Variation in Severe Acute Respiratory Syndrome Coronavirus 2 Bioaerosol Production in Exhaled Breath

Verma, Renu; Kim, Eugene; Degner, Nicholas; Walter, Katharine S.; Singh, Upinder; Andrews, Jason R

doi:10.1093/ofid/ofab600

Cited by 3 publications

(3 citation statements)

References 13 publications

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“…We found that vaccinated and unvaccinated participants exhaled similar numbers of SARS-CoV-2 RNA copies (Fig 2C), when accounting for age, sex, presence of co-morbidities, days since symptom onset and symptom severity (Supplementary Appendix, Wilcoxon rank sum test, P = 0.31, z = 1.02) (Fig 3A). Viral RNA levels in 57 samples collected by vaccinated individuals on days 1 to 16 from symptom onset ranged from 0 to 549 exhaled copies per minute (%95 CI: [17,78]) while viral loads for unvaccinated individuals on days 1 to 16 ranged from 0 to 876 exhaled copies per minute (%95 CI: [25,55]).…”

Section: Vaccinated and Unvaccinated Individuals Exhaled Similar Leve...mentioning

confidence: 99%

“…At the time of each sample collection, participants recorded time of day, symptoms, and subjective self-assessed overall symptom severity (resolved/none, mild, moderate, severe). Exhaled breath condensate samples were taken from 60 participants within an average of 19 hours (range 1-120, %95 CI: [13,25]) after clinical diagnostic COVID-19 testing (Fig 1A). A subset of 31 COVID-19-positive participants (70.5%) produced an additional 250 samples longitudinally from home (range 2-30, %95 CI: [6,12]).…”

Section: Specimen Collectionmentioning

confidence: 99%

“…Current techniques for measuring viral load in exhaled breath have successfully detected SARS-CoV-2 in specimens (18)(19)(20)(21)(22)(23)(24)(25)(26)(27), though with variable detection rates ranging from 26.9% to 86%. Recent work has also shown that SARS-CoV-2 can be isolated from exhaled breath, confirming that it contains replication-competent virus (17).…”

Section: Introductionmentioning

confidence: 99%

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Quantity of SARS-CoV-2 RNA copies exhaled per minute during natural breathing over the course of COVID-19 infection

Lane,

Zhou,

Hultquist

et al. 2023

Preprint

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SARS-CoV-2 is spread through exhaled breath of infected individuals. A fundamental question in understanding transmission of SARS-CoV-2 is how much virus an individual is exhaling into the environment while they breathe, over the course of their infection. Research on viral load dynamics during COVID-19 infection has focused on internal swab specimens, which provide a measure of viral loads inside the respiratory tract, but not on breath. Therefore, the dynamics of viral shedding on exhaled breath over the course of infection are poorly understood. Here, we collected exhaled breath specimens from COVID-19 patients and used RTq-PCR to show that numbers of exhaled SARS-CoV-2 RNA copies during COVID-19 infection do not decrease significantly until day 8 from symptom-onset. COVID-19-positive participants exhaled an average of 80 SARS-CoV-2 viral RNA copies per minute during the first 8 days of infection, with significant variability both between and within individuals, including spikes over 800 copies a minute in some patients. After day 8, there was a steep drop to levels nearing the limit of detection, persisting for up to 20 days. We further found that levels of exhaled viral RNA increased with self-rated symptom-severity, though individual variation was high. Levels of exhaled viral RNA did not differ across age, sex, time of day, vaccination status or viral variant. Our data provide a fine-grained, direct measure of the number of SARS-CoV-2 viral copies exhaled per minute during natural breathing, including 312 breath specimens collected multiple times daily over the course of infection, in order to fill an important gap in our understanding of the time course of exhaled viral loads in COVID-19.

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Section: Vaccinated and Unvaccinated Individuals Exhaled Similar Leve...mentioning

confidence: 99%

Section: Specimen Collectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Quantity of SARS-CoV-2 RNA copies exhaled per minute during natural breathing over the course of COVID-19 infection

Lane,

Zhou,

Hultquist

et al. 2023

Preprint

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Mask device as a new wearable sampler for breath analysis: what can we expect in the future?

Liu

2023

Anal Bioanal Chem

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Human exhaled breath is becoming an attractive clinical source as it is foreseen to enable noninvasive diagnosis of many diseases. Because mask devices can be used for efficiently filtering exhaled substances, mask-wearing has been required in the past few years in daily life since the unprecedented COVID-19 pandemic. In recent years, there is a new development of mask devices as new wearable breath samplers for collecting exhaled substances for disease diagnosis and biomarker discovery. This paper attempts to identify new trends in mask samplers for breath analysis. The couplings of mask samplers with different (bio)analytical approaches, including mass spectrometry (MS), polymerase chain reaction (PCR), sensor, and others for breath analysis, are summarized. The developments and applications of mask samplers in disease diagnosis and human health are reviewed. The limitations and future trends of mask samplers are also discussed. Graphical abstract

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Challenges in Harnessing Shared Within-Host Severe Acute Respiratory Syndrome Coronavirus 2 Variation for Transmission Inference

Walter

Kim

Verma

et al. 2023

Open Forum Infectious Diseases

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Background The limited variation observed among SARS-CoV-2 consensus sequences makes it difficult to reconstruct transmission linkages in outbreak settings. Previous studies have recovered variation within individual SARS-CoV-2 infections but have not yet measured the informativeness of within-host variation for transmission inference. Methods We performed tiled amplicon sequencing on 307 SARS-CoV-2 samples, including 130 samples from 32 individuals in 14 households and 47 longitudinally sampled individuals, from four prospective studies with household membership data, a proxy for transmission linkage. Results Consensus sequences from households had limited diversity (mean pairwise distance, 3.06 SNPs; range, 0-40). Most (83.1%, 255/307) samples harbored at least one intrahost single nucleotide variant (iSNV; median: 117; IQR: 17-208), above a minor allele frequency threshold of 0.2%. Pairs in the same household shared significantly more iSNVs (mean: 1.20 iSNVs; 95% CI: 1.02-1.39) than did pairs in different households infected with the same viral clade (mean: 0.31 iSNVs; 95% CI: 0.28-0.34), a signal that decreases with increasingly stringent minor allele frequency thresholds. The number of shared iSNVs was significantly associated with an increased odds of household membership (aOR: 1.35; 95% CI: 1.23 -1.49). However, the poor concordance of iSNVs detected across sequencing replicates (24.8% and 35.0% above a 0.2% and 1% threshold), confirms technical concerns that current sequencing and bioinformatic workflows do not consistently recover low frequency within-host variants. Conclusions Shared within-host variation may augment the information in consensus sequences for predicting transmission linkages. Improving sensitivity and specificity of within-host variant identification will improve the informativeness of within-host variation.

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Variation in Severe Acute Respiratory Syndrome Coronavirus 2 Bioaerosol Production in Exhaled Breath

Cited by 3 publications

References 13 publications

Quantity of SARS-CoV-2 RNA copies exhaled per minute during natural breathing over the course of COVID-19 infection

Quantity of SARS-CoV-2 RNA copies exhaled per minute during natural breathing over the course of COVID-19 infection

Mask device as a new wearable sampler for breath analysis: what can we expect in the future?

Challenges in Harnessing Shared Within-Host Severe Acute Respiratory Syndrome Coronavirus 2 Variation for Transmission Inference

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