Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China.
Guangzhou Laboratory, Bio-Island, Guangzhou, China.
J Med Virol. 2023 Jan;95(1):e28219. doi: 10.1002/jmv.28219. Epub 2022 Oct 20.
Retest-positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral RNA, as a unique phenomenon among discharged individuals, has been demonstrated to be safe in the community. Still, the underlying mechanism of viral lingering is less investigated. In this study, first, we find that the frequency of viral RNA-positive retesting differs among variants. Higher ratios of viral RNA-positive retest were more frequently observed among Delta (61.41%, 514 of 837 cases) and Omicron (39.53%, 119 of 301 cases) infections than among ancestral viral infection (7.27%, 21 of 289 cases). Second, the tissues where viral RNA reoccurred were altered. Delta RNA reoccurred mainly in the upper respiratory tract (90%), but ancestral virus RNA reoccurred mainly in the gastrointestinal tract (71%). Third, vaccination did not reduce the frequency of viral RNA-positive retests, despite high concentrations of viral-specific antibodies in the blood. Finally, 37 of 55 (67.27%) Delta-infected patients receiving neutralizing antibody therapy become viral RNA retest positive when high concentrations of neutralizing antibodies still patrol in the blood. Altogether, our findings suggest that the presentence of high titers of neutralizing antibodies in the blood is incompetent in clearing residual viral RNA in the upper respiratory tract.
再检测呈阳性的严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）病毒 RNA，作为一种已出院个体中特有的现象，已被证明在社区中是安全的。然而，病毒持续存在的潜在机制尚未得到充分研究。在这项研究中，首先，我们发现不同变体的病毒 RNA 再检测阳性率存在差异。Delta（61.41%，837 例中的 514 例）和奥密克戎（39.53%，301 例中的 119 例）感染中再检测阳性率更高，而原始病毒感染中再检测阳性率较低（7.27%，289 例中的 21 例）。其次，病毒 RNA 再次出现的组织发生了改变。Delta RNA 主要在上呼吸道重新出现（90%），而原始病毒 RNA 主要在上消化道重新出现（71%）。第三，尽管血液中存在高浓度的病毒特异性抗体，但疫苗接种并不能降低病毒 RNA 再检测阳性率。最后，接受中和抗体治疗的 55 例 Delta 感染患者中有 37 例在血液中仍存在高浓度中和抗体时再次出现病毒 RNA 阳性。总的来说，我们的发现表明，血液中高滴度的中和抗体并不能清除上呼吸道中残留的病毒 RNA。
