Spatial and Temporal Virus Load Dynamics of SARS-CoV-2: A Single-Center Cohort Study.

Enagnon Alidjinou,Julien Poissy,Claire Tinez,Sébastien Preau,Saad Nseir,Ilyes Benhalima,Karine Faure,Marc Lambert,Ilka Engelmann,Didier Hober,Julien Goutay,Morgan Caplan,Cécile Yelnik,Marie-Charlotte Chopin,Mahdi Ouafi

doi:10.3390/diagnostics11030427

Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused an ongoing pandemic. Reverse transcription polymerase chain reaction (RT-PCR) is the gold standard for the detection of SARS-CoV-2 and has been applied to different specimen types. Understanding the virus load and virus detection frequency in different specimen types is important to improve diagnosis and estimate the duration of potential infectivity. We conducted a retrospective single-center cohort study on hospitalized and outpatients with SARS-CoV-2 infection. We analyzed the frequency of virus detection, virus load, and duration of the virus excretion in upper and lower respiratory specimens as well as stool and plasma. We found that the frequency of SARS-CoV-2 detection, the virus load, and duration of virus excretion was higher in lower respiratory tract (LRT) than in upper respiratory tract (URT) specimens. The duration of virus excretion was longer in patients requiring intensive care unit (ICU) admission. In conclusion, LRT specimens are the most appropriate specimen type for the detection and follow-up of SARS-CoV-2 infection. Duration of virus excretion is longer in severe cases of SARS-CoV-2 infection.

Highlights

A novel coronavirus, later named SARS-CoV-2, associated with severe acute respiratory syndromes, emerged in Wuhan, China at the end of 2019 [1,2] and rapidly spread worldwide to cause a pandemic with over 77 million cases and 1.7 million deaths reported as of 22 December 2020 [3]
Our results found that 383/433 (88.5%) of patients had SARS-CoV-2 RNA detected in the upper respiratory tract (URT), 329/333 (98.8%) had SARS-CoV-2 RNA detected in the lower respiratory tract (LRT), 67/133 (50.4%) had SARS-CoV-2 RNA detected in stool, and 14/54 (25.9%) had SARS-CoV-2 RNA detected in plasma
There was an inverse correlation of Ct values with cohort are representative of the virus load kinetics in individual patients, nine patients time after symptom onset (p < 0.0001 for URT and LRT specimens and p = 0.005 for stool who had several follow-up specimens of different specimen types were analyzed in despecimens; Spearman r = 0.56, 95% confidence interval (CI95) 0.51–0.61 for URT specimens; tail

Summary

Introduction

A novel coronavirus, later named SARS-CoV-2, associated with severe acute respiratory syndromes, emerged in Wuhan, China at the end of 2019 [1,2] and rapidly spread worldwide to cause a pandemic with over 77 million cases and 1.7 million deaths reported as of 22 December 2020 [3]. Virological diagnosis is based on detection of viral RNA by RT-PCR [4]. Several laboratories have developed RT-PCR assays available to perform SARSCoV-2 RNA detection. The optimal specimen type for diagnosis has yet to be determined. A detailed knowledge of the temporo-spatial virus load kinetics is necessary to determine which specimen type is the most useful for diagnosis. Since the beginning of the pandemic, a lot of studies have been published on small case series or small patient cohorts focusing mainly on the kinetics of viral detection in hospitalized patients with SARS-CoV-2 [6,7,8,9], reviewed in [10]

Methods

Results

Conclusion