Skip to main content
Journal cover image

Infectious Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Virus in Symptomatic Coronavirus Disease 2019 (COVID-19) Outpatients: Host, Disease, and Viral Correlates.

Publication ,  Journal Article
Mollan, KR; Eron, JJ; Krajewski, TJ; Painter, W; Duke, ER; Morse, CG; Goecker, EA; Premkumar, L; Wolfe, CR; Szewczyk, LJ; Alabanza, PL ...
Published in: Clin Infect Dis
August 24, 2022

BACKGROUND: Although severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infectious virus isolation in outpatients with coronavirus disease 2019 (COVID-19) has been associated with viral RNA levels and symptom duration, little is known about the host, disease, and viral determinants of infectious virus detection. METHODS: COVID-19 adult outpatients were enrolled within 7 days of symptom onset. Clinical symptoms were recorded via patient diary. Nasopharyngeal swabs were collected to quantitate SARS-CoV-2 RNA by reverse transcriptase polymerase chain reaction and for infectious virus isolation in Vero E6-cells. SARS-CoV-2 antibodies were measured in serum using a validated ELISA assay. RESULTS: Among 204 participants with mild-to-moderate symptomatic COVID-19, the median nasopharyngeal viral RNA was 6.5 (interquartile range [IQR] 4.7-7.6 log10 copies/mL), and 26% had detectable SARS-CoV-2 antibodies (immunoglobulin (Ig)A, IgM, IgG, and/or total Ig) at baseline. Infectious virus was recovered in 7% of participants with SARS-CoV-2 antibodies compared to 58% of participants without antibodies (prevalence ratio [PR] = 0.12, 95% confidence interval [CI]: .04, .36; P = .00016). Infectious virus isolation was also associated with higher levels of viral RNA (mean RNA difference +2.6 log10, 95% CI: 2.2, 3.0; P < .0001) and fewer days since symptom onset (PR = 0.79, 95% CI: .71, .88 per day; P < .0001). CONCLUSIONS: The presence of SARS-CoV-2 antibodies is strongly associated with clearance of infectious virus. Seropositivity and viral RNA levels are likely more reliable markers of infectious virus clearance than subjective measure of COVID-19 symptom duration. Virus-targeted treatment and prevention strategies should be administered as early as possible and ideally before seroconversion. CLINICAL TRIALS REGISTRATION: NCT04405570.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Clin Infect Dis

DOI

EISSN

1537-6591

Publication Date

August 24, 2022

Volume

75

Issue

1

Start / End Page

e1028 / e1036

Location

United States

Related Subject Headings

  • SARS-CoV-2
  • RNA, Viral
  • Outpatients
  • Microbiology
  • Immunoglobulin A
  • Humans
  • Communicable Diseases
  • COVID-19 Testing
  • COVID-19
  • Antibodies, Viral
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Mollan, K. R., Eron, J. J., Krajewski, T. J., Painter, W., Duke, E. R., Morse, C. G., … Fischer, W. A. (2022). Infectious Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Virus in Symptomatic Coronavirus Disease 2019 (COVID-19) Outpatients: Host, Disease, and Viral Correlates. Clin Infect Dis, 75(1), e1028–e1036. https://doi.org/10.1093/cid/ciab968
Mollan, Katie R., Joseph J. Eron, Taylor J. Krajewski, Wendy Painter, Elizabeth R. Duke, Caryn G. Morse, Erin A. Goecker, et al. “Infectious Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Virus in Symptomatic Coronavirus Disease 2019 (COVID-19) Outpatients: Host, Disease, and Viral Correlates.Clin Infect Dis 75, no. 1 (August 24, 2022): e1028–36. https://doi.org/10.1093/cid/ciab968.
Mollan, Katie R., et al. “Infectious Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Virus in Symptomatic Coronavirus Disease 2019 (COVID-19) Outpatients: Host, Disease, and Viral Correlates.Clin Infect Dis, vol. 75, no. 1, Aug. 2022, pp. e1028–36. Pubmed, doi:10.1093/cid/ciab968.
Mollan KR, Eron JJ, Krajewski TJ, Painter W, Duke ER, Morse CG, Goecker EA, Premkumar L, Wolfe CR, Szewczyk LJ, Alabanza PL, Loftis AJ, Degli-Angeli EJ, Brown AJ, Dragavon JA, Won JJ, Keys J, Hudgens MG, Fang L, Wohl DA, Cohen MS, Baric RS, Coombs RW, Sheahan TP, Fischer WA. Infectious Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Virus in Symptomatic Coronavirus Disease 2019 (COVID-19) Outpatients: Host, Disease, and Viral Correlates. Clin Infect Dis. 2022 Aug 24;75(1):e1028–e1036.
Journal cover image

Published In

Clin Infect Dis

DOI

EISSN

1537-6591

Publication Date

August 24, 2022

Volume

75

Issue

1

Start / End Page

e1028 / e1036

Location

United States

Related Subject Headings

  • SARS-CoV-2
  • RNA, Viral
  • Outpatients
  • Microbiology
  • Immunoglobulin A
  • Humans
  • Communicable Diseases
  • COVID-19 Testing
  • COVID-19
  • Antibodies, Viral