SARS-CoV-2 Virus Culture and Subgenomic RNA for Respiratory Specimens from Patients with Mild Coronavirus Disease

Perera, Ranawaka A.P.M.; Tso, Eugene Yuk‐Keung; Tsang, Owen Tak‐Yin; Tsang, Dominic N.C.; Fung, Kitty S. C.; Leung, Yonna W. Y.; Chin, Alex W. H.; Chu, Daniel K W; Cheng, Samuel; Poon, Leo L M; Chuang, Vivien Wai‐Man; Peiris, Malik

doi:10.3201/eid2611.203219

Cited by 204 publications

(249 citation statements)

References 9 publications

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“…At 10 days after symptom onset, in line with current guidance from the World Health Organization [3] and the UK [4] on release from isolation, probability of culturing virus declines to 6%. The findings concur with smaller studies that identified infectious virus shed for 8 or 9 days [5][6][7][8][9] and others demonstrating correlation between Ct value/viral load and cultivable virus [5,[9][10][11]. Strengths include the comparatively large size of this dataset, inclusion of a large proportion (> 50%) of samples taken more than 7 days after symptom onset and that all analysis was performed in a single laboratory.…”

Section: Discussionsupporting

confidence: 86%

Duration of infectiousness and correlation with RT-PCR cycle threshold values in cases of COVID-19, England, January to May 2020

et al. 2020

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Severe acute respiratory syndrome coronavirus 2 viral load in the upper respiratory tract peaks around symptom onset and infectious virus persists for 10 days in mild-to-moderate coronavirus disease (n = 324 samples analysed). RT-PCR cycle threshold (Ct) values correlate strongly with cultivable virus. Probability of culturing virus declines to 8% in samples with Ct > 35 and to 6% 10 days after onset; it is similar in asymptomatic and symptomatic persons. Asymptomatic persons represent a source of transmissible virus.

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Section: Discussionsupporting

confidence: 86%

Duration of infectiousness and correlation with RT-PCR cycle threshold values in cases of COVID-19, England, January to May 2020

et al. 2020

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“…This classi cation was made based on the clinical features, evidence of pneumonia, oxygen requirements, and the presence of serious complications. In addition to respiratory symptoms, patients also reported gastrointestinal symptoms in the form of vomiting, diarrhea, abdominal pain, nauseas, and anorexia which is in line with other reports from different countries [29]. Fever also was reported in 100% of infants, a feature that was well documented in other studies, despite the low number of cases in our study [30].…”

Section: Discussionsupporting

confidence: 93%

Predictors of illness severity in COVID-19 cases

AlDossary

Alnimr

Aljindan

et al. 2020

Preprint

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Background Multiple studies worldwide reported the clinical and epidemiological features of coronavirus disease 2019 (COVID-19) with limited reports form the Middle East area. Methods This is an observational study to describe the clinical and epidemiological features of 341 COVID-19 cases in the Eastern Province of Saudi Arabia over the first three months from reporting the first case in the country and identify factors associated with severity of the illness. Results The median age was 45 years and males were twice as affected as females (p value < 0.0001). The duration of viral shedding ranged from 9 to 36 days. The most common clinical presentations include fever, shortness of breath, cough, myalgia, sore throat, vomiting, and headache. Severe and critical cases were significantly higher in males compared to females (23% vs 8.7%), senior adults (> 65 years), Bengali ethnicity, and in patient with com-morbidities including diabetes, hypertension, and dyslipidemia (p-value = 0.001). Furthermore, case fatality rate was found to be 10% and was significantly higher in male gender compared to female (13.8%vs 2.6%), and in Asian ethnicity (17.9%) compared to Arabs (6%) and African counterparts (0) (p-value = 0.002). No association was found between viral load represented by the RT-PCR cycle threshold (Ct) values and severity of illness. Conclusion Age, gender and ethnicity are important predictors of COVID-19 severity while Cycle threshold (Ct) of SARS-CoV-2 RT-PCR test cannot be used as a predictor of criticality of illness.

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“…Ag-RDT sensitivity increases when testing samples with higher RNA or virus concentrations, which is likely to be during the pre-symptomatic and early phases of the infection [ 24 ]. Although the correlation between viral load and transmissibility is not entirely clear, several studies showed that samples with higher viral loads of ≥6 log 10 RNA copies/mL were likely to correlate with infectivity in cell culture models [ 15 , 25 , 26 , 27 , 28 ]. We, and others, showed that Ag-RDTs, although less sensitive, align better with cell culture-based testing for infectivity than rRT-PCRs [ 14 , 25 , 29 , 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

The Comparative Clinical Performance of Four SARS-CoV-2 Rapid Antigen Tests and Their Correlation to Infectivity In Vitro

Kohmer

Toptan

Pallas

et al. 2021

JCM

145

138

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Due to globally rising numbers of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, resources for real-time reverse-transcription polymerase chain reaction (rRT-PCR)-based testing have been exhausted. In order to meet the demands of testing and reduce transmission, SARS-CoV-2 antigen-detecting rapid diagnostic tests (Ag-RDTs) are being considered. These tests are fast, inexpensive, and simple to use, but whether they detect potentially infectious cases has not been well studied. We evaluated three lateral flow assays (RIDA®QUICK SARS-CoV-2 Antigen (R-Biopharm), SARS-CoV-2 Rapid Antigen Test (Roche)), and NADAL® COVID-19 Ag Test (Nal von Minden GmbH, Regensburg, Germany) and one microfluidic immunofluorescence assay (SARS-CoV-2 Ag Test (LumiraDx GmbH, Cologne, Germany)) using 100 clinical samples. Diagnostic rRT-PCR and cell culture testing as a marker for infectivity were performed in parallel. The overall Ag-RDT sensitivity for rRT-PCR-positive samples ranged from 24.3% to 50%. However, for samples with a viral load of more than 6 log10 RNA copies/mL (22/100), typically seen in infectious individuals, Ag-RDT positivity was between 81.8% and 100%. Only 51.6% (33/64) of the rRT-PCR-positive samples were infectious in cell culture. In contrast, three Ag-RDTs demonstrated a more significant correlation with cell culture infectivity (61.8–82.4%). Our findings suggest that large-scale SARS-CoV-2 Ag-RDT-based testing can be considered for detecting potentially infective individuals and reducing the virus spread.

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SARS-CoV-2 Virus Culture and Subgenomic RNA for Respiratory Specimens from Patients with Mild Coronavirus Disease

Cited by 204 publications

References 9 publications

Duration of infectiousness and correlation with RT-PCR cycle threshold values in cases of COVID-19, England, January to May 2020

Duration of infectiousness and correlation with RT-PCR cycle threshold values in cases of COVID-19, England, January to May 2020

Predictors of illness severity in COVID-19 cases

The Comparative Clinical Performance of Four SARS-CoV-2 Rapid Antigen Tests and Their Correlation to Infectivity In Vitro

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