Abstract
SARS-CoV-2 infections are characterized by viral proliferation and clearance phases and can be followed by low-level persistent viral RNA shedding. The dynamics of viral RNA concentration, particularly in the early stages of infection, can inform clinical measures and interventions such as test-based screening. We used prospective longitudinal quantitative reverse transcription PCR testing to measure the viral RNA trajectories for 68 individuals during the resumption of the 2019–2020 National Basketball Association season. For 46 individuals with acute infections, we inferred the peak viral concentration and the duration of the viral proliferation and clearance phases. According to our mathematical model, we found that viral RNA concentrations peaked an average of 3.3 days (95% credible interval [CI] 2.5, 4.2) after first possible detectability at a cycle threshold value of 22.3 (95% CI 20.5, 23.9). The viral clearance phase lasted longer for symptomatic individuals (10.9 days [95% CI 7.9, 14.4]) than for asymptomatic individuals (7.8 days [95% CI 6.1, 9.7]). A second test within 2 days after an initial positive PCR test substantially improves certainty about a patient’s infection stage. The effective sensitivity of a test intended to identify infectious individuals declines substantially with test turnaround time. These findings indicate that SARS-CoV-2 viral concentrations peak rapidly regardless of symptoms. Sequential tests can help reveal a patient’s progress through infection stages. Frequent, rapid-turnaround testing is needed to effectively screen individuals before they become infectious.
Highlights
Introduction agreement forTempus and receives financialA critical strategy to curb the spread of SARS-CoV-2 is to rapidly identify and isolate infectious support from Tempus to develop SARS-CoV-2 diagnostic tests
According to our mathematical model, we found that viral RNA concentrations peaked an average of 3.3 days (95% credible interval [CI] 2.5, 4.2) after first possible detectability at a cycle threshold value of 22.3
This compares with 22.3 cycle threshold (Ct), 3.5 days, and 7.8 days, respectively, for individuals who did not report symptoms at the time of diagnosis (Fig 3)
Summary
A critical strategy to curb the spread of SARS-CoV-2 is to rapidly identify and isolate infectious support from Tempus to develop SARS-CoV-2 diagnostic tests. SMK, SWO, and YHG have a consulting agreement with the NBA. Because symptoms are an unreliable indicator of infectiousness and infections are frequently asymptomatic [1], testing is key to determining whether a person is infected and may be contagious. Real-time quantitative reverse transcription polymerase chain reaction. Can quantify the viral titer via the cycle threshold (Ct). The Ct is the number of thermal cycles needed to amplify sampled viral RNA to a detectable level: the higher the sampled viral
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