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA., Li JZ; Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Eron JJ; Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA., Aga E; Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA., Daar ES; Lundquist Institute at Harbor-UCLA Medical Center, Torrance, California, USA., Wohl DA; Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA., Coombs RW; Department of Laboratory Medicine and Pathology, Department of Medicine, University of Washington, Seattle, Washington, USA., Javan AC; National Institutes of Health, Rockville, Maryland, USA., Bender Ignacio RA; Department of Medicine, University of Washington, Seattle, Washington, USA.; Vaccine and Infectious Disease Division, Fred Hutch Cancer Center, Seattle, Washington, USA., Jagannathan P; Department of Medicine, Stanford University, Palo Alto, California, USA., Ritz J; Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA., Sieg SF; Department of Medicine, Case Western University, Cleveland, Ohio, USA., Parikh UM; Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA., Hughes MD; Department of Biostatistics and Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA., Currier JS; Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA., Smith DM; Department of Medicine, University of California, San Diego, La Jolla, California, USA., Chew KW; Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA.
Jazyk: angličtina
Zdroj: Open forum infectious diseases [Open Forum Infect Dis] 2022 Nov 11; Vol. 9 (11), pp. ofac618. Date of Electronic Publication: 2022 Nov 11 (Print Publication: 2022).
DOI: 10.1093/ofid/ofac618
Abstrakt: 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 10  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 10  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.
Competing Interests: Potential conflicts of interest. K.W.C. has received research funding to the institution from Merck Sharp & Dohme and is a consultant for Pardes Biosciences. E.S.D. receives consulting fees from Gilead Sciences, Merck, and GSK/ViiV and research support through the institution from Gilead Sciences and GSK/ViiV. D.A.W. has received funding to the institution to support research and honoraria for advisory boards and consulting from Gilead Sciences. J.Z.L. has consulted for AbbVie and received research support from Merck. J.J.E. is an ad hoc consultant to GSK/VIR and data monitoring committee (DMC) chair for Adagio Phase III studies. J.S.C. has consulted with Merck and Company. R.B.I. has consulted for AbbVie and SeaGen and received research funding to the institution from Novartis. D.M.S. has consulted for the following companies: Fluxergy, Kiadis, Linear Therapies, Pharma Holdings, VxBiosciences, Model Medicines, Bayer Pharmaceuticals, and Signant Health. U.M.P. is a consultant with Merck and Co. All other authors (C.M., E.A., R.W.C., A.C.J., P.J., J.R., S.J.S., and M.D.H.) 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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