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奥密克戎变异株的传染性排出时间及其与症状的关系。

Duration of infectious shedding of SARS-CoV-2 Omicron variant and its relation with symptoms.

机构信息

Department of Infectious Diseases and Clinical Microbiology, Koç University School of Medicine, Istanbul, Turkey; Koç University-Isbank Center for Infectious Diseases, Turkey.

Koç University-Isbank Center for Infectious Diseases, Turkey.

出版信息

Clin Microbiol Infect. 2023 Feb;29(2):221-224. doi: 10.1016/j.cmi.2022.07.009. Epub 2022 Jul 16.

Abstract

OBJECTIVES

SARS-CoV-2 infections with Omicron variants have a high capability of human-to-human transmission. Nevertheless, the duration of isolation for mild cases was shortened to 5 to 7 days. We aimed to detect the duration of viral shedding among healthcare workers (HCWs) with Omicron by using viral culture.

METHODS

We prospectively included newly diagnosed nonsevere, symptomatic SARS-CoV-2 positive HCWs. Nasopharyngeal swab samples were obtained consecutively on days 5, 7,10, and 14 of onset of symptoms. The samples were examined by nucleic acid amplification test and viral culture.

RESULTS

In total, 55 non-severe patients with SARS-CoV-2 Omicron variant were included. The mean age of the population was 34 years (range, 23 to 54) and 78% (43/55) were female. The PCR positivity rate on days 5, 7, 10, and 14 was 96.4% (53/55), 87.3% (48/55), 74.545% (41/55), and 41.8% (23/55) consecutively, whereas the viral culture positivity rates were 83% (44/53), 52% (26/50), 13.5% (7/52), and 8% (4/50). Among the patients who became symptom-free, the viral culture positivity rates were 100% (4/4), 58% (7/12), 11% (3/27), and 5% (2/41).

DISCUSSION

We showed that among the SARS-CoV-2 Omicron variant infected patients, viral shedding continues for ≥10 days in 13.5% of all cases and 11% in symptom-free cases. The decision for cessation of isolation according to the presence of symptoms could be reconsidered until further studies disapprove of our results. Meanwhile, the infected HCWs who give care to high-risk patients for severe COVID-19 might extend their isolations ≤10 days after the onset of symptoms, regardless of their symptoms.

摘要

目的

感染奥密克戎变异株的 SARS-CoV-2 具有很强的人际传播能力。然而,轻度病例的隔离时间已缩短至 5 至 7 天。我们旨在通过病毒培养检测奥密克戎变异株感染的医护人员 (HCWs) 的病毒脱落持续时间。

方法

我们前瞻性纳入新诊断的非重症、有症状的 SARS-CoV-2 阳性 HCWs。在症状出现的第 5、7、10 和 14 天连续采集鼻咽拭子样本。使用核酸扩增试验和病毒培养法检测样本。

结果

共纳入 55 例非重症 SARS-CoV-2 奥密克戎变异株感染患者。人群平均年龄为 34 岁(范围,23 至 54 岁),78%(43/55)为女性。第 5、7、10 和 14 天的 PCR 阳性率分别为 96.4%(53/55)、87.3%(48/55)、74.545%(41/55)和 41.8%(23/55),病毒培养阳性率分别为 83%(44/53)、52%(26/50)、13.5%(7/52)和 8%(4/50)。在症状缓解的患者中,病毒培养阳性率分别为 100%(4/4)、58%(7/12)、11%(3/27)和 5%(2/41)。

讨论

我们发现,在奥密克戎变异株感染患者中,所有病例中有 13.5%、无症状病例中有 11%的病毒脱落持续时间≥10 天。根据症状决定停止隔离的决定可能需要重新考虑,直到进一步的研究证明我们的结果不可靠。同时,对于照顾 COVID-19 重症高危患者的感染 HCWs,无论症状如何,在症状出现后 10 天内可能需要延长隔离时间。

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