Viral dynamics of acute SARS-CoV-2 infection and applications to diagnostic and public health strategies.
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-base...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2021-07-01
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| Series: | PLoS Biology |
| Online Access: | https://journals.plos.org/plosbiology/article/file?id=10.1371/journal.pbio.3001333&type=printable |
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| author | Stephen M Kissler Joseph R Fauver Christina Mack Scott W Olesen Caroline Tai Kristin Y Shiue Chaney C Kalinich Sarah Jednak Isabel M Ott Chantal B F Vogels Jay Wohlgemuth James Weisberger John DiFiori Deverick J Anderson Jimmie Mancell David D Ho Nathan D Grubaugh Yonatan H Grad |
| author_facet | Stephen M Kissler Joseph R Fauver Christina Mack Scott W Olesen Caroline Tai Kristin Y Shiue Chaney C Kalinich Sarah Jednak Isabel M Ott Chantal B F Vogels Jay Wohlgemuth James Weisberger John DiFiori Deverick J Anderson Jimmie Mancell David D Ho Nathan D Grubaugh Yonatan H Grad |
| author_sort | Stephen M Kissler |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-01f7e7f6f2cf4783ad7919da296f0587 |
| institution | OA Journals |
| issn | 1544-9173 1545-7885 |
| language | English |
| publishDate | 2021-07-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Biology |
| spelling | doaj-art-01f7e7f6f2cf4783ad7919da296f05872025-08-20T02:18:24ZengPublic Library of Science (PLoS)PLoS Biology1544-91731545-78852021-07-01197e300133310.1371/journal.pbio.3001333Viral dynamics of acute SARS-CoV-2 infection and applications to diagnostic and public health strategies.Stephen M KisslerJoseph R FauverChristina MackScott W OlesenCaroline TaiKristin Y ShiueChaney C KalinichSarah JednakIsabel M OttChantal B F VogelsJay WohlgemuthJames WeisbergerJohn DiFioriDeverick J AndersonJimmie MancellDavid D HoNathan D GrubaughYonatan H GradSARS-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.https://journals.plos.org/plosbiology/article/file?id=10.1371/journal.pbio.3001333&type=printable |
| spellingShingle | Stephen M Kissler Joseph R Fauver Christina Mack Scott W Olesen Caroline Tai Kristin Y Shiue Chaney C Kalinich Sarah Jednak Isabel M Ott Chantal B F Vogels Jay Wohlgemuth James Weisberger John DiFiori Deverick J Anderson Jimmie Mancell David D Ho Nathan D Grubaugh Yonatan H Grad Viral dynamics of acute SARS-CoV-2 infection and applications to diagnostic and public health strategies. PLoS Biology |
| title | Viral dynamics of acute SARS-CoV-2 infection and applications to diagnostic and public health strategies. |
| title_full | Viral dynamics of acute SARS-CoV-2 infection and applications to diagnostic and public health strategies. |
| title_fullStr | Viral dynamics of acute SARS-CoV-2 infection and applications to diagnostic and public health strategies. |
| title_full_unstemmed | Viral dynamics of acute SARS-CoV-2 infection and applications to diagnostic and public health strategies. |
| title_short | Viral dynamics of acute SARS-CoV-2 infection and applications to diagnostic and public health strategies. |
| title_sort | viral dynamics of acute sars cov 2 infection and applications to diagnostic and public health strategies |
| url | https://journals.plos.org/plosbiology/article/file?id=10.1371/journal.pbio.3001333&type=printable |
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