Prolonged viral shedding in severely ill patients infected with SARS-CoV-2 Delta variants: A retrospective cohort study.
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ABSTRACT:
SUBMITTER: Baek YJ
PROVIDER: S-EPMC8979836 | biostudies-literature | 2022 Jul
REPOSITORIES: biostudies-literature
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Prolonged viral shedding in severely ill patients infected with SARS-CoV-2 Delta variants: A retrospective cohort study.
Baek Yae Jee YJ Lee Youn-Jung YJ Kim Jae In JI Lee Seju S Kim Jinnam J Lee Eun Hwa EH Lee Ki Hyun KH Kim Jung Ho JH Ahn Jin Young JY Jeong Su Jin SJ Ku Nam Su NS Yeom Joon-Sup JS Choi Jun Yong JY
The Journal of infection 20220405 1
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Project description:BACKGROUND:The duration of viral shedding is central to guide the decisions of isolation precautions and antiviral treatment. However, studies regarding the risk factors associated with prolonged SARS-CoV-2 shedding and the impact of Lopinavir/Ritonavir (LPV/r) treatment on viral shedding remain scarce. METHODS:Data were collected from all SARS-CoV-2 infected patients who were admitted to isolation wards and had reverse transcription polymerase chain-reaction conversion at the No.3 People's Hospital of Hubei province between 31 January and 09 March 2020. We compared clinical characteristics and SARS-CoV-2 RNA shedding between patients initiated with LPV/r treatment and those without. Logistic regression analysis was employed to evaluate the risk factors associated with prolonged viral shedding. RESULTS:Of 120 patients, the median age was 52?years, 54 (45%) were male and 78 (65%) received LPV/r treatment. The median duration of SARS-CoV-2 RNA detection from symptom onset was 23?days (IQR, 18-32?days). Older age (odd ratio [OR] 1.03, 95% confidence interval [CI] 1.00-1.05, p=0.03) and the lack of LPV/r treatment (OR 2.42, 95% CI 1.10-5.36, p=0.029) were independent risk factors of prolonged SARS-CoV-2 RNA shedding. Patients who initiated LPV/r treatment within 10?days from symptom onset, but not initiated from day 11 onwards, had significantly shorter viral shedding duration compared with those without LPV/r treatment (median 19?days versus 28.5?days, Log-rank p<0.001). CONCLUSION:Older age and the lack of LPV/r treatment were independently associated with prolonged SARS-CoV-2 RNA shedding in patients with COVID-19. Earlier administration of LPV/r treatment could shorten viral shedding duration.
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Project description:The continued progression of the COVID-19 pandemic can partly be attributed to the ability of SARS-CoV-2 to mutate and introduce new viral variants. Some of these variants with the potential to spread quickly and conquer the globe are termed variants of concern (VOC). The existing vaccines implemented on a global scale are based on the ancestral strain, which has resulted in increased numbers of breakthrough infections as these VOC have emerged. It is imperative to show protection against VOC infection with newly developed vaccines. Previously, we evaluated two vesicular stomatitis virus (VSV)-based vaccines expressing the SARS-CoV-2 spike protein alone (VSV-SARS2) or in combination with the Ebola virus glycoprotein (VSV-SARS2-EBOV) and demonstrated their fast-acting potential. Here, we prolonged the time to challenge; we vaccinated hamsters intranasally (IN) or intramuscularly 28 days prior to infection with three SARS-CoV-2 VOC-the Alpha, Beta, and Delta variants. IN vaccination with either the VSV-SARS2 or VSV-SARS2-EBOV resulted in the highest protective efficacy as demonstrated by decreased virus shedding and lung viral load of vaccinated hamsters. Histopathologic analysis of the lungs revealed the least amount of lung damage in the IN-vaccinated animals regardless of the challenge virus. This data demonstrates the ability of a VSV-based vaccine to not only protect from disease caused by SARS-CoV-2 VOC but also reduce viral shedding.
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