Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol Universitygrid.10223.32, Bangkok, Thailand.
Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol Universitygrid.10223.32, Bangkok, Thailand.
Microbiol Spectr. 2022 Jun 29;10(3):e0050322. doi: 10.1128/spectrum.00503-22. Epub 2022 May 23.
Determination of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infectivity is important in guiding the infection control and differentiating between reinfection and persistent viral RNA. Although viral culture is the gold standard to determine viral infectivity, the method is not practical. We studied the kinetics of SARS-CoV-2 total RNAs and subgenomic RNAs (sgRNAs) and their potential role as surrogate markers of viral infectivity. The kinetics of SARS-CoV-2 sgRNAs compared to those of the culture and total RNA shedding in a prospective cohort of patients diagnosed with coronavirus disease 2019 (COVID-19) were investigated. A total of 260 nasopharyngeal swabs from 36 patients were collected every other day after entering the study until the day of viral total RNA clearance, as measured by reverse transcription PCR (RT-PCR). Time to cessation of viral shedding was in order from shortest to longest: by viral culture, sgRNA RT-PCR, and total RNA RT-PCR. The median time (interquartile range) to negativity of viral culture, subgenomic N transcript, and N gene were 7 (5 to 9), 11 (9 to 16), and 18 (13 to 21) days, respectively ( < 0.001). Further analysis identified the receipt of steroid as the factors associated with longer duration of viral infectivity (hazard ratio, 3.28; 95% confidence interval, 1.02 to 10.61; = 0.047). We propose the potential role of the detection of SARS-CoV-2 subgenomic RNA as the surrogate marker of viral infectivity. Patients with negative subgenomic N RNA RT-PCR could be considered for ending isolation. Our study, combined with existing evidence, suggests the feasibility of the use of subgenomic RNA RT-PCR as a surrogate marker for SARS-CoV-2 infectivity. The kinetics of SARS-CoV-2 subgenomic RNA should be further investigated in immunocompromised patients.
确定严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)的感染力对于指导感染控制以及区分再感染和持续性病毒 RNA 非常重要。尽管病毒培养是确定病毒感染力的金标准,但该方法并不实用。我们研究了 SARS-CoV-2 总 RNA 和亚基因组 RNA(sgRNA)的动力学及其作为病毒感染力替代标志物的潜在作用。研究了在确诊为 2019 年冠状病毒病(COVID-19)的患者前瞻性队列中,SARS-CoV-2 sgRNA 的动力学与培养和总 RNA 脱落的关系。在研究开始后,每隔一天收集 36 名患者的 260 个鼻咽拭子,直到通过逆转录 PCR(RT-PCR)检测到总病毒 RNA 清除为止。病毒脱落停止的时间顺序最短到最长为:病毒培养、sgRNA RT-PCR 和总 RNA RT-PCR。病毒培养、亚基因组 N 转录物和 N 基因的阴性中位时间(四分位间距)分别为 7(5 至 9)、11(9 至 16)和 18(13 至 21)天(<0.001)。进一步分析发现,接受类固醇治疗是与病毒感染持续时间较长相关的因素(危险比,3.28;95%置信区间,1.02 至 10.61;=0.047)。我们提出了检测 SARS-CoV-2 亚基因组 RNA 作为病毒感染力替代标志物的潜在作用。亚基因组 N RNA RT-PCR 阴性的患者可考虑结束隔离。我们的研究结合现有证据表明,亚基因组 RNA RT-PCR 作为 SARS-CoV-2 感染力替代标志物具有可行性。应进一步研究免疫功能低下患者中 SARS-CoV-2 亚基因组 RNA 的动力学。
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