田纳西州 2020 年 4 月至 7 月 SARS-CoV-2 症状与病毒培养阳性率的关系

IF 4.3 4区 医学 Q1 INFECTIOUS DISEASES Influenza and Other Respiratory Viruses Pub Date : 2024-06-21 DOI:10.1111/irv.13318
Jessica E. Biddle, Gaston Bonenfant, Carlos G. Grijalva, Yuwei Zhu, Natasha B. Halasa, James D. Chappell, Alexandra Mellis, Carrie Reed, H. Keipp Talbot, Bin Zhou, Melissa A. Rolfes
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摘要

背景 了解症状与 SARS-CoV-2 培养阳性之间的关系对于制定隔离和传播控制指南非常重要。 方法 在田纳西州招募 SARS-CoV-2 急性感染者及其家庭接触者参与一项前瞻性研究。所有参与者在 14 天内每天自行采集鼻拭子,并填写从发病当天到加入后第 14 天的症状日记。使用 RT-qPCR 对鼻腔标本进行 SARS-CoV-2 检测。周期阈值为 40 的阳性标本被送往美国疾病控制和预防中心(CDC)进行病毒培养。首先,我们使用年龄调整后的广义加法模型(GAM)对症状与培养阳性风险之间的关系进行了建模,该模型考虑了参与者内部的重复测量和症状日曲线。接下来,我们研究了症状缓解的时间与培养缓解的时间之间的关系。 结果 在仅限于症状开始后随访天数的 GAM 中,当出现喘息、味觉或嗅觉丧失、流鼻涕、鼻塞、咽痛、发烧或任何症状时,标本培养呈阳性的几率会显著增加。对于除咽喉痛以外的所有症状,参与者在症状缓解前培养结果呈阳性的情况比症状缓解后或症状缓解当天培养结果呈阳性的情况更为常见。 结论 总体而言,有症状的人更有可能出现 SARS-CoV-2 病毒培养阳性。就大多数症状而言,培养阳性更有可能在症状缓解前结束。然而,在所有症状中,有一部分人在症状缓解后病毒培养仍呈阳性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Association of Symptoms and Viral Culture Positivity for SARS-CoV-2—Tennessee, April–July 2020

Background

Understanding how symptoms are associated with SARS-CoV-2 culture positivity is important for isolation and transmission control guidelines.

Methods

Individuals acutely infected with SARS-CoV-2 in Tennessee and their household contacts were recruited into a prospective study. All participants self-collected nasal swabs daily for 14 days and completed symptom diaries from the day of illness onset through day 14 postenrollment. Nasal specimens were tested for SARS-CoV-2 using RT-qPCR. Positive specimens with cycle threshold values < 40 were sent to the Centers for Disease Control and Prevention (CDC) for viral culture. First, we modeled the association between symptoms and the risk of culture positivity using an age-adjusted generalized additive model (GAM) accounting for repeated measurements within participants and a symptom-day spline. Next, we investigated how timing of symptom resolution was associated with the timing of culture resolution.

Results

In a GAM restricted to follow-up days after symptoms began, the odds of a specimen being culture positive was significantly increased on days when wheezing, loss of taste or smell, runny nose, nasal congestion, sore throat, fever, or any symptom were reported. For all symptoms except sore throat, it was more common for participants to have culture resolution before symptom resolution than for culture to resolve after or on the same day as symptom resolution.

Conclusions

Overall, symptomatic individuals were more likely to be SARS-CoV-2 viral culture positive. For most symptoms, culture positivity was more likely to end before symptoms resolved. However, a proportion of individuals remained culture positive after symptom resolved, across all symptoms.

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来源期刊
CiteScore
7.20
自引率
4.50%
发文量
120
审稿时长
6-12 weeks
期刊介绍: Influenza and Other Respiratory Viruses is the official journal of the International Society of Influenza and Other Respiratory Virus Diseases - an independent scientific professional society - dedicated to promoting the prevention, detection, treatment, and control of influenza and other respiratory virus diseases. Influenza and Other Respiratory Viruses is an Open Access journal. Copyright on any research article published by Influenza and Other Respiratory Viruses is retained by the author(s). Authors grant Wiley a license to publish the article and identify itself as the original publisher. Authors also grant any third party the right to use the article freely as long as its integrity is maintained and its original authors, citation details and publisher are identified.
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