Associations of viral ribonucleic acid (RNA) shedding patterns with clinical illness and immune responses in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2) infection
Abstract Objectives A wide range of duration of viral RNA shedding in patients infected with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2) has been observed. We aimed to investigate factors associated with prolonged and intermittent viral RNA shedding in a retrospective cohort of symp...
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doaj-61bd508c080c4454baf08593c07884522020-11-25T03:07:38ZengWileyClinical & Translational Immunology2050-00682020-01-0197n/an/a10.1002/cti2.1160Associations of viral ribonucleic acid (RNA) shedding patterns with clinical illness and immune responses in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2) infectionPei Hua Lee0Woo Chiao Tay1Stephanie Sutjipto2Siew‐Wai Fong3Sean Wei Xiang Ong4Wycliff Enli Wei5Yi‐Hao Chan6Li Min Ling7Barnaby E Young8Matthias Paul HS Toh9Laurent Renia10Lisa FP Ng11Yee‐Sin Leo12David C Lye13Tau Hong Lee14National Centre for Infectious Diseases SingaporeTan Tock Seng Hospital SingaporeNational Centre for Infectious Diseases SingaporeSingapore Immunology Network Agency for Science, Technology and Research SingaporeNational Centre for Infectious Diseases SingaporeNational Centre for Infectious Diseases SingaporeSingapore Immunology Network Agency for Science, Technology and Research SingaporeNational Centre for Infectious Diseases SingaporeNational Centre for Infectious Diseases SingaporeNational Centre for Infectious Diseases SingaporeSingapore Immunology Network Agency for Science, Technology and Research SingaporeSingapore Immunology Network Agency for Science, Technology and Research SingaporeNational Centre for Infectious Diseases SingaporeNational Centre for Infectious Diseases SingaporeNational Centre for Infectious Diseases SingaporeAbstract Objectives A wide range of duration of viral RNA shedding in patients infected with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2) has been observed. We aimed to investigate factors associated with prolonged and intermittent viral RNA shedding in a retrospective cohort of symptomatic COVID‐19 patients. Methods Demographic, clinical and laboratory data from hospitalised COVID‐19 patients from a single centre with two consecutive negative respiratory reverse transcription‐polymerase chain reaction (RT‐PCR) results were extracted from electronic medical records. Kaplan–Meier survival curve analysis was used to assess the effect of clinical characteristics on the duration and pattern of shedding. Plasma levels of immune mediators were measured using Luminex multiplex microbead‐based immunoassay. Results There were 201 symptomatic patients included. Median age was 49 years (interquartile range 16–61), and 52.2% were male. Median RNA shedding was 14 days (IQR 9–18). Intermittent shedding was observed in 77 (38.3%). We did not identify any factor associated with prolonged or intermittent viral RNA shedding. Duration of shedding was inversely correlated with plasma levels of T‐cell cytokines IL‐1β and IL‐17A at the initial phase of infection, and patients had lower levels of pro‐inflammatory cytokines during intermittent shedding. Conclusions Less active T‐cell responses at the initial phase of infection were associated with prolonged viral RNA shedding, suggesting that early immune responses are beneficial to control viral load and prevent viral RNA shedding. Intermittent shedding is common and may explain re‐detection of viral RNA in recovered patients.https://doi.org/10.1002/cti2.1160COVID‐19cytokinesimmune responsesSARS‐CoV‐2viral RNA shedding |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Pei Hua Lee Woo Chiao Tay Stephanie Sutjipto Siew‐Wai Fong Sean Wei Xiang Ong Wycliff Enli Wei Yi‐Hao Chan Li Min Ling Barnaby E Young Matthias Paul HS Toh Laurent Renia Lisa FP Ng Yee‐Sin Leo David C Lye Tau Hong Lee |
spellingShingle |
Pei Hua Lee Woo Chiao Tay Stephanie Sutjipto Siew‐Wai Fong Sean Wei Xiang Ong Wycliff Enli Wei Yi‐Hao Chan Li Min Ling Barnaby E Young Matthias Paul HS Toh Laurent Renia Lisa FP Ng Yee‐Sin Leo David C Lye Tau Hong Lee Associations of viral ribonucleic acid (RNA) shedding patterns with clinical illness and immune responses in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2) infection Clinical & Translational Immunology COVID‐19 cytokines immune responses SARS‐CoV‐2 viral RNA shedding |
author_facet |
Pei Hua Lee Woo Chiao Tay Stephanie Sutjipto Siew‐Wai Fong Sean Wei Xiang Ong Wycliff Enli Wei Yi‐Hao Chan Li Min Ling Barnaby E Young Matthias Paul HS Toh Laurent Renia Lisa FP Ng Yee‐Sin Leo David C Lye Tau Hong Lee |
author_sort |
Pei Hua Lee |
title |
Associations of viral ribonucleic acid (RNA) shedding patterns with clinical illness and immune responses in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2) infection |
title_short |
Associations of viral ribonucleic acid (RNA) shedding patterns with clinical illness and immune responses in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2) infection |
title_full |
Associations of viral ribonucleic acid (RNA) shedding patterns with clinical illness and immune responses in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2) infection |
title_fullStr |
Associations of viral ribonucleic acid (RNA) shedding patterns with clinical illness and immune responses in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2) infection |
title_full_unstemmed |
Associations of viral ribonucleic acid (RNA) shedding patterns with clinical illness and immune responses in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2) infection |
title_sort |
associations of viral ribonucleic acid (rna) shedding patterns with clinical illness and immune responses in severe acute respiratory syndrome coronavirus 2 (sars‐cov‐2) infection |
publisher |
Wiley |
series |
Clinical & Translational Immunology |
issn |
2050-0068 |
publishDate |
2020-01-01 |
description |
Abstract Objectives A wide range of duration of viral RNA shedding in patients infected with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2) has been observed. We aimed to investigate factors associated with prolonged and intermittent viral RNA shedding in a retrospective cohort of symptomatic COVID‐19 patients. Methods Demographic, clinical and laboratory data from hospitalised COVID‐19 patients from a single centre with two consecutive negative respiratory reverse transcription‐polymerase chain reaction (RT‐PCR) results were extracted from electronic medical records. Kaplan–Meier survival curve analysis was used to assess the effect of clinical characteristics on the duration and pattern of shedding. Plasma levels of immune mediators were measured using Luminex multiplex microbead‐based immunoassay. Results There were 201 symptomatic patients included. Median age was 49 years (interquartile range 16–61), and 52.2% were male. Median RNA shedding was 14 days (IQR 9–18). Intermittent shedding was observed in 77 (38.3%). We did not identify any factor associated with prolonged or intermittent viral RNA shedding. Duration of shedding was inversely correlated with plasma levels of T‐cell cytokines IL‐1β and IL‐17A at the initial phase of infection, and patients had lower levels of pro‐inflammatory cytokines during intermittent shedding. Conclusions Less active T‐cell responses at the initial phase of infection were associated with prolonged viral RNA shedding, suggesting that early immune responses are beneficial to control viral load and prevent viral RNA shedding. Intermittent shedding is common and may explain re‐detection of viral RNA in recovered patients. |
topic |
COVID‐19 cytokines immune responses SARS‐CoV‐2 viral RNA shedding |
url |
https://doi.org/10.1002/cti2.1160 |
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