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Long title: Exhaled SARS-CoV-2 RNA viral load kinetics measured by facemask sampling associates with household transmission.
Pan, Daniel; Williams, Caroline M; Decker, Jonathan; Fletcher, Eve; Sze, Shirley; Assadi, Sara; Haigh, Richard; Saleem, Baber; Nazareth, Joshua; Garton, Natalie J; Pareek, Manish; Barer, Michael R.
  • Pan D; Department of Respiratory Sciences, University of Leicester; Department of Infectious Diseases and HIV Medicine, University Hospitals of Leicester NHS Trust. Electronic address: Daniel.pan@nhs.net.
  • Williams CM; Department of Respiratory Sciences, University of Leicester; Department of Clinical Microbiology, University Hospitals of Leicester NHS Trust.
  • Decker J; Department of Respiratory Sciences, University of Leicester.
  • Fletcher E; Department of Respiratory Sciences, University of Leicester.
  • Sze S; Department of Cardiovascular Sciences, University Hospitals of Leicester NHS Trust.
  • Assadi S; Department of Infectious Diseases and HIV Medicine, University Hospitals of Leicester NHS Trust.
  • Haigh R; Department of Respiratory Sciences, University of Leicester.
  • Saleem B; Deparment of Engineering, University of Leicester, United Kingdom.
  • Nazareth J; Department of Respiratory Sciences, University of Leicester; Department of Infectious Diseases and HIV Medicine, University Hospitals of Leicester NHS Trust.
  • Garton NJ; Department of Respiratory Sciences, University of Leicester.
  • Pareek M; Department of Respiratory Sciences, University of Leicester; Department of Infectious Diseases and HIV Medicine, University Hospitals of Leicester NHS Trust.
  • Barer MR; Department of Respiratory Sciences, University of Leicester; Department of Clinical Microbiology, University Hospitals of Leicester NHS Trust.
Clin Microbiol Infect ; 2022 Jul 14.
Article in English | MEDLINE | ID: covidwho-2234114
ABSTRACT

OBJECTIVES:

No studies have examined longitudinal patterns of naturally exhaled SARS-CoV-2 RNA viral load (VL) during acute infection. We report this using facemask sampling (FMS) and assessed the relationship between emitted RNA VL and household transmission.

METHODS:

Between December 2020 and February 2021, we recruited participants within 24 hours of a positive RT-qPCR on upper respiratory tract sampling (URTS) (day 0). Participants gave FMS (for 1 hour) and URTS (self-taken) on 7 occasions up to day 21. Samples were analysed by RT-qPCR (from sampling matrix strips within the mask) and symptom diaries recorded. Household transmission was assessed through reporting of positive URTS RT-qPCR in household contacts.

RESULTS:

Analysis of 203 FMS and 190 URTS from 34 participants showed that RNA VL peaked in the first five days following sampling. Concomitant URTS, FMS RNA VL and symptom scores however were poorly correlated, but a higher severity of reported symptoms was associated with FMS positivity up to day 5. Of 28 participants who had household contacts, 12 (43%) reported transmission. Frequency of household transmission was associated with the highest (peak) FMS RNA VL obtained (negative copies/strip 0% household transmission; 1-1000 copies/strip 20%; 1001 - 10,000 copies/strip 57%; >10,000 copies/strip 75%; p=0.048; age adjusted odds ratio of transmission per log increase in copies/strip 4.97; 95% CI 1.20-20.55, p=0.02) but this was not observed with peak URTS RNA VL.

CONCLUSIONS:

Exhaled RNA VL measured by FMS is highest in early infection, can be positive in symptomatic patients with concomitantly negative URTS and is strongly associated with household transmission.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study Topics: Long Covid Language: English Journal subject: Communicable Diseases / Microbiology Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study Topics: Long Covid Language: English Journal subject: Communicable Diseases / Microbiology Year: 2022 Document Type: Article