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Clin Infect Dis . Surveillance and correlation of SARS-CoV-2 viral RNA, antigen, virus isolation, and self-reported symptoms in a longitudinal stud

tetano

Editor, Senior Moderator
Clin Infect Dis


. 2022 Apr 20;ciac282.
doi: 10.1093/cid/ciac282. Online ahead of print.
Surveillance and correlation of SARS-CoV-2 viral RNA, antigen, virus isolation, and self-reported symptoms in a longitudinal study with daily sampling


Gaston Bonenfant[SUP] 1 2 [/SUP], Jessica Deyoe[SUP] 1 2 [/SUP], Terianne Wong[SUP] 1 [/SUP], Carlos G Grijalva[SUP] 3 [/SUP], Dan Cui[SUP] 1 4 [/SUP], H Keipp Talbot[SUP] 3 [/SUP], Norman Hassell[SUP] 1 [/SUP], Natasha Halasa[SUP] 3 [/SUP], James Chappell[SUP] 3 [/SUP], Natalie J Thornburg[SUP] 1 [/SUP], Melissa A Rolfes[SUP] 1 [/SUP], David Wentworth[SUP] 1 [/SUP], Bin Zhou[SUP] 1 [/SUP]



Affiliations

Abstract

The novel coronavirus pandemic incited unprecedented demand for assays that detect viral nucleic acids, viral proteins, and corresponding antibodies. The 320 molecular diagnostics in receipt of FDA emergency use authorization mainly focus on viral detection; however, no currently approved test can be used to infer infectiousness, i.e., the presence of replicable virus. As the number of tests conducted increased, persistent SARS-CoV-2 RNA positivity by RT-PCR in some individuals led to concerns over quarantine guidelines. To this end, we attempted to design an assay that reduces the frequency of positive test results from individuals who do not shed culturable virus. We describe multiplex quantitative RT-PCR (qRT-PCR) assays that detect genomic RNA (gRNA) and subgenomic RNA (sgRNA) species of SARS-CoV-2, including spike (S), nucleocapsid (N), membrane (M), envelope (E), and ORF8. Viral RNA abundances calculated from these assays were compared with antigen presence, self-reported symptoms, and culture outcome (virus isolation) using samples from a 14-day longitudinal household transmission study. By characterizing the clinical and molecular dynamics of infection, we show sgRNA detection has higher predictive value for culture outcome compared to detection of gRNA alone. Our findings suggest sgRNA presence correlates with active infection and may help identify individuals shedding culturable virus.
 
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