Repeat COVID-19 molecular testing: Correlation with recovery of infectious virus, molecular assay cycle thresholds, and analytical sensitivity

Victoria Gniazdowski; C. Paul Morris; Shirlee Wohl; Thomas Mehoke; Srividya Ramakrishnan; Peter Thielen; Harrison Powell; Brendan D. Smith; Derek T. Armstrong; Monica Herrera; Carolyn Reifsnyder; Maria Sevdali; Karen C. Carroll; Andrew Pekosz; Heba H. Mostafa

doi:10.1101/2020.08.05.20168963

Repeat COVID-19 molecular testing: Correlation with recovery of infectious virus, molecular assay cycle thresholds, and analytical sensitivity

Victoria Gniazdowski, C. Paul Morris, Shirlee Wohl, Thomas Mehoke, Srividya Ramakrishnan, Peter Thielen, Harrison Powell, Brendan D. Smith, Derek T. Armstrong, Monica Herrera, Carolyn Reifsnyder, Maria Sevdali, Karen C. Carroll, Andrew Pekosz, Heba H. Mostafa

Research output: Contribution to journal › Article › peer-review

Abstract

Repeat molecular testing for SARS-CoV-2 may result in scenarios including multiple positive results, positive test results after negative tests, and repeated false negative results in symptomatic individuals. Consecutively collected specimens from a retrospective cohort of COVID-19 patients at the Johns Hopkins Hospital were assessed for RNA and infectious virus shedding. Whole genome sequencing confirmed the virus genotype in patients with prolonged viral RNA shedding and droplet digital PCR (ddPCR) was used to assess the rate of false negative standard of care PCR results. Recovery of infectious virus was associated with Ct values of 18.8 ± 3.4. Prolonged viral RNA shedding was associated with recovery of infectious virus in specimens collected up to 20 days after the first positive result in patients who were symptomatic at the time of specimen collection. The use of Ct values and clinical symptoms provides a more accurate assessment of the potential for infectious virus shedding.

Original language	English (US)
Journal	Unknown Journal
DOIs	https://doi.org/10.1101/2020.08.05.20168963
State	Published - Aug 6 2020

Keywords

Cell culture
COVID-19
Repeat testing
SARS-CoV-2

ASJC Scopus subject areas

Medicine(all)

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Gniazdowski, V., Morris, C. P., Wohl, S., Mehoke, T., Ramakrishnan, S., Thielen, P., Powell, H., Smith, B. D., Armstrong, D. T., Herrera, M., Reifsnyder, C., Sevdali, M., Carroll, K. C., Pekosz, A., & Mostafa, H. H. (2020). Repeat COVID-19 molecular testing: Correlation with recovery of infectious virus, molecular assay cycle thresholds, and analytical sensitivity. Unknown Journal. https://doi.org/10.1101/2020.08.05.20168963

Repeat COVID-19 molecular testing : Correlation with recovery of infectious virus, molecular assay cycle thresholds, and analytical sensitivity. / Gniazdowski, Victoria; Morris, C. Paul; Wohl, Shirlee; Mehoke, Thomas; Ramakrishnan, Srividya; Thielen, Peter; Powell, Harrison; Smith, Brendan D.; Armstrong, Derek T.; Herrera, Monica; Reifsnyder, Carolyn; Sevdali, Maria; Carroll, Karen C.; Pekosz, Andrew ; Mostafa, Heba H.

In: Unknown Journal, 06.08.2020.

Research output: Contribution to journal › Article › peer-review

Gniazdowski, V, Morris, CP, Wohl, S, Mehoke, T, Ramakrishnan, S, Thielen, P, Powell, H, Smith, BD, Armstrong, DT, Herrera, M, Reifsnyder, C, Sevdali, M, Carroll, KC , Pekosz, A & Mostafa, HH 2020, 'Repeat COVID-19 molecular testing: Correlation with recovery of infectious virus, molecular assay cycle thresholds, and analytical sensitivity', Unknown Journal. https://doi.org/10.1101/2020.08.05.20168963

Gniazdowski, Victoria ; Morris, C. Paul ; Wohl, Shirlee ; Mehoke, Thomas ; Ramakrishnan, Srividya ; Thielen, Peter ; Powell, Harrison ; Smith, Brendan D. ; Armstrong, Derek T. ; Herrera, Monica ; Reifsnyder, Carolyn ; Sevdali, Maria ; Carroll, Karen C. ; Pekosz, Andrew ; Mostafa, Heba H. / Repeat COVID-19 molecular testing : Correlation with recovery of infectious virus, molecular assay cycle thresholds, and analytical sensitivity. In: Unknown Journal. 2020.

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abstract = "Repeat molecular testing for SARS-CoV-2 may result in scenarios including multiple positive results, positive test results after negative tests, and repeated false negative results in symptomatic individuals. Consecutively collected specimens from a retrospective cohort of COVID-19 patients at the Johns Hopkins Hospital were assessed for RNA and infectious virus shedding. Whole genome sequencing confirmed the virus genotype in patients with prolonged viral RNA shedding and droplet digital PCR (ddPCR) was used to assess the rate of false negative standard of care PCR results. Recovery of infectious virus was associated with Ct values of 18.8 ± 3.4. Prolonged viral RNA shedding was associated with recovery of infectious virus in specimens collected up to 20 days after the first positive result in patients who were symptomatic at the time of specimen collection. The use of Ct values and clinical symptoms provides a more accurate assessment of the potential for infectious virus shedding.",

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AU - Mostafa, Heba H.

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