SARS-CoV-2 viral load is associated with risk of transmission to household and community contacts.
SARS-CoV-2 viral load is associated with risk of transmission to household and community contacts.
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DOI：
10.1186/s12879-022-07663-1
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发表时间：
2022-08-05
影响因子：
3.7
通讯作者：
Young, Amy E.
中科院分区：
文献类型：
--
作者：
Bhavnani, Darlene;James, Emily R.;Johnson, Kaitlyn E.;Beaudenon-Huibregtse, Sylvie;Chang, Patrick;Rathouz, Paul J.;Weldon, Minda;Matouschek, Andreas;Young, Amy E.
导致SARS-CoV-2成功传播的因素仍然没有得到很好的描述。我们在其他暴露相关因素的背景下，调查了病例的病毒载量与传播给接触者的风险之间的关联。数据是通过一所大型大学的常规测试和接触者追踪产生的。病例病毒载量是从2020年10月1日至2021年4月15日与聚合酶链式反应阳性结果相关的周期阈值获得的。如果病例在暴露后3-14天内至少有一名接触者进行了检测，则包括在内。病例-接触者对是通过将索引病例与接触者联系起来而形成的。用卡方检验评估阳性接触者所占比例的差异。使用带有对数链接的广义估计方程模型来评估病毒载量和其他暴露相关因素是否与接触检测呈阳性相关。纳入研究的212例患者中，病毒载量的中位数为每毫升唾液5.6(1.8-10.4)log10个RNA拷贝。在365名接触者中，70人(19%)在接触后检测呈阳性；36人(51%)在接触当天接触到无症状或无症状的病例。检测阳性的接触者的比例随着指示病例病毒载量的增加而单调增加(分别对应于<； 5、5-8和>； 8每毫升对数10拷贝的12%、23%和25%；X2 = 7.18、DF = 2、p = 0.03)。校正咳嗽、检测和暴露之间的时间以及身体接触，传播给密切接触者的风险与病毒载量显著相关(RR = 1.27，95%CI 1.22-1.32)。需要进一步的研究来了解这些关系是否会在较新的变种中持续存在。对于那些通过高病毒载量传播优势的变种，可以相应地调整公共卫生措施。病毒载量较高的索引病例可优先用于接触者追踪，并可根据病毒载量等风险因素的传播可能性提出隔离接触者的建议。网上版载有补充材料，可在10.1186/s12879-022-07663-1查阅。
Factors that lead to successful SARS-CoV-2 transmission are still not well described. We investigated the association between a case’s viral load and the risk of transmission to contacts in the context of other exposure-related factors. Data were generated through routine testing and contact tracing at a large university. Case viral loads were obtained from cycle threshold values associated with a positive polymerase chain reaction test result from October 1, 2020 to April 15, 2021. Cases were included if they had at least one contact who tested 3–14 days after the exposure. Case-contact pairs were formed by linking index cases with contacts. Chi-square tests were used to evaluate differences in proportions of contacts testing positive. Generalized estimating equation models with a log link were used to evaluate whether viral load and other exposure-related factors were associated with a contact testing positive. Median viral load among the 212 cases included in the study was 5.6 (1.8–10.4) log10 RNA copies per mL of saliva. Among 365 contacts, 70 (19%) tested positive following their exposure; 36 (51%) were exposed to a case that was asymptomatic or pre-symptomatic on the day of exposure. The proportion of contacts that tested positive increased monotonically with index case viral load (12%, 23% and 25% corresponding to < 5, 5–8 and > 8 log10 copies per mL, respectively; X2 = 7.18, df = 2, p = 0.03). Adjusting for cough, time between test and exposure, and physical contact, the risk of transmission to a close contact was significantly associated with viral load (RR = 1.27, 95% CI 1.22–1.32). Further research is needed to understand whether these relationships persist for newer variants. For those variants whose transmission advantage is mediated through a high viral load, public health measures could be scaled accordingly. Index cases with higher viral loads could be prioritized for contact tracing and recommendations to quarantine contacts could be made according to the likelihood of transmission based on risk factors such as viral load. The online version contains supplementary material available at 10.1186/s12879-022-07663-1.
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影响因子：
82.9
作者：
Levine-Tiefenbrun, Matan;Yelin, Idan;Kishony, Roy
通讯作者：
Kishony, Roy
影响因子：
3.7
作者：
Kawasuji H;Takegoshi Y;Kaneda M;Ueno A;Miyajima Y;Kawago K;Fukui Y;Yoshida Y;Kimura M;Yamada H;Sakamaki I;Tani H;Morinaga Y;Yamamoto Y
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Yamamoto Y
DOI：
10.1016/s1473-3099(21)00005-0
发表时间：
2021-05
期刊：
The Lancet. Infectious diseases
影响因子：
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作者：
Cornelissen L;André E
通讯作者：
André E
DOI：
10.15585/mmwr.mm7035a4
发表时间：
2021-09-03
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
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作者：
Nerhood KJ;James ER;Hardin A;Bray JE;Hines TS;Young AE;Bhavnani D
通讯作者：
Bhavnani D
DOI：
10.1016/j.cmi.2021.08.001
发表时间：
2021-12
期刊：
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
影响因子：
--
作者：
Costa R;Bueno F;Albert E;Torres I;Carbonell-Sahuquillo S;Barrés-Fernández A;Sánchez D;Padrón C;Colomina J;Lázaro Carreño MI;Bretón-Martínez JR;Martínez-Costa C;Navarro D
通讯作者：
Navarro D