Exhaled SARS-CoV-2 quantified by face-mask sampling in hospitalised patients with COVID-19.
Exhaled SARS-CoV-2 quantified by face-mask sampling in hospitalised patients with COVID-19.
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DOI：
10.1016/j.jinf.2021.03.018
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发表时间：
2021-06
期刊：
影响因子：
--
通讯作者：
Barer MR
中科院分区：
文献类型：
--
作者：
Williams CM;Pan D;Decker J;Wisniewska A;Fletcher E;Sze S;Assadi S;Haigh R;Abdulwhhab M;Bird P;Holmes CW;Al-Taie A;Saleem B;Pan J;Garton NJ;Pareek M;Barer MR
SARS-CoV-2在人与人之间的传播是通过呼吸道途径进行的，但人们对呼气输出病毒的模式和数量知之甚少。我们先前已经证明，口罩采样可以检测呼出的结核病杆菌，并已将其用于量化入院的冠状病毒病患者呼出的SARS-CoV-2RNA-2019年(新冠肺炎)。在2020年5月至12月期间，我们在英国莱斯特NHS信托大学医院从新冠肺炎患者常规病毒阳性NPS的24小时内开始，在两天内采集了两个伴随的FMS和鼻咽样本(NPS)。参与者被要求佩戴改良的鸭嘴型口罩30分钟，然后用鼻咽拭子擦拭。获得了人口学、临床和放射学数据，以及国际严重急性呼吸系统和新发感染联盟(ISARIC)的死亡率和恶化评分。曝光的口罩通过移除、溶解和固定在口罩内的采样基质条进行处理，并通过RT-qPCR进行分析。病毒基因组拷贝数测定结果为阴性；低：≤999拷贝；中：1,000-99,999拷贝；高≥，100,000拷贝(FMS)或每100 L拷贝(NP)。从66例常规阳性患者中收集102例FMS和NPS；中位年龄：61岁(IQR49-77)，其中FMS阳性者占38%，伴发NPS阳性者占50%。FMS阳性病毒载量变化超过五个数量级(<；10-3.3x106个基因组拷贝/条)；21例(32%)患者在采样时没有症状。FMS病毒载量高与采样时的呼吸道症状和采样至症状出现的间隔较短(FMS高：中位数(智商)2天(2-3)vs FMS阴性：7天(7-10)，p = 0.002)。多变量线性回归分析显示，高病毒载量与ISARIC病死率和恶化评分(高病毒感染与阴性病毒感染的调整系数分别为37.6，95%CI14.0~61.3，p = 0.002)和恶化程度评分无显著相关。我们展示了一种简单而有效的方法来检测和定量新冠肺炎住院患者中呼出的SARS-CoV-2。与NPS病毒载量相比，FMS病毒载量较高更有可能与严重疾病的发生有关。与NPS相似，FMS病毒载量在早期疾病和有活跃呼吸道症状的人中最高，这突显了FMS在了解传染性方面的潜在作用。
Human to human transmission of SARS-CoV-2 is driven by the respiratory route but little is known about the pattern and quantity of virus output from exhaled breath. We have previously shown that face-mask sampling (FMS) can detect exhaled tubercle bacilli and have adapted its use to quantify exhaled SARS-CoV-2 RNA in patients admitted to hospital with Coronavirus Disease-2019 (COVID-19). Between May and December 2020, we took two concomitant FMS and nasopharyngeal samples (NPS) over two days, starting within 24 h of a routine virus positive NPS in patients hospitalised with COVID-19, at University Hospitals of Leicester NHS Trust, UK. Participants were asked to wear a modified duckbilled facemask for 30 min, followed by a nasopharyngeal swab. Demographic, clinical, and radiological data, as well as International Severe Acute Respiratory and emerging Infections Consortium (ISARIC) mortality and deterioration scores were obtained. Exposed masks were processed by removal, dissolution and analysis of sampling matrix strips fixed within the mask by RT-qPCR. Viral genome copy numbers were determined and results classified as Negative; Low: ≤999 copies; Medium: 1000–99,999 copies and High ≥ 100,000 copies per strip for FMS or per 100 µl for NPS. 102 FMS and NPS were collected from 66 routinely positive patients; median age: 61 (IQR 49 - 77), of which FMS was positive in 38% of individuals and concomitant NPS was positive in 50%. Positive FMS viral loads varied over five orders of magnitude (<10–3.3 x 106 genome copies/strip); 21 (32%) patients were asymptomatic at the time of sampling. High FMS viral load was associated with respiratory symptoms at time of sampling and shorter interval between sampling and symptom onset (FMS High: median (IQR) 2 days (2–3) vs FMS Negative: 7 days (7–10), p = 0.002). On multivariable linear regression analysis, higher FMS viral loads were associated with higher ISARIC mortality (Medium FMS vs Negative FMS gave an adjusted coefficient of 15.7, 95% CI 3.7–27.7, p = 0.01) and deterioration scores (High FMS vs Negative FMS gave an adjusted coefficient of 37.6, 95% CI 14.0 to 61.3, p = 0.002), while NPS viral loads showed no significant association. We demonstrate a simple and effective method for detecting and quantifying exhaled SARS-CoV-2 in hospitalised patients with COVID-19. Higher FMS viral loads were more likely to be associated with developing severe disease compared to NPS viral loads. Similar to NPS, FMS viral load was highest in early disease and in those with active respiratory symptoms, highlighting the potential role of FMS in understanding infectivity.
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影响因子：
56.3
作者：
Williams, Caroline M.;Abdulwhhab, Mohamad;Barer, Michael R.
通讯作者：
Barer, Michael R.
影响因子：
8.4
作者：
Lednickya, John A.;Lauzardo, Michael;Wu, Chang-Yu
通讯作者：
Wu, Chang-Yu
影响因子：
3.7
作者：
Williams, Caroline M. L.;Cheah, Eddy S. G.;Barer, Michael R.
通讯作者：
Barer, Michael R.
DOI：
10.1016/s2213-2600(20)30559-2
发表时间：
2021-04
期刊：
The Lancet. Respiratory medicine
影响因子：
--
作者：
Gupta RK;Harrison EM;Ho A;Docherty AB;Knight SR;van Smeden M;Abubakar I;Lipman M;Quartagno M;Pius R;Buchan I;Carson G;Drake TM;Dunning J;Fairfield CJ;Gamble C;Green CA;Halpin S;Hardwick HE;Holden KA;Horby PW;Jackson C;Mclean KA;Merson L;Nguyen-Van-Tam JS;Norman L;Olliaro PL;Pritchard MG;Russell CD;Scott-Brown J;Shaw CA;Sheikh A;Solomon T;Sudlow C;Swann OV;Turtle L;Openshaw PJM;Baillie JK;Semple MG;Noursadeghi M;ISARIC4C Investigators
通讯作者：
ISARIC4C Investigators
DOI：
10.1164/rccm.200308-1101oc
发表时间：
2004-03-01
影响因子：
24.7
作者：
Fennelly, KP;Martyny, JW;Heifets, LB
通讯作者：
Heifets, LB