Vlaming-van Eijk Larissa E, Ertugrul Imran A, Upasani Vinit, Wold Karin I, Vincenti-Gonzalez María F, Veloo Alida C M, Bourgonje Arno R, Pantano Daniele, Gard Lilli, de Boer Gerolf, Niesters Hubert G M, Friedrich Alexander W, Knoester Marjolein, van der Gun Bernardina T F, Rodenhuis-Zybert Izabela A, Tami Adriana
Department of Pathology and Medical Biology, Division of Pathology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Department of Cardiothoracic Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
J Med Virol. 2024 Dec;96(12):e70125. doi: 10.1002/jmv.70125.
Understanding temporal patterns and determinants of RNA shedding is important to comprehend SARS-CoV-2 transmission and improve biosafety/isolation guidelines. Nonhospitalized SARS-CoV-2-infected individuals and household members were enrolled between March 2020 and June 2021 and followed prospectively ≥ 3 weeks during acute disease and at 3-, 6-, 12-, and 18-months to obtain (para)clinical data and biospecimens. Flow cytometry-based surrogate assay (FlowSA) detected viable SARS-CoV-2. Determinants of long RNA shedding ( ≥ 21 days) were investigated. RNA shedding median duration was 14 days (IQR 8.0-21.0) for nasopharyngeal/throat (NPT) and 7 days (IQR 1.0-27.0) for feces- but 20 days (IQR 7.0-27.8) when excluding individuals positive at a single timepoint (25.2%). Among 17 NPT long shedders with FlowSA results, 12 (70.6%) demonstrated viable virus. NPT long shedding was independently positively associated with endocrine disease and chills. Fecal long shedding was independently inversely associated with age, female sex, and fatigue, but positively with vomiting. No associations with long-term COVID-19-related complaints were observed. Finally, fecal long shedders demonstrated higher anti-spike(S1) IgG levels over 18-month follow-up than non-long shedders (p = 0.006). (Long) SARS-CoV-2 RNA shedding in NPT and feces associates with age and acute-but not prolonged-symptoms. The roles of prolonged infectious shedding and fecal shedding in transmission and immunity remain unclear.
了解新冠病毒RNA脱落的时间模式和决定因素对于理解新冠病毒传播及完善生物安全/隔离指南至关重要。2020年3月至2021年6月期间招募了非住院的新冠病毒感染个体及其家庭成员，并在急性疾病期间及3个月、6个月、12个月和18个月时进行前瞻性随访≥3周，以获取（准）临床数据和生物样本。基于流式细胞术的替代检测方法（FlowSA）用于检测活的新冠病毒。对长期RNA脱落（≥21天）的决定因素进行了研究。鼻咽/咽喉（NPT）的RNA脱落中位持续时间为14天（四分位间距8.0 - 21.0），粪便为7天（四分位间距1.0 - 27.0），但排除单次检测呈阳性的个体（25.2%）后为20天（四分位间距7.0 - 27.8）。在17名有FlowSA检测结果的NPT长期脱落者中，12名（70.6%）检测到活病毒。NPT长期脱落与内分泌疾病和寒战独立正相关。粪便长期脱落与年龄、女性性别和疲劳独立负相关，但与呕吐正相关。未观察到与长期新冠相关症状的关联。最后，在18个月的随访中，粪便长期脱落者的抗刺突蛋白（S1）IgG水平高于非长期脱落者（p = 0.006）。NPT和粪便中（长期）新冠病毒RNA脱落与年龄及急性症状相关，但与长期症状无关。长期传染性脱落和粪便脱落在传播及免疫中的作用仍不清楚。
Zotero 插件