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Background Data on the clinical and virological characteristics of the delta variant of SARS-CoV-2 are limited. This prospective cohort study compared the characteristics of the delta variant to other variants. Methods Adult patients with mild COVID-19 who agreed to daily saliva sampling at a community isolation facility in South Korea between July and August 2021 were enrolled. Scores of 28 COVID-19-related symptoms were recorded daily. The genomic RNA and subgenomic RNA from saliva samples were measured by real-time reverse-transcriptase-PCR. Cell cultures were performed on saliva samples with positive genomic RNA results. Results A total of 141 patients (delta group, n = 108 [77%]; non-delta group, n = 33 [23%]) were enrolled. Myalgia was more common in the delta group than in the non-delta group (52% vs. 27%, P = .03). Total symptom scores were significantly higher in the delta group between days 3 to 10 after symptom onset. Initial genomic RNA titers were similar between the two groups; however, during the late course of disease, genomic RNA titers were higher in the delta group. Negative conversion of subgenomic RNA was slower in the delta group (median 9 vs. 5 days; P &amp;lt; .001). The duration of viral shedding in terms of positive viral culture was also longer in the delta group (median 5 vs. 3 days; P = .002). Conclusions COVID-19 patients infected with the delta variant exhibited prolonged viable viral shedding with more severe symptoms than those infected with non-delta variants.

clinical infectious diseases/clinical infectious diseases (online. university of chicago. press)

Clinical and Virological Characteristics of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) B.1.617.2 (Delta) Variant: A Prospective Cohort Study