Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Influenza Other Respir Viruses. 2024 Jun;18(6):e13318. doi: 10.1111/irv.13318.
Understanding how symptoms are associated with SARS-CoV-2 culture positivity is important for isolation and transmission control guidelines.
Individuals acutely infected with SARS-CoV-2 in Tennessee and their household contacts were recruited into a prospective study. All participants self-collected nasal swabs daily for 14 days and completed symptom diaries from the day of illness onset through day 14 postenrollment. Nasal specimens were tested for SARS-CoV-2 using RT-qPCR. Positive specimens with cycle threshold values < 40 were sent to the Centers for Disease Control and Prevention (CDC) for viral culture. First, we modeled the association between symptoms and the risk of culture positivity using an age-adjusted generalized additive model (GAM) accounting for repeated measurements within participants and a symptom-day spline. Next, we investigated how timing of symptom resolution was associated with the timing of culture resolution.
In a GAM restricted to follow-up days after symptoms began, the odds of a specimen being culture positive was significantly increased on days when wheezing, loss of taste or smell, runny nose, nasal congestion, sore throat, fever, or any symptom were reported. For all symptoms except sore throat, it was more common for participants to have culture resolution before symptom resolution than for culture to resolve after or on the same day as symptom resolution.
Overall, symptomatic individuals were more likely to be SARS-CoV-2 viral culture positive. For most symptoms, culture positivity was more likely to end before symptoms resolved. However, a proportion of individuals remained culture positive after symptom resolved, across all symptoms.
了解症状与 SARS-CoV-2 培养阳性之间的关联对于隔离和传播控制指南很重要。
田纳西州急性感染 SARS-CoV-2 的个体及其家庭接触者被招募到一项前瞻性研究中。所有参与者每天自我采集鼻拭子，共采集 14 天，并在发病当天至第 14 天入组后完成症状日记。使用 RT-qPCR 检测鼻拭子中的 SARS-CoV-2。循环阈值<40 的阳性标本被送往疾病预防控制中心（CDC）进行病毒培养。首先，我们使用年龄调整广义加性模型（GAM）对症状与培养阳性风险之间的关联进行建模，该模型考虑了参与者内部的重复测量和症状日样条。接下来，我们调查了症状消退的时间与培养消退的时间之间的关系。
在仅针对症状开始后随访日的 GAM 中，出现喘息、味觉或嗅觉丧失、流涕、鼻塞、喉咙痛、发热或任何症状的那天，标本培养阳性的可能性显著增加。除了喉咙痛，对于大多数症状，培养结果在症状消退之前得到解决的情况比培养结果在症状消退之后或同一天得到解决的情况更为常见。
总体而言，有症状的个体更有可能成为 SARS-CoV-2 病毒培养阳性。对于大多数症状，培养阳性更有可能在症状消退之前结束。然而，在所有症状中，仍有一部分人在症状消退后仍保持培养阳性。
