Delayed rise of oral fluid antibodies, elevated BMI, and absence of early fever correlate with longer time to SARS-CoV-2 RNA clearance in an longitudinally sampled cohort of COVID-19 outpatients

ABSTRACT Background Sustained molecular detection of SARS-CoV-2 RNA in the upper respiratory tract (URT) in mild to moderate COVID-19 is common. We sought to identify host and immune determinants of prolonged SARS-CoV-2 RNA detection.Methods Ninety-five outpatients self-collected mid-turbinate nasal, oropharyngeal (OP), and gingival crevicular fluid (oral fluid) samples at home and in a research clinic a median of 6 times over 1-3 months. Samples were tested for viral RNA, virus culture, and SARS-CoV-2 and other human coronavirus antibodies, and associations were estimated using Cox proportional hazards models.Results Viral RNA clearance, as measured by SARS-CoV-2 RT-PCR, in 507 URT samples occurred a median (IQR) 33.5 (17-63.5) days post-symptom onset. Sixteen nasal-OP samples collected 2-11 days post-symptom onset were virus culture positive out of 183 RT-PCR positive samples tested. All participants but one with positive virus culture were negative for concomitant oral fluid anti-SARS-CoV-2 antibodies. The mean time to first antibody detection in oral fluid was 8-13 days post-symptom onset. A longer time to first detection of oral fluid anti-SARS-CoV-2 S antibodies (aHR 0.96, 95% CI 0.92-0.99, p=0.020) and BMI ≥ 25kg/m2 (aHR 0.37, 95% CI 0.18-0.78, p=0.009) were independently associated with a longer time to SARS-CoV-2 viral RNA clearance. Fever as one of first three COVID-19 symptoms correlated with shorter time to viral RNA clearance (aHR 2.06, 95% CI 1.02-4.18, p=0.044).Conclusions We demonstrate that delayed rise of oral fluid SARS-CoV-2-specific antibodies, elevated BMI, and absence of early fever are independently associated with delayed URT viral RNA clearance..

Medienart:

Preprint

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

bioRxiv.org - (2021) vom: 15. Dez. Zur Gesamtaufnahme - year:2021

Sprache:

Englisch

Beteiligte Personen:

Antar, Annukka A. R. [VerfasserIn]
Yu, Tong [VerfasserIn]
Pisanic, Nora [VerfasserIn]
Azamfirei, Razvan [VerfasserIn]
Tornheim, Jeffrey A. [VerfasserIn]
Brown, Diane M. [VerfasserIn]
Kruczynski, Kate [VerfasserIn]
Hardick, Justin P. [VerfasserIn]
Sewell, Thelio [VerfasserIn]
Jang, Minyoung [VerfasserIn]
Church, Taylor [VerfasserIn]
Walch, Samantha N. [VerfasserIn]
Reuland, Carolyn [VerfasserIn]
Bachu, Vismaya S. [VerfasserIn]
Littlefield, Kirsten [VerfasserIn]
Park, Han-Sol [VerfasserIn]
Ursin, Rebecca L. [VerfasserIn]
Ganesan, Abhinaya [VerfasserIn]
Kusemiju, Oyinkansola [VerfasserIn]
Barnaba, Brittany [VerfasserIn]
Charles, Curtisha [VerfasserIn]
Prizzi, Michelle [VerfasserIn]
Johnstone, Jaylynn R. [VerfasserIn]
Payton, Christine [VerfasserIn]
Dai, Weiwei [VerfasserIn]
Fuchs, Joelle [VerfasserIn]
Massaccesi, Guido [VerfasserIn]
Armstrong, Derek T. [VerfasserIn]
Townsend, Jennifer L. [VerfasserIn]
Keller, Sara C. [VerfasserIn]
Demko, Zoe O [VerfasserIn]
Hu, Chen [VerfasserIn]
Wang, Mei-Cheng [VerfasserIn]
Sauer, Lauren M. [VerfasserIn]
Mostafa, Heba H. [VerfasserIn]
Keruly, Jeanne C. [VerfasserIn]
Mehta, Shruti H. [VerfasserIn]
Klein, Sabra L. [VerfasserIn]
Cox, Andrea L. [VerfasserIn]
Pekosz, Andrew [VerfasserIn]
Heaney, Christopher D. [VerfasserIn]
Thomas, David L. [VerfasserIn]
Blair, Paul W. [VerfasserIn]
Manabe, Yukari C. [VerfasserIn]

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doi:

10.1101/2021.03.02.21252420

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

XBI020068484