TY - JOUR
T1 - Factors Associated with SARS-CoV-2 Repeat Positivity — Beijing, China, June–September 2020
AU - Li, Siqi
AU - Wang, Xiaoli
AU - Li, Li
AU - Pan, Yang
AU - Yang, Siyuan
AU - Tan, Dawei
AU - Shen, Ying
AU - Yang, Peng
AU - Bar-Zeev, Naor
AU - Hu, Yaling
AU - Jennings, Jacky M.
AU - Li, Simin
AU - Wang, Linghang
AU - Wang, Quanyi
N1 - Funding Information:
Conflicts of interest: NBZ declares investigator-initiated research grants from Merck and from the Serum Institute of India unrelated to this work. Other authors declared no conflicts of interest.
Funding Information:
Funding: This work was supported by the National Key Research and Development Program of China (2020YFA0707600), the National Key Research and Development Program of China (2020YFC0840800), Beijing Talent Project (2020A50) and National Key R&D Program of China (2021ZD0114103).
Publisher Copyright:
© 2022, Chinese Center for Disease Control and Prevention. All rights reserved.
PY - 2022
Y1 - 2022
N2 - Introduction: Repeat positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) following COVID-19 initial viral clearance (re-positivity) poses a public health management challenge. The objective was to determine factors associated with neutralizing antibody (Nab) level and re-positivity among patients infected with a single strain SARS-CoV-2. Methods: During a single strain SARS-CoV-2 cluster in Beijing, China, longitudinal individual clinical, virological, and immunological data were collected from 368 infections from June 13 to September 22, 2020. Factors associated with Nab level and re-positivity were analyzed using generalized estimating equations. Results: A total of 353 (96%) SARS-CoV-2 infections had demographic, clinical, and laboratory data available. Among the 353 infections, 55 (15.5%) were re-positive, and blood draws were taken from 346 individuals (98.0%) during hospitalization and/or during the follow-up period. Symptoms were milder for the second-time admission for the re-positives, although 36.4% of re-positives presented with radiographic appearance of pneumonia manifestation. Compared to non-re-positive patients, NAb titers were lower among re-positives; NAb was positively associated with clinical severity. Samples from the lower respiratory tract manifested higher viral load than that from the upper respiratory tract. Multivariable analysis showed re-positivity was positively associated with being female [odd ratio (OR)=1.7, 95% confidence interval (CI) 1.1–2.8] and being aged <18 years (OR=5.2, 95% CI 1.5–18.1); having initially asymptomatic infection (OR=13.7, 95% CI 1.6–116.3); and negatively associated with a higher NAb level (OR=0.9, 95% CI 0.5–1.7). Conclusions: NAb may be important for sustained viral clearance. Lower respiratory tract infection was associated with higher viral load among all infections when compared to upper respiratory tract infection. Continuous lower respiratory and intermittent upper respiratory viral shedding among COVID-19 infections may occur.
AB - Introduction: Repeat positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) following COVID-19 initial viral clearance (re-positivity) poses a public health management challenge. The objective was to determine factors associated with neutralizing antibody (Nab) level and re-positivity among patients infected with a single strain SARS-CoV-2. Methods: During a single strain SARS-CoV-2 cluster in Beijing, China, longitudinal individual clinical, virological, and immunological data were collected from 368 infections from June 13 to September 22, 2020. Factors associated with Nab level and re-positivity were analyzed using generalized estimating equations. Results: A total of 353 (96%) SARS-CoV-2 infections had demographic, clinical, and laboratory data available. Among the 353 infections, 55 (15.5%) were re-positive, and blood draws were taken from 346 individuals (98.0%) during hospitalization and/or during the follow-up period. Symptoms were milder for the second-time admission for the re-positives, although 36.4% of re-positives presented with radiographic appearance of pneumonia manifestation. Compared to non-re-positive patients, NAb titers were lower among re-positives; NAb was positively associated with clinical severity. Samples from the lower respiratory tract manifested higher viral load than that from the upper respiratory tract. Multivariable analysis showed re-positivity was positively associated with being female [odd ratio (OR)=1.7, 95% confidence interval (CI) 1.1–2.8] and being aged <18 years (OR=5.2, 95% CI 1.5–18.1); having initially asymptomatic infection (OR=13.7, 95% CI 1.6–116.3); and negatively associated with a higher NAb level (OR=0.9, 95% CI 0.5–1.7). Conclusions: NAb may be important for sustained viral clearance. Lower respiratory tract infection was associated with higher viral load among all infections when compared to upper respiratory tract infection. Continuous lower respiratory and intermittent upper respiratory viral shedding among COVID-19 infections may occur.
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U2 - 10.46234/ccdcw2022.017
DO - 10.46234/ccdcw2022.017
M3 - Article
C2 - 35186376
AN - SCOPUS:85130258005
SN - 2096-7071
VL - 4
SP - 88
EP - 95
JO - China CDC Weekly
JF - China CDC Weekly
IS - 5
ER -