Modeling the early temporal dynamics of viral load in respiratory tract specimens of COVID-19 patients in Incheon, the Republic of Korea
Objective: To investigate the duration and peak of severe acute respiratory syndrome coronavirus 2 shedding as infectivity markers for determining the isolation period. Methods: A total of 2,558 upper respiratory tract (URT) and lower respiratory tract (LRT) specimens from 138 patients with laborato...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2021-07-01
|
| Series: | International Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971221004653 |
| _version_ | 1818424687415263232 |
|---|---|
| author | Ah-Young Lim Hae-Kwan Cheong Yoon Ju Oh Jae Kap Lee Jae Bum So Hyun Jin Kim Boram Han Sung Won Park Yongsun Jang Chang Yong Yoon Yun Ok Park Jong-Hun Kim Jin Yong Kim |
| author_facet | Ah-Young Lim Hae-Kwan Cheong Yoon Ju Oh Jae Kap Lee Jae Bum So Hyun Jin Kim Boram Han Sung Won Park Yongsun Jang Chang Yong Yoon Yun Ok Park Jong-Hun Kim Jin Yong Kim |
| author_sort | Ah-Young Lim |
| collection | DOAJ |
| description | Objective: To investigate the duration and peak of severe acute respiratory syndrome coronavirus 2 shedding as infectivity markers for determining the isolation period. Methods: A total of 2,558 upper respiratory tract (URT) and lower respiratory tract (LRT) specimens from 138 patients with laboratory-confirmed coronavirus disease were analyzed. Measurements of sequential viral loads were aggregated using the cubic spline smoothing function of a generalized additive model. The time to negative conversion was compared between symptom groups using survival analysis. Results: In URT samples, viral RNA levels peaked on day 4 after symptom onset and rapidly decreased until day 10 for both E and RdRp genes, whereas those in LRT samples immediately peaked from symptom onset and decreased until days 15.6 and 15.0 for E and RdRp genes, respectively. Median (interquartile range) time to negative conversion was significantly longer in symptomatic (18.0 [13.0–25.0] days) patients than in asymptomatic (13.0 [9.5–17.5] days) patients. The more types of symptoms a patient had, the longer the time to negative conversion. Conclusions: The viral load rapidly changes depending on the time after symptom onset; the viral shedding period may be longer with more clinical symptoms. Different isolation policies should be applied depending on disease severity. |
| first_indexed | 2024-12-14T14:02:00Z |
| format | Article |
| id | doaj.art-5b9a0afb1e8e439cb1ebc7b36ab2f990 |
| institution | Directory Open Access Journal |
| issn | 1201-9712 |
| language | English |
| last_indexed | 2024-12-14T14:02:00Z |
| publishDate | 2021-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-5b9a0afb1e8e439cb1ebc7b36ab2f9902022-12-21T22:58:42ZengElsevierInternational Journal of Infectious Diseases1201-97122021-07-01108428434Modeling the early temporal dynamics of viral load in respiratory tract specimens of COVID-19 patients in Incheon, the Republic of KoreaAh-Young Lim0Hae-Kwan Cheong1Yoon Ju Oh2Jae Kap Lee3Jae Bum So4Hyun Jin Kim5Boram Han6Sung Won Park7Yongsun Jang8Chang Yong Yoon9Yun Ok Park10Jong-Hun Kim11Jin Yong Kim12Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Republic of KoreaDepartment of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Republic of KoreaDepartment of Internal Medicine, Incheon Medical Center, Incheon, Republic of KoreaDepartment of Internal Medicine, Incheon Medical Center, Incheon, Republic of KoreaDepartment of Internal Medicine, Incheon Medical Center, Incheon, Republic of KoreaDepartment of Internal Medicine, Incheon Medical Center, Incheon, Republic of KoreaDepartment of Neurosurgery, Incheon Medical Center, Incheon, Republic of KoreaDepartment of Surgery, Incheon Medical Center, Incheon, Republic of KoreaDepartment of Surgery, Incheon Medical Center, Incheon, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Incheon Medical Center, Incheon, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Incheon Medical Center, Incheon, Republic of KoreaDepartment of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea; Corresponding author at: Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, 2066 Seobu-ro, Jangan-gu, Suwon 16419, Republic of Korea.Department of Internal Medicine, Incheon Medical Center, Incheon, Republic of Korea; Corresponding author at: Division of Infectious Diseases, Department of Internal Medicine, Incheon Medical Center, 217 Bangchuk-ro, Dong-gu, Incheon 22532, Republic of Korea.Objective: To investigate the duration and peak of severe acute respiratory syndrome coronavirus 2 shedding as infectivity markers for determining the isolation period. Methods: A total of 2,558 upper respiratory tract (URT) and lower respiratory tract (LRT) specimens from 138 patients with laboratory-confirmed coronavirus disease were analyzed. Measurements of sequential viral loads were aggregated using the cubic spline smoothing function of a generalized additive model. The time to negative conversion was compared between symptom groups using survival analysis. Results: In URT samples, viral RNA levels peaked on day 4 after symptom onset and rapidly decreased until day 10 for both E and RdRp genes, whereas those in LRT samples immediately peaked from symptom onset and decreased until days 15.6 and 15.0 for E and RdRp genes, respectively. Median (interquartile range) time to negative conversion was significantly longer in symptomatic (18.0 [13.0–25.0] days) patients than in asymptomatic (13.0 [9.5–17.5] days) patients. The more types of symptoms a patient had, the longer the time to negative conversion. Conclusions: The viral load rapidly changes depending on the time after symptom onset; the viral shedding period may be longer with more clinical symptoms. Different isolation policies should be applied depending on disease severity.http://www.sciencedirect.com/science/article/pii/S1201971221004653COVID-19SARS-CoV-2Viral sheddingNatural historyRT-PCRViral load |
| spellingShingle | Ah-Young Lim Hae-Kwan Cheong Yoon Ju Oh Jae Kap Lee Jae Bum So Hyun Jin Kim Boram Han Sung Won Park Yongsun Jang Chang Yong Yoon Yun Ok Park Jong-Hun Kim Jin Yong Kim Modeling the early temporal dynamics of viral load in respiratory tract specimens of COVID-19 patients in Incheon, the Republic of Korea International Journal of Infectious Diseases COVID-19 SARS-CoV-2 Viral shedding Natural history RT-PCR Viral load |
| title | Modeling the early temporal dynamics of viral load in respiratory tract specimens of COVID-19 patients in Incheon, the Republic of Korea |
| title_full | Modeling the early temporal dynamics of viral load in respiratory tract specimens of COVID-19 patients in Incheon, the Republic of Korea |
| title_fullStr | Modeling the early temporal dynamics of viral load in respiratory tract specimens of COVID-19 patients in Incheon, the Republic of Korea |
| title_full_unstemmed | Modeling the early temporal dynamics of viral load in respiratory tract specimens of COVID-19 patients in Incheon, the Republic of Korea |
| title_short | Modeling the early temporal dynamics of viral load in respiratory tract specimens of COVID-19 patients in Incheon, the Republic of Korea |
| title_sort | modeling the early temporal dynamics of viral load in respiratory tract specimens of covid 19 patients in incheon the republic of korea |
| topic | COVID-19 SARS-CoV-2 Viral shedding Natural history RT-PCR Viral load |
| url | http://www.sciencedirect.com/science/article/pii/S1201971221004653 |
| work_keys_str_mv | AT ahyounglim modelingtheearlytemporaldynamicsofviralloadinrespiratorytractspecimensofcovid19patientsinincheontherepublicofkorea AT haekwancheong modelingtheearlytemporaldynamicsofviralloadinrespiratorytractspecimensofcovid19patientsinincheontherepublicofkorea AT yoonjuoh modelingtheearlytemporaldynamicsofviralloadinrespiratorytractspecimensofcovid19patientsinincheontherepublicofkorea AT jaekaplee modelingtheearlytemporaldynamicsofviralloadinrespiratorytractspecimensofcovid19patientsinincheontherepublicofkorea AT jaebumso modelingtheearlytemporaldynamicsofviralloadinrespiratorytractspecimensofcovid19patientsinincheontherepublicofkorea AT hyunjinkim modelingtheearlytemporaldynamicsofviralloadinrespiratorytractspecimensofcovid19patientsinincheontherepublicofkorea AT boramhan modelingtheearlytemporaldynamicsofviralloadinrespiratorytractspecimensofcovid19patientsinincheontherepublicofkorea AT sungwonpark modelingtheearlytemporaldynamicsofviralloadinrespiratorytractspecimensofcovid19patientsinincheontherepublicofkorea AT yongsunjang modelingtheearlytemporaldynamicsofviralloadinrespiratorytractspecimensofcovid19patientsinincheontherepublicofkorea AT changyongyoon modelingtheearlytemporaldynamicsofviralloadinrespiratorytractspecimensofcovid19patientsinincheontherepublicofkorea AT yunokpark modelingtheearlytemporaldynamicsofviralloadinrespiratorytractspecimensofcovid19patientsinincheontherepublicofkorea AT jonghunkim modelingtheearlytemporaldynamicsofviralloadinrespiratorytractspecimensofcovid19patientsinincheontherepublicofkorea AT jinyongkim modelingtheearlytemporaldynamicsofviralloadinrespiratorytractspecimensofcovid19patientsinincheontherepublicofkorea |