Karolinska University Laboratory, Karolinska University Hospital, Stockholm, Sweden.
Karolinska University Hospital, Stockholm, Sweden.
J Infect Dis. 2021 Jul 2;224(1):14-20. doi: 10.1093/infdis/jiab099.
Whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positivity among asymptomatic subjects reflects past or future disease may be difficult to ascertain.
We tested 9449 employees at Karolinska University Hospital, Stockholm, Sweden for SARS-CoV-2 RNA and antibodies, linked the results to sick leave records, and determined associations with past or future sick leave using multinomial logistic regression.
Subjects with high amounts of SARS-CoV-2 virus, indicated by polymerase chain reaction (PCR) cycle threshold (Ct) value, had the highest risk for sick leave in the 2 weeks after testing (odds ratio [OR], 11.97; 95% confidence interval [CI], 6.29-22.80) whereas subjects with low amounts of virus had the highest risk for sick leave in the 3 weeks before testing (OR, 6.31; 95% CI, 4.38-9.08). Only 2.5% of employees were SARS-CoV-2 positive while 10.5% were positive by serology and 1.2% were positive in both tests. Serology-positive subjects were not at excess risk for future sick leave (OR, 1.06; 95% CI, .71-1.57).
High amounts of SARS-CoV-2 virus, as determined using PCR Ct values, was associated with development of sickness in the next few weeks. Results support the concept that PCR Ct may be informative when testing for SARS-CoV-2. Clinical Trials Registration. NCT04411576.
无症状个体中严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）阳性是否反映过去或未来的疾病可能难以确定。
我们在瑞典斯德哥尔摩卡罗林斯卡大学医院对 9449 名员工进行了 SARS-CoV-2 RNA 和抗体检测，将结果与病假记录相关联，并使用多项逻辑回归确定与过去或未来病假的关联。
聚合酶链反应（PCR）循环阈值（Ct）值高的 SARS-CoV-2 病毒含量高的受试者在检测后 2 周内病假风险最高（优势比[OR]，11.97；95%置信区间[CI]，6.29-22.80），而病毒含量低的受试者在检测前 3 周内病假风险最高（OR，6.31；95%CI，4.38-9.08）。只有 2.5%的员工 SARS-CoV-2 呈阳性，而 10.5%的员工血清学呈阳性，1.2%的员工两种检测均呈阳性。血清学阳性的受试者未来病假的风险没有增加（OR，1.06；95%CI，0.71-1.57）。
使用 PCR Ct 值确定的大量 SARS-CoV-2 病毒与未来几周内疾病的发生有关。结果支持 PCR Ct 在检测 SARS-CoV-2 时可能具有信息性的概念。临床试验注册。NCT04411576。
