Combined analyses of within-host SARS-CoV-2 viral kinetics and information on past exposures to the virus in a human cohort identifies intrinsic differences of Omicron and Delta variants.

The emergence of successive Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) variants of concern (VOCs) during 2020 to 2022, each exhibiting increased epidemic growth relative to earlier circulating variants, has created a need to understand the drivers of such growth. However, both path...

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Main Authors: Timothy W Russell, Hermaleigh Townsley, Sam Abbott, Joel Hellewell, Edward J Carr, Lloyd A C Chapman, Rachael Pung, Billy J Quilty, David Hodgson, Ashley S Fowler, Lorin Adams, Chris Bailey, Harriet V Mears, Ruth Harvey, Bobbi Clayton, Nicola O'Reilly, Yenting Ngai, Jerome Nicod, Steve Gamblin, Bryan Williams, Sonia Gandhi, Charles Swanton, Rupert Beale, David L V Bauer, Emma C Wall, Adam J Kucharski
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2024-01-01
Series:PLoS Biology
Online Access:https://journals.plos.org/plosbiology/article/file?id=10.1371/journal.pbio.3002463&type=printable
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author Timothy W Russell
Hermaleigh Townsley
Sam Abbott
Joel Hellewell
Edward J Carr
Lloyd A C Chapman
Rachael Pung
Billy J Quilty
David Hodgson
Ashley S Fowler
Lorin Adams
Chris Bailey
Harriet V Mears
Ruth Harvey
Bobbi Clayton
Nicola O'Reilly
Yenting Ngai
Jerome Nicod
Steve Gamblin
Bryan Williams
Sonia Gandhi
Charles Swanton
Rupert Beale
David L V Bauer
Emma C Wall
Adam J Kucharski
author_facet Timothy W Russell
Hermaleigh Townsley
Sam Abbott
Joel Hellewell
Edward J Carr
Lloyd A C Chapman
Rachael Pung
Billy J Quilty
David Hodgson
Ashley S Fowler
Lorin Adams
Chris Bailey
Harriet V Mears
Ruth Harvey
Bobbi Clayton
Nicola O'Reilly
Yenting Ngai
Jerome Nicod
Steve Gamblin
Bryan Williams
Sonia Gandhi
Charles Swanton
Rupert Beale
David L V Bauer
Emma C Wall
Adam J Kucharski
author_sort Timothy W Russell
collection DOAJ
description The emergence of successive Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) variants of concern (VOCs) during 2020 to 2022, each exhibiting increased epidemic growth relative to earlier circulating variants, has created a need to understand the drivers of such growth. However, both pathogen biology and changing host characteristics-such as varying levels of immunity-can combine to influence replication and transmission of SARS-CoV-2 within and between hosts. Disentangling the role of variant and host in individual-level viral shedding of VOCs is essential to inform Coronavirus Disease 2019 (COVID-19) planning and response and interpret past epidemic trends. Using data from a prospective observational cohort study of healthy adult volunteers undergoing weekly occupational health PCR screening, we developed a Bayesian hierarchical model to reconstruct individual-level viral kinetics and estimate how different factors shaped viral dynamics, measured by PCR cycle threshold (Ct) values over time. Jointly accounting for both interindividual variation in Ct values and complex host characteristics-such as vaccination status, exposure history, and age-we found that age and number of prior exposures had a strong influence on peak viral replication. Older individuals and those who had at least 5 prior antigen exposures to vaccination and/or infection typically had much lower levels of shedding. Moreover, we found evidence of a correlation between the speed of early shedding and duration of incubation period when comparing different VOCs and age groups. Our findings illustrate the value of linking information on participant characteristics, symptom profile and infecting variant with prospective PCR sampling, and the importance of accounting for increasingly complex population exposure landscapes when analysing the viral kinetics of VOCs. Trial Registration: The Legacy study is a prospective observational cohort study of healthy adult volunteers undergoing weekly occupational health PCR screening for SARS-CoV-2 at University College London Hospitals or at the Francis Crick Institute (NCT04750356) (22,23). The Legacy study was approved by London Camden and Kings Cross Health Research Authority Research and Ethics committee (IRAS number 286469). The Legacy study was approved by London Camden and Kings Cross Health Research Authority Research and Ethics committee (IRAS number 286469) and is sponsored by University College London Hospitals. Written consent was given by all participants.
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spelling doaj-art-cfe2aa3e3c23488697cdd2e92920d4292025-08-20T02:22:59ZengPublic Library of Science (PLoS)PLoS Biology1544-91731545-78852024-01-01221e300246310.1371/journal.pbio.3002463Combined analyses of within-host SARS-CoV-2 viral kinetics and information on past exposures to the virus in a human cohort identifies intrinsic differences of Omicron and Delta variants.Timothy W RussellHermaleigh TownsleySam AbbottJoel HellewellEdward J CarrLloyd A C ChapmanRachael PungBilly J QuiltyDavid HodgsonAshley S FowlerLorin AdamsChris BaileyHarriet V MearsRuth HarveyBobbi ClaytonNicola O'ReillyYenting NgaiJerome NicodSteve GamblinBryan WilliamsSonia GandhiCharles SwantonRupert BealeDavid L V BauerEmma C WallAdam J KucharskiThe emergence of successive Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) variants of concern (VOCs) during 2020 to 2022, each exhibiting increased epidemic growth relative to earlier circulating variants, has created a need to understand the drivers of such growth. However, both pathogen biology and changing host characteristics-such as varying levels of immunity-can combine to influence replication and transmission of SARS-CoV-2 within and between hosts. Disentangling the role of variant and host in individual-level viral shedding of VOCs is essential to inform Coronavirus Disease 2019 (COVID-19) planning and response and interpret past epidemic trends. Using data from a prospective observational cohort study of healthy adult volunteers undergoing weekly occupational health PCR screening, we developed a Bayesian hierarchical model to reconstruct individual-level viral kinetics and estimate how different factors shaped viral dynamics, measured by PCR cycle threshold (Ct) values over time. Jointly accounting for both interindividual variation in Ct values and complex host characteristics-such as vaccination status, exposure history, and age-we found that age and number of prior exposures had a strong influence on peak viral replication. Older individuals and those who had at least 5 prior antigen exposures to vaccination and/or infection typically had much lower levels of shedding. Moreover, we found evidence of a correlation between the speed of early shedding and duration of incubation period when comparing different VOCs and age groups. Our findings illustrate the value of linking information on participant characteristics, symptom profile and infecting variant with prospective PCR sampling, and the importance of accounting for increasingly complex population exposure landscapes when analysing the viral kinetics of VOCs. Trial Registration: The Legacy study is a prospective observational cohort study of healthy adult volunteers undergoing weekly occupational health PCR screening for SARS-CoV-2 at University College London Hospitals or at the Francis Crick Institute (NCT04750356) (22,23). The Legacy study was approved by London Camden and Kings Cross Health Research Authority Research and Ethics committee (IRAS number 286469). The Legacy study was approved by London Camden and Kings Cross Health Research Authority Research and Ethics committee (IRAS number 286469) and is sponsored by University College London Hospitals. Written consent was given by all participants.https://journals.plos.org/plosbiology/article/file?id=10.1371/journal.pbio.3002463&type=printable
spellingShingle Timothy W Russell
Hermaleigh Townsley
Sam Abbott
Joel Hellewell
Edward J Carr
Lloyd A C Chapman
Rachael Pung
Billy J Quilty
David Hodgson
Ashley S Fowler
Lorin Adams
Chris Bailey
Harriet V Mears
Ruth Harvey
Bobbi Clayton
Nicola O'Reilly
Yenting Ngai
Jerome Nicod
Steve Gamblin
Bryan Williams
Sonia Gandhi
Charles Swanton
Rupert Beale
David L V Bauer
Emma C Wall
Adam J Kucharski
Combined analyses of within-host SARS-CoV-2 viral kinetics and information on past exposures to the virus in a human cohort identifies intrinsic differences of Omicron and Delta variants.
PLoS Biology
title Combined analyses of within-host SARS-CoV-2 viral kinetics and information on past exposures to the virus in a human cohort identifies intrinsic differences of Omicron and Delta variants.
title_full Combined analyses of within-host SARS-CoV-2 viral kinetics and information on past exposures to the virus in a human cohort identifies intrinsic differences of Omicron and Delta variants.
title_fullStr Combined analyses of within-host SARS-CoV-2 viral kinetics and information on past exposures to the virus in a human cohort identifies intrinsic differences of Omicron and Delta variants.
title_full_unstemmed Combined analyses of within-host SARS-CoV-2 viral kinetics and information on past exposures to the virus in a human cohort identifies intrinsic differences of Omicron and Delta variants.
title_short Combined analyses of within-host SARS-CoV-2 viral kinetics and information on past exposures to the virus in a human cohort identifies intrinsic differences of Omicron and Delta variants.
title_sort combined analyses of within host sars cov 2 viral kinetics and information on past exposures to the virus in a human cohort identifies intrinsic differences of omicron and delta variants
url https://journals.plos.org/plosbiology/article/file?id=10.1371/journal.pbio.3002463&type=printable
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