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Davies M, Bramwell LR, Jeffery N, Bunce B, Lee BP, Knight B, Auckland C, Masoli JA, Harries LW. Persistence of clinically-relevant levels of SARS-CoV2 envelope gene subgenomic RNAs in non-immunocompromised individuals. Int J Infect Dis 2021; 116:418-425. [PMID: 34890790 PMCID: PMC8757659 DOI: 10.1016/j.ijid.2021.12.312] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 11/29/2021] [Accepted: 12/02/2021] [Indexed: 11/19/2022] Open
Abstract
Objectives This study aimed to evaluate the associations between COVID-19 severity and active viral load, and to characterize the dynamics of active SARS-CoV-2 clearance in a series of archival samples taken from patients in the first wave of COVID-19 infection in the South West of the UK. Methods Subgenomic RNA (sgRNA) and E-gene genomic sequences were measured in a retrospective collection of PCR-confirmed SARS-CoV-2-positive samples from 176 individuals, and related to disease severity. Viral clearance dynamics were then assessed in relation to symptom onset and last positive test. Results Whilst E-gene sgRNAs declined before E-gene genomic sequences, some individuals retained sgRNA positivity for up to 68 days. 13% of sgRNA-positive cases still exhibited clinically relevant levels of virus after 10 days, with no clinical features previously associated with prolonged viral clearance times. Conclusions Our results suggest that potentially active virus can sometimes persist beyond a 10-day period, and could pose a potential risk of onward transmission. Where this would pose a serious public health threat, additional mitigation strategies may be necessary to reduce the risk of secondary cases in vulnerable settings.
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Affiliation(s)
- Merlin Davies
- Institute of Clinical and Biomedical Sciences, University of Exeter, RILD building, Royal Devon and Exeter Hospital (Wonford), Barrack Road, Exeter, UK
| | - Laura R Bramwell
- Institute of Clinical and Biomedical Sciences, University of Exeter, RILD building, Royal Devon and Exeter Hospital (Wonford), Barrack Road, Exeter, UK
| | - Nicola Jeffery
- Institute of Clinical and Biomedical Sciences, University of Exeter, RILD building, Royal Devon and Exeter Hospital (Wonford), Barrack Road, Exeter, UK
| | - Ben Bunce
- NIHR Exeter Clinical Research Facility, Royal Devon and Exeter NHS Foundation Trust, Royal Devon and Exeter Hospital, Barrack Road, Exeter, UK
| | - Ben P Lee
- Institute of Clinical and Biomedical Sciences, University of Exeter, RILD building, Royal Devon and Exeter Hospital (Wonford), Barrack Road, Exeter, UK
| | - Bridget Knight
- NIHR Exeter Clinical Research Facility, Royal Devon and Exeter NHS Foundation Trust, Royal Devon and Exeter Hospital, Barrack Road, Exeter, UK
| | - Cressida Auckland
- Microbiology Department, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Jane Ah Masoli
- Institute of Clinical and Biomedical Sciences, University of Exeter, RILD building, Royal Devon and Exeter Hospital (Wonford), Barrack Road, Exeter, UK; Healthcare for Older People, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Lorna W Harries
- Institute of Clinical and Biomedical Sciences, University of Exeter, RILD building, Royal Devon and Exeter Hospital (Wonford), Barrack Road, Exeter, UK.
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