1
|
Levy ME, Burrows E, Chilunda V, Pawloski PA, Heaton PR, Grzymski J, Goldman JD, McEwen LM, Wyman D, Dei Rossi A, Dai H, Isaksson M, Washington NL, Basler T, Tsan K, Nguyen J, Ramirez J, Sandoval E, Lee W, Lu J, Luo S. SARS-CoV-2 Antiviral Prescribing Gaps Among Non-Hospitalized High-Risk Adults. Clin Infect Dis 2024:ciad796. [PMID: 38170452 DOI: 10.1093/cid/ciad796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/07/2023] [Accepted: 12/29/2023] [Indexed: 01/05/2024] Open
Abstract
Within a multi-state clinical cohort, SARS-CoV-2 antiviral prescribing patterns were evaluated from April 2022-June 2023 among non-hospitalized SARS-CoV-2-infected patients with risk factors for severe COVID-19. Among 3,247 adults, only 31.9% were prescribed an antiviral agent (87.6% nirmatrelvir/ritonavir, 11.9% molnupiravir, 0.5% remdesivir), highlighting the need to identify and address treatment barriers.
Collapse
Affiliation(s)
| | | | | | | | - Phillip R Heaton
- Department of Pathology and Laboratory Medicine, HealthPartners, Bloomington, Minnesota, USA
| | - Joseph Grzymski
- Department of Internal Medicine, University of Nevada Reno, School of Medicine, Reno, Nevada, USA
- Renown Health, Reno, Nevada, USA
| | - Jason D Goldman
- Providence St. Joseph Health System, Renton, Washington, USA
- Swedish Center for Research and Innovation, Swedish Medical Center, Seattle, Washington, USA
- Division of Infectious Disease, University of Washington, Seattle, Washington, USA
| | | | | | | | - Hang Dai
- Helix, San Mateo, California, USA
| | | | | | | | | | | | | | | | | | - James Lu
- Helix, San Mateo, California, USA
| | | |
Collapse
|
2
|
Bolze A, Basler T, White S, Dei Rossi A, Wyman D, Dai H, Roychoudhury P, Greninger AL, Hayashibara K, Beatty M, Shah S, Stous S, McCrone JT, Kil E, Cassens T, Tsan K, Nguyen J, Ramirez J, Carter S, Cirulli ET, Schiabor Barrett K, Washington NL, Belda-Ferre P, Jacobs S, Sandoval E, Becker D, Lu JT, Isaksson M, Lee W, Luo S. Evidence for SARS-CoV-2 Delta and Omicron co-infections and recombination. Med (N Y) 2022; 3:848-859.e4. [PMID: 36332633 PMCID: PMC9581791 DOI: 10.1016/j.medj.2022.10.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/14/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Between November 2021 and February 2022, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta and Omicron variants co-circulated in the United States, allowing for co-infections and possible recombination events. METHODS We sequenced 29,719 positive samples during this period and analyzed the presence and fraction of reads supporting mutations specific to either the Delta or Omicron variant. FINDINGS We identified 18 co-infections, one of which displayed evidence of a low Delta-Omicron recombinant viral population. We also identified two independent cases of infection by a Delta-Omicron recombinant virus, where 100% of the viral RNA came from one clonal recombinant. In the three cases, the 5' end of the viral genome was from the Delta genome and the 3' end from Omicron, including the majority of the spike protein gene, though the breakpoints were different. CONCLUSIONS Delta-Omicron recombinant viruses were rare, and there is currently no evidence that Delta-Omicron recombinant viruses are more transmissible between hosts compared with the circulating Omicron lineages. FUNDING This research was supported by the NIH RADx initiative and by the Centers for Disease Control Contract 75D30121C12730 (Helix).
Collapse
Affiliation(s)
| | | | | | | | | | | | - Pavitra Roychoudhury
- Department of Laboratory Medicine and Pathology, University of Washington Medical Center, Seattle, WA 98195, USA
| | - Alexander L Greninger
- Department of Laboratory Medicine and Pathology, University of Washington Medical Center, Seattle, WA 98195, USA
| | | | - Mark Beatty
- County of San Diego Health and Human Services, San Diego, CA 92110, USA
| | - Seema Shah
- County of San Diego Health and Human Services, San Diego, CA 92110, USA
| | - Sarah Stous
- County of San Diego Health and Human Services, San Diego, CA 92110, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
3
|
Bolze A, Luo S, White S, Cirulli ET, Wyman D, Dei Rossi A, Machado H, Cassens T, Jacobs S, Schiabor Barrett KM, Tanudjaja F, Tsan K, Nguyen J, Ramirez JM, Sandoval E, Wang X, Wong D, Becker D, Laurent M, Lu JT, Isaksson M, Washington NL, Lee W. SARS-CoV-2 variant Delta rapidly displaced variant Alpha in the United States and led to higher viral loads. Cell Rep Med 2022; 3:100564. [PMID: 35474739 PMCID: PMC8922438 DOI: 10.1016/j.xcrm.2022.100564] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 01/10/2022] [Accepted: 02/17/2022] [Indexed: 11/22/2022]
Abstract
We report on the sequencing of 74,348 SARS-CoV-2 positive samples collected across the United States and show that the Delta variant, first detected in the United States in March 2021, made up the majority of SARS-CoV-2 infections by July 1, 2021 and accounted for >99.9% of the infections by September 2021. Not only did Delta displace variant Alpha, which was the dominant variant at the time, it also displaced the Gamma, Iota, and Mu variants. Through an analysis of quantification cycle (Cq) values, we demonstrate that Delta infections tend to have a 1.7× higher viral load compared to Alpha infections (a decrease of 0.8 Cq) on average. Our results are consistent with the hypothesis that the increased transmissibility of the Delta variant could be due to the ability of the Delta variant to establish a higher viral load earlier in the infection as compared to the Alpha variant. Alpha was dominant in spring 2021 and went extinct in fall 2021 in the United States Delta also displaced Gamma, Iota, and Mu variants On average, viral load was ∼1.7× higher in Delta infections versus Alpha infections
Collapse
|