Epidemiologic, Immunologic, and Virus Characteristics in Patients With Paired Severe Acute Respiratory Syndrome Coronavirus 2 Serology and Reverse-Transcription Polymerase Chain Reaction Testing. (3rd July 2021)

• Record Type: Journal Article
• Authors: Shragai, Talya; Smith-Jeffcoat, Sarah E; Koh, Mitsuki; Schechter, Marcos C; Rebolledo, Paulina A; Kasinathan, Vyjayanti; Wang, Yun; Hoffman, Adam; Miller, Halie; Tejada-Strop, Alexandra; Jain, Shilpi; Tamin, Azaibi; Harcourt, Jennifer L; Thornburg, Natalie J; Wong, Phili; Medrzycki, Magdalena; Folster, Jennifer M; Semenova, Vera; Steward-Clark, Evelene; Drobenuic, Jan; Biedron, Caitlin; Stewart, Rebekah J; da Silva, Juliana; Kirking, Hannah L; Tate, Jacqueline E
• Is Part Of: Journal of infectious diseases. Volume 225:Number 2(2022)
• Page Start: 229
• Page End: 237
• Publication Date: 2021-07-03
• Subjects: COVID-19 -- SARS-CoV-2 -- serology -- viral culture; Communicable diseases -- Periodicals; Diseases -- Causes and theories of causation -- Periodicals; Medicine -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.9
• DOI: 10.1093/infdis/jiab349
• Languages: English
• ISSNs: 0022-1899

Abstract

Abstract: Background: The natural history and clinical progression of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections can be better understood using combined serological and reverse-transcription polymerase chain reaction (RT-PCR) testing. Methods: Nasopharyngeal swabs and serum were collected at a single time-point from patients at an urban, public hospital during August–November 2020 and tested for SARS-CoV-2 using RT-PCR, viral culture, and anti-spike pan-immunoglobulin antibody testing. Participant demographics and symptoms were collected through interview. The χ 2 and Fisher exact tests were used to identify associations between RT-PCR and serology results with presence of viable virus and frequency of symptoms. Results: Among 592 participants, 129 (21.8%) had evidence of SARS-CoV-2 infection by RT-PCR or serology. Presence of SARS-CoV-2 antibodies was strongly associated with lack of viable virus ( P = .016). COVID-19 symptom frequency was similar for patients testing RT-PCR positive/seronegative and patients testing RT-PCR positive/seropositive. Patients testing RT-PCR positive/seronegative reported headaches, fatigue, diarrhea, and vomiting at rates not statistically significantly different from those testing RT-PCR negative/seropositive. Conclusions: While patients testing SARS-CoV-2 seropositive were unlikely to test positive for viable virus and were therefore at low risk for forward transmission, coronavirus disease 2019 (COVID-19) symptoms were common. Paired SARS-CoV-2 RT-PCR and antibody testing provides more nuanced understanding of patients' COVID-19 status. Abstract : For participants with paired severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse-transcription polymerase chain reaction (RT-PCR) and pan-immunoglobulin serology testing, presence of SARS-CoV-2 antibodies among those testing RT-PCR positive was associated with lack of viable virus.