UNASSIGNED: Participants were enrolled August 2020 to February 2021 in ACTIV-2/A5401, a placebo-controlled platform trial evaluating investigational therapies for mild-to-moderate coronavirus disease 2019 (COVID-19), and underwent quantitative SARS-CoV-2 RNA testing on nasopharyngeal and anterior nasal swabs, oral wash/saliva, and plasma at entry (day 0, pretreatment) and days 3, 7, 14, and 28. Concordance of RNA levels (copies/mL) across compartments and predictors of nasopharyngeal RNA levels were assessed at entry (n = 537). Predictors of changes over time were evaluated among placebo recipients (n = 265) with censored linear regression models.
UNASSIGNED: Nasopharyngeal and anterior nasal RNA levels at study entry were highly correlated (r = 0.84); higher levels of both were associated with greater detection of RNA in plasma and oral wash/saliva. Older age, White non-Hispanic race/ethnicity, lower body mass index (BMI), SARS-CoV-2 immunoglobulin G seronegativity, and shorter prior symptom duration were associated with higher nasopharyngeal RNA at entry. In adjusted models, body mass index and race/ethnicity associations were attenuated, but the association with age remained (for every 10 years older, mean nasopharyngeal RNA was 0.27 log10 copies/mL higher; P < .001). Examining longitudinal viral RNA levels among placebo recipients, women had faster declines in nasopharyngeal RNA than men (mean change, -2.0 vs -1.3 log10 copies/mL, entry to day 3; P < .001).
UNASSIGNED: SARS-CoV-2 RNA shedding was concordant across compartments. Age was strongly associated with viral shedding, and men had slower viral clearance than women, which could explain sex differences in acute COVID-19 outcomes.
UNASSIGNED:参与者于2020年8月至2021年2月参加ACTIV-2/A5401,这是一项安慰剂对照平台试验,评估2019年轻度至中度冠状病毒病(COVID-19)的研究性治疗,并对鼻咽和前鼻拭子进行了SARS-CoV-2RNA定量检测,口腔冲洗/唾液,和血浆在进入(第0天,预处理)和第3、7、14和28天。在进入时评估隔室之间的RNA水平(拷贝/mL)和鼻咽RNA水平的预测因子的一致性(n=537)。使用截尾线性回归模型评估安慰剂接受者(n=265)随时间变化的预测因子。
UNASSIGNED:研究进入时的鼻咽和鼻前RNA水平高度相关(r=0.84);两者的较高水平与血浆和口腔洗液/唾液中RNA的较高检测相关。年纪大了,白人非西班牙裔种族/种族,较低的体重指数(BMI),SARS-CoV-2免疫球蛋白G血清阴性,较短的既往症状持续时间与较高的鼻咽RNA相关。在调整后的模型中,体重指数和种族/民族关联减弱,但是与年龄的联系仍然存在(每10岁,平均鼻咽RNA高0.27log10拷贝/mL;P<.001)。检查安慰剂接受者的纵向病毒RNA水平,女性鼻咽RNA的下降速度比男性快(平均变化,-2.0vs-1.3log10拷贝/mL,进入第3天;P<.001)。
未经证实:SARS-CoV-2RNA的脱落在区室中是一致的。年龄与病毒脱落密切相关,男性的病毒清除速度比女性慢,这可以解释急性COVID-19结局的性别差异。