Contribution of High Viral Loads, Detection of Viral Antigen and Seroconversion to Severe Acute Respiratory Syndrome Coronavirus 2 Infectivity

Buder, Felix; Bauswein, Markus; Magnus, Clara Luzia; Audebert, Franz; Lang, Henriette; Kundel, Christof; Distler, Karin; Reuschel, E; Lubnow, Matthias; Müller, Thomas; Lunz, Dirk; Graf, Bernhard M.; Schmid, Stephan; Müller, Martina; Poeck, Hendrik; Hanses, Frank; Salzberger, Bernd; Peterhoff, David; Wenzel, Jürgen J.; Schmidt, Bárbara; Lampl, Benedikt

doi:10.1093/infdis/jiab415

Cited by 12 publications

(9 citation statements)

References 41 publications

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“…The successful rescue of SARS-CoV-2 in cell culture is very challenging and strongly correlates with high viral load in the samples (>10 7 RNA copies/mL), positive detection of viral antigen, and short period after symptom onset ( Gniazdowski et al 2020 ; Wölfel et al 2020 ; Buder et al 2021 ; Hakki et al 2022 ). Therefore, positive antigen point-of-care tests and symptom onset within the last 72 h were inclusion criteria for the present study, but still SARS-CoV-2 could not be successfully cultured from all baseline oropharyngeal specimens, reducing sample size to 6 (test group) or 9 patients (control group), which can be considered a limitation of the present study.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of a Mouthwash Containing CHX and CPC in SARS-CoV-2–Positive Patients: A Randomized Controlled Clinical Trial

Bonn

Rohrhofer

Audebert³

et al. 2023

J Dent Res

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Soon after the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, preprocedural mouthwashes were recommended for temporarily reducing intraoral viral load and infectivity of individuals potentially infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in order to protect medical personnel. Particularly, the antiseptic cetylpyridinium chloride (CPC) has shown virucidal effects against SARS-CoV-2 in vitro. Therefore, the aim of this randomized controlled clinical trial was to investigate the efficacy of a commercially available mouthwash containing CPC and chlorhexidine digluconate (CHX) at 0.05% each in SARS-CoV-2–positive patients as compared to a placebo mouthwash. Sixty-one patients who tested positive for SARS-CoV-2 with onset of symptoms within the last 72 h were included in this study. Oropharyngeal specimens were taken at baseline, whereupon patients had to gargle mouth and throat with 20 mL test or placebo (0.9% NaCl) mouthwash for 60 s. After 30 min, further oropharyngeal specimens were collected. Viral load was analyzed by quantitative reverse transcriptase polymerase chain reaction, and infectivity of oropharyngeal specimens was analyzed by virus rescue in cell culture and quantified via determination of tissue culture infectious doses 50% (TCID50). Data were analyzed nonparametrically (α = 0.05). Viral load slightly but significantly decreased upon gargling in the test group ( P = 0.0435) but not in the placebo group. Viral infectivity as measured by TCID50 also significantly decreased in the test group ( P = 0.0313), whereas there was no significant effect but a trend in the placebo group. Furthermore, it was found that the specimens from patients with a vaccine booster exhibited significantly lower infectivity at baseline as compared to those without vaccine booster ( P = 0.0231). This study indicates that a preprocedural mouthwash containing CPC and CHX could slightly but significantly reduce the viral load and infectivity in SARS-CoV-2–positive patients. Further studies are needed to corroborate these results and investigate whether the observed reductions in viral load and infectivity could translate into clinically useful effects in reducing COVID-19 transmission (German Clinical Trials Register DRKS00027812).

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Section: Discussionmentioning

confidence: 99%

Efficacy of a Mouthwash Containing CHX and CPC in SARS-CoV-2–Positive Patients: A Randomized Controlled Clinical Trial

Bonn

Rohrhofer

Audebert³

et al. 2023

J Dent Res

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“…In any event, there is no requirement to confirm such results with RT-PCR [2]. The PPV of antigen testing was 99.71%, showing that SARS-CoV-2 infection in asymptomatic individuals with positive antigen results does not necessitate confirmatory realtime RT-PCR [9][10][11]. Antigen testing also had a 99.09% NPV, meaning that asymptomatic people with negative antigen results are unlikely to have SARS-CoV-2 infection [1,4].…”

Section: Discussionmentioning

confidence: 99%

Rapid Detection of Sars Cov-2 Infection in Comparision With Rt-PCR in Tertiary Care Hospital

LAXMI

RAMYA

DUNDIGALLA

et al. 2023

Asian J Pharm Clin Res

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Objectives: The goal of the present study was to assess the SARS-CoV-2 antigen detection test’s performance features and compare them to the real-time reverse transcription polymerase chain reaction (RT-PCR) test, the gold standard test for the diagnosis of COVID-19 cases. Methods: From October 2020 to May 2021, patients attending the OPD, including those undergoing surgery, at a Tertiary Care Teaching Hospital in Telangana provided 1000 respiratory samples, primarily nasopharyngeal swabs. A skilled technician had collected two nasopharyngeal swabs from each person in a COVID sample collection room while wearing personal protective equipment and following strict infection control procedures. One swab was used for the rapid antigen test given by the standard Q COVID-19 Ag test kit and placed into the extraction buffer tube. Second swab was kept in the viral transport medium and used for Allplex™ 2019-nCoV Assay (Seegene, Korea), which targets envelope gene (E), and RNA dependent RNA polymerase (RdRp) and nucleocapsid (N) genes of SARS CoV-2, was used for SARS-CoV-2 RNA detection according to the manufacturer’s instructions. Results: Out of 1000 samples tested for COVID-19, 623 (63.7%) were males and 377 (36.3%) were females. Out of 1000 samples, 347 samples were RT-PCR positive and 653 were RT-PCR negative. Out of 347 RT-PCR samples positive, 341 were Rapid antigen test positive samples and six were negative. Overall sensitivity and specificity are 98.27% and 99.85%, respectively. Conclusion: The real-time RT-PCR assay’s sensitivity and specificity were comparable to those of the rapid assay for SARS-CoV-2 antigen detection. It can be utilized for contact tracing measures to control the COVID-19 pandemic in places such as border crossings, airports, interregional bus and train stations, and mass testing campaigns needing quick findings. This is especially true in areas with a high prevalence of the disease.

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“…Notably, viral excretion from respiratory samples was higher in persons infected with the Alpha and Delta variants than with other VOCs/VOIs and non-VOCs/VOIs. 20,[34][35][36] Higher viral loads in respiratory samples were found to be associated with efficient transmissibility, 37 which could be reduced by wearing face masks. 38 In contrast to older children and adults, younger children are not able to wear face masks or maintain appropriate masking.…”

Section: Discussionmentioning

confidence: 99%

Household Secondary Transmission of the Severe Acute Respiratory Syndrome Coronavirus 2 Alpha Variant From a Community Cluster in a Nursery in Japan

Ikuse

Aizawa

Shobugawa

et al. 2022

Pediatric Infectious Disease Journal

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Background: Spread of variants of concerns (VOCs) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to an increase in children with coronavirus disease 2019 (COVID-19). In February 2021, clusters of the Alpha variant of SARS-CoV-2 started to be reported in Niigata, Japan, including a large nursery cluster. We investigated the transmission routes and household secondary attack rates (SARs) in this cluster. Methods: Epidemiologic data related to a nursery cluster in Niigata, Japan, particularly child-origin and adult-origin SARs, were analyzed. VOCs were confirmed by whole-genome sequencing of virus from patients. Results: In total, 42 persons (22 children and 20 adults) in the cluster were infected with the Alpha variant. In the nursery, 13 of 81 children (16.0%) and 4 of 24 teachers (16.7%) were infected. SARS-CoV-2 later spread to 25 persons (10 children and 15 adults) outside the nursery. Child-origin and adult-origin household SARs were 27.7% (13/47) and 47.0% (8/17) ( P = 0.11), respectively, which were higher than rates attributable to non-VOCs in previous studies. Conclusions: As compared with non-VOCs, the Alpha variant of SARS-CoV-2 exhibited high transmissibility among children and adults and may pose a high risk for household secondary transmission from SARS-CoV-2–infected children. Increased transmissibility of current or future VOCs could lead to greater transmission from children to adults or other children.

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Contribution of High Viral Loads, Detection of Viral Antigen and Seroconversion to Severe Acute Respiratory Syndrome Coronavirus 2 Infectivity

Cited by 12 publications

References 41 publications

Efficacy of a Mouthwash Containing CHX and CPC in SARS-CoV-2–Positive Patients: A Randomized Controlled Clinical Trial

Efficacy of a Mouthwash Containing CHX and CPC in SARS-CoV-2–Positive Patients: A Randomized Controlled Clinical Trial

Rapid Detection of Sars Cov-2 Infection in Comparision With Rt-PCR in Tertiary Care Hospital

Household Secondary Transmission of the Severe Acute Respiratory Syndrome Coronavirus 2 Alpha Variant From a Community Cluster in a Nursery in Japan

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