Open AccessDetection and Kinetics of Subgenomic Severe Acute Respiratory Syndrome Coronavirus 2 RNA Viral Load in Longitudinal Diagnostic RNA–Positive Samples
Author(s) -
Meagan E. Deming,
Tracy Qi Dong,
Vaidehi Agrawal,
Margaret G. Mills,
MeeiLi Huang,
Alexander L. Greninger,
Keith R. Jerome,
Mark H. Wener,
Michael K. PaascheOrlow,
Patricia Kissinger,
Alfred Luk,
Risa M. Hoffman,
Jenell Stewart,
Angelica C Kottkamp,
Anna Bershteyn,
Helen Y. Chu,
Helen C. Stankiewicz Karita,
Christine Johnston,
Anna Wald,
Ruanne V. Barnabas,
Elizabeth R. Brown,
Kathleen M. Neuzil
Publication year - 2022
Publication title -
the journal of infectious diseases (online. university of chicago press)/the journal of infectious diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.69
H-Index - 252
eISSN - 1537-6613
pISSN - 0022-1899
DOI - 10.1093/infdis/jiac048
Subject(s) - subgenomic mrna , rna , virology , biology , coronavirus , viral load , reverse transcription polymerase chain reaction , polymerase chain reaction , reverse transcriptase , viral replication , virus , covid-19 , medicine , messenger rna , gene , infectious disease (medical specialty) , pathology , disease , genetics
While detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by diagnostic reverse-transcription polymerase chain reaction (RT-PCR) is highly sensitive for viral RNA, the nucleic acid amplification of subgenomic RNAs (sgRNAs) that are the product of viral replication may more accurately identify replication. We characterized the diagnostic RNA and sgRNA detection by RT-PCR from nasal swab samples collected daily by participants in postexposure prophylaxis or treatment studies for SARS-CoV-2. Among 1932 RT-PCR-positive swab samples with sgRNA tests, 40% (767) had detectable sgRNA. Above a diagnostic RNA viral load (VL) threshold of 5.1 log10 copies/mL, 96% of samples had detectable sgRNA with VLs that followed a linear trend. The trajectories of diagnostic RNA and sgRNA VLs differed, with 80% peaking on the same day but duration of sgRNA detection being shorter (8 vs 14 days). With a large sample of daily swab samples we provide comparative sgRNA kinetics and a diagnostic RNA threshold that correlates with replicating virus independent of symptoms or duration of illness.