The relationship between early isolation and the duration of viral shedding of mild and asymptomatic infection with SARS-CoV-2 Omicron BA.2 variant.
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ABSTRACT:
SUBMITTER: Yin Y
PROVIDER: S-EPMC9433329 | biostudies-literature | 2022 Sep
REPOSITORIES: biostudies-literature
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The relationship between early isolation and the duration of viral shedding of mild and asymptomatic infection with SARS-CoV-2 Omicron BA.2 variant.
Yin Yong Y Lin Jilei J Yuan Shuhua S Tong Shilu S Chen Erzhen E Zheng Junhua J Wang Wei W
The Journal of infection 20220901 6
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Project description:ObjectivesTo explore the multifactorial causality of prolonged viral shedding time and identify different viral shedding trajectories in Omicron BA.2 variant infections.MethodsThe Kaplan-Meier method was used to estimate the survivor function, and the Cox proportional hazards model was fitted to identify factors associated with viral shedding time. Group-based trajectory model (GBTM) was used to identify different viral shedding trajectories. Ordinal logistic regression was used to identify factors that significantly impacted the trajectory membership.ResultsThe overall median viral shedding time was 12 days (interquartile range [IQR]: 8-15). Viral shedding time was longer for female cases, cases who were incompletely vaccinated, cases with comorbidities, cases with severe or critical infections and cases who had not taken Paxlovid within 5 days after diagnosis. Compared to the 3 to 17-year-old group, all older groups had significantly longer viral shedding times. The GBTMs based on the N gene and the ORF1ab gene were consistent. Three viral shedding trajectories were identified and age group, comorbidities, vaccination status, disease state, Paxlovid treatment were significantly associated with the trajectory membership.ConclusionIncreased age, comorbidities, incomplete vaccination, severe or critical infections, and delayed Paxlovid treatment were the risk factors for prolonged viral shedding time.
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Project description:BackgroundCoronavirus disease 2019 (COVID-19) is a respiratory-related disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). More than 200 countries worldwide are affected by this disease. The Omicron variant of SARS-CoV-2 is the major epidemic variant worldwide and is characterized by higher infectivity. However, the immunity and risk factors for prolonged viral elimination in patients with non-severe SARS-CoV-2 Omicron variant infections are unclear. Therefore, this study aimed to examine the relationship between immunity and duration of viral elimination in non-severe SARS-CoV-2 Omicron variant-infected patients in Shanghai.MethodsIn total, 108 non-severe SARS-CoV-2 Omicron variant-infected patients from Shanghai New International Expo Center Fangcang Shelter Hospital were recruited in this study. They were further allocated to the early elimination (EE) and prolonged elimination (PE) groups according to SARS-CoV-2 nucleic acid positivity duration.ResultsCompared to patients with EE, those with PE had increased serum concentrations of interleukin (IL)-5, IL-6, and IL-8; higher neutrophil count and neutrophil-to-lymphocyte ratio (NLR); lower lymphocyte, eosinophil, and red blood cell counts; and lower concentrations of hemoglobin and albumin (ALB). In lymphocyte subpopulation analysis, lower numbers of CD3+ T cells, CD4+ T cells, CD8+ T cells, and NK cells and a higher CD4/CD8 ratio were observed in patients with PE. In addition, correlation analysis results revealed that cycle threshold values of SARS-CoV-2 Omicron variant ORF1ab and N were negatively correlated with IL-6 and IL-8 levels and positively correlated with eosinophil count in patients with COVID-19. Finally, multivariate regression analysis showed that ALB, CD4/CD8 ratio, NLR, and eosinophil count were predictors of the SARS-CoV-2 Omicron variant elimination.ConclusionIn this study, we identified that the ALB, CD4/CD8 ratio, NLR, and eosinophil count were risk factors for prolonged viral elimination in non-severe SARS-CoV-2 Omicron variant-infected patients. These factors might be efficient indicators in the diagnosis, evaluation, and prognosis monitoring of the disease.
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Project description:ObjectivesWe assessed the effect of inactivated COVID-19 vaccine boosting immunization on the viral shedding time for patients infected with the Omicron variant BA.2.MethodsWe performed a real-world study by analyzing the outbreak data of patients infected with the COVID-19 Omicron variant BA.2 from March to May 2022 in Shanghai, China. Patients were categorized into three groups, including not fully vaccinated (zero and one dose), fully vaccinated (two doses), and booster-vaccinated (three doses).ResultsA total of 4443 patients infected with COVID-19 were included in the analysis. The proportion of viral shedding within 14 days in the three groups was 94.7%, 95.5%, and 96.7%, respectively (P <0.001). After adjusting for sex, age, underlying conditions, and clinical symptoms, the booster vaccination had a 29% increased possibility (hazard ratio: 1.29, 95% confidence interval: 1.18-1.41) of no detectable viral shedding within 14 days, whereas the fully vaccinated group had an 11% increased possibility of no detectable viral shedding (hazard ratio: 1.11, 95% confidence interval: 1.01-1.23). The effect of booster vaccination was more significant in males, the elderly, and people with underlying conditions or symptomatic infections.ConclusionOur study confirmed that the booster vaccination could significantly shorten the viral shedding time of patients infected with the Omicron variant BA.2.
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Project description:BackgroundIn late March 2022, an outbreak of coronavirus disease 2019 (COVID-19) caused by the Omicron BA.2 strain occurred in Shanghai, China. This retrospective study aimed to investigate the clinical characteristics, laboratory parameters, and vaccine protectiveness related to this disease in China.MethodsWe conducted a single-center retrospective study on 735 patients with COVID-19 hospitalized from March 17 to May 14, 2022. Clinical characteristics were analyzed based on vaccination status and viral shedding time (VST). The least absolute shrinkage and selection operator (LASSO) regression and 5-fold cross-validation were applied to screen factors linked to the rate of the VST. Generalized linear models were further applied to estimate the odds ratios for factors influencing the VST.ResultsThe median VST of unvaccinated patients was 13 (11-16) days, which was longer than that of patients vaccinated with one or two doses (11 [9-13] days) and with completed booster doses (11 [8-12] days). A LASSO regression model and 5-fold cross-validation showed that age of ≥60 years (β = 0.01), pneumonia (β = 0.53), and higher number of comorbidities (β = 0.69) were positively associated with the VST, whereas the platelet count (β = -8.0×10-5) was inversely associated with the VST. Subgroup analysis revealed that the number of vaccinations was significantly associated with a decreased VST among patients with renal dysfunction (odds ratio [OR], 0.65; 95% confidence interval [CI], 0.44-0.97; P = 0.034) and patients with two or more comorbidities (OR, 0.09; 95% CI, 0.03-0.28; P < 0.001). The lymphocyte count was significantly associated with a decreased VST among patients aged <60 years (OR, 0.51; 95% CI, 0.30-0.85; P = 0.011), patients with normal renal function (OR, 0.41; 95% CI, 0.21-0.80; P = 0.009), and patients with fewer than two comorbidities (OR, 0.49; 95% CI, 0.30-0.80; P = 0.005).ConclusionOur preliminary results suggest that the complete and booster vaccination contributes to the viral clearance of Omicron BA.2 variants, while the protectiveness of vaccination is most imperative in patients with impaired renal function and more comorbidities.
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