Duration of infectious shedding of SARS-CoV-2 Omicron variant and its relation with symptoms

Keske, Şiran; Esken, Gülen Güney; Vatansever, Cansel; Beşli, Yeşim; Kuloğlu, Zeynep Ece; Nergiz, Zeliş; Barlas, Tayfun; Şencanlı, Özgür; Kuşkucu, Mert Ahmet; Palaoğlu, Erhan; Can, Füsun; Ergönül, Önder

doi:10.1016/j.cmi.2022.07.009

Cited by 22 publications

(17 citation statements)

References 7 publications

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“…The Ct assay used was validated in house against known viral copy numbers, obtained from live-virus quantification (5,22). Our reported Ct values are consistent with Omicron in the general population (58), and are well within the range in which infectious virus could be detected during both human challenge with SARS-CoV-2 and other prospectively sampled cohorts (27,28,59). The heterogenity in lowest value and longditinal Ct kinetics in our cohort are also very similar to other cohorts (42,60).…”

Section: Discussionsupporting

confidence: 88%

“…Participants who reported acute infection provided serial self-performed upper respiratory tract swabs for RT-qPCR analysis of SARS-CoV-2 RNA during isolation, with predominately Delta, BA.1 and BA.2 infections. We profiled the kinetics of each infection using the Ct value, as an inverse proxy for representative of levels of replicating, viable virus (27, 28). Across all cohorts, the median Ct values remained at levels considered to be infectious for 7-10 days, irrespective of symptom severity and including asymptomatic participants ( Figure 4A ).…”

Section: Resultsmentioning

confidence: 99%

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COVID-19 in non-hospitalised adults caused by either SARS-CoV-2 sub-variants Omicron BA.1, BA.2, BA.5 or Delta associates with similar illness duration, symptom severity and viral kinetics, irrespective of vaccination history

Townsley

Carr

Russell

et al. 2022

Preprint

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Introduction The impact of COVID-19 vaccination on disease in the community has been limited, as a result of both SARS-CoV-2 Variants of Concern that partially escape vaccine-induced immunity. We sought to characterise symptoms and viral loads over the course of COVID-19 infection in otherwise-healthy vaccinated adults, representative of the general population, to assess whether current self-isolation guidance remains justified. Methods In a prospective, observational cohort study, healthy vaccinated UK adults who reported a positive PCR or lateral flow test, self-swabbed on alternate days until day 10. We compared symptoms and viral kinetics between infections caused by VOCs Delta and Omicron (sub-variants BA.1 and BA.2) and investigated applicability of UK NHS isolation guidelines to these newer VOCs. Results 373 infection episodes were reported among 349 participants. Across VOCs, symptom duration was similar, however symptom profiles differed significantly among infections caused by Delta, Omicron BA.1 and BA.2. Anosmia was reported in <10% of participants with BA.1 and BA.2, compared to 42% with Delta infection, coryza fatigue and myalgia predominated. Most notably, viral load trajectories and peaks did not differ between Delta, BA.1 and BA.2, irrespective of symptom severity, VOC or vaccination status. Conclusion COVID-19 isolation guidance should not differ based on symptom severity or febrile illness and must remain under review as new SARS-CoV-2 VOCs emerge and population immunity changes. Our study emphasises the ongoing transmission risk of Omicron sub-variants in vaccinated adults with mild symptoms that may extend beyond current isolation periods.

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Section: Discussionsupporting

confidence: 88%

Section: Resultsmentioning

confidence: 99%

COVID-19 in non-hospitalised adults caused by either SARS-CoV-2 sub-variants Omicron BA.1, BA.2, BA.5 or Delta associates with similar illness duration, symptom severity and viral kinetics, irrespective of vaccination history

Townsley

Carr

Russell

et al. 2022

Preprint

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“…Several studies reported that the duration of culturable viral shedding of SARS-CoV-2 shedding from the upper respiratory tract and the related variables differed in terms of dominant genotypic variants, clinical severity of patients, status of COVID-19 vaccination, types of upper respiratory specimens, and immune status. 14 15 16 17 18 Generally, the number of subjects was small (18 to 66 patients) and antiviral therapy was not used. The median duration of culturable viral shedding in the untreated patients was four to seven days from the onset of symptoms or date of laboratory diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Short-Term Effectiveness of Oral Nirmatrelvir/Ritonavir Against the SARS-CoV-2 Omicron Variant and Culture-Positive Viral Shedding

et al. 2023

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Background Information on the effectiveness of nirmatrelvir/ritonavir against the omicron is limited. The clinical response and viral kinetics to therapy in the real world need to be evaluated. Methods Mild to moderate coronavirus disease 2019 (COVID-19) patients with risk factors for severe illness were prospectively enrolled as a treatment group with nirmatrelvir/ritonavir therapy versus a control group with supportive care. Serial viral load and culture from the upper respiratory tract were evaluated for seven days, and clinical responses and adverse reactions were evaluated for 28 days. Results A total of 51 patients were analyzed including 40 in the treatment group and 11 in the control group. Faster symptom resolution during hospitalization ( P = 0.048) was observed in the treatment group. Only minor adverse reactions were reported in 27.5% of patients. The viral load on Day 7 was lower in the treatment group ( P = 0.002). The viral culture showed a positivity of 67.6% (25/37) vs. 100% (6/6) on Day 1, 0% (0/37) vs. 16.7 (1/6) on Day 5, and 0% (0/16) vs. 50.0% (2/4) on Day 7 in the treatment and control groups, respectively. Conclusions Nirmatrelvir/ritonavir against the omicron was safe and resulted in negative viral culture conversion after Day 5 of treatment with better symptomatic resolution.

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“…This study included 108 patients diagnosed with COVID-19 caused by the SARS-CoV-2 Omicron variant based on nucleic acid detection of the N and ORF1ab Asymptomatic, mild, or moderate cases were considered non-severe. Patients with non-severe COVID-19 who tested SARS-CoV-2 positive within 10 days after diagnosis were allocated to the early elimination (EE) group and those who tested SARS-CoV-2 positive for more than 10 days were allocated to the prolonged elimination (PE) group (12,13).…”

Section: Patient Populationmentioning

confidence: 99%

Association between immunity and viral shedding duration in non-severe SARS-CoV-2 Omicron variant-infected patients

Fang

Yang

et al. 2022

Front. Public Health

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BackgroundCoronavirus disease 2019 (COVID-19) is a respiratory-related disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). More than 200 countries worldwide are affected by this disease. The Omicron variant of SARS-CoV-2 is the major epidemic variant worldwide and is characterized by higher infectivity. However, the immunity and risk factors for prolonged viral elimination in patients with non-severe SARS-CoV-2 Omicron variant infections are unclear. Therefore, this study aimed to examine the relationship between immunity and duration of viral elimination in non-severe SARS-CoV-2 Omicron variant-infected patients in Shanghai.MethodsIn total, 108 non-severe SARS-CoV-2 Omicron variant-infected patients from Shanghai New International Expo Center Fangcang Shelter Hospital were recruited in this study. They were further allocated to the early elimination (EE) and prolonged elimination (PE) groups according to SARS-CoV-2 nucleic acid positivity duration.ResultsCompared to patients with EE, those with PE had increased serum concentrations of interleukin (IL)-5, IL-6, and IL-8; higher neutrophil count and neutrophil-to-lymphocyte ratio (NLR); lower lymphocyte, eosinophil, and red blood cell counts; and lower concentrations of hemoglobin and albumin (ALB). In lymphocyte subpopulation analysis, lower numbers of CD3+ T cells, CD4+ T cells, CD8+ T cells, and NK cells and a higher CD4/CD8 ratio were observed in patients with PE. In addition, correlation analysis results revealed that cycle threshold values of SARS-CoV-2 Omicron variant ORF1ab and N were negatively correlated with IL-6 and IL-8 levels and positively correlated with eosinophil count in patients with COVID-19. Finally, multivariate regression analysis showed that ALB, CD4/CD8 ratio, NLR, and eosinophil count were predictors of the SARS-CoV-2 Omicron variant elimination.ConclusionIn this study, we identified that the ALB, CD4/CD8 ratio, NLR, and eosinophil count were risk factors for prolonged viral elimination in non-severe SARS-CoV-2 Omicron variant-infected patients. These factors might be efficient indicators in the diagnosis, evaluation, and prognosis monitoring of the disease.

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Duration of infectious shedding of SARS-CoV-2 Omicron variant and its relation with symptoms

Cited by 22 publications

References 7 publications

COVID-19 in non-hospitalised adults caused by either SARS-CoV-2 sub-variants Omicron BA.1, BA.2, BA.5 or Delta associates with similar illness duration, symptom severity and viral kinetics, irrespective of vaccination history

COVID-19 in non-hospitalised adults caused by either SARS-CoV-2 sub-variants Omicron BA.1, BA.2, BA.5 or Delta associates with similar illness duration, symptom severity and viral kinetics, irrespective of vaccination history

Short-Term Effectiveness of Oral Nirmatrelvir/Ritonavir Against the SARS-CoV-2 Omicron Variant and Culture-Positive Viral Shedding

Association between immunity and viral shedding duration in non-severe SARS-CoV-2 Omicron variant-infected patients

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