Viral loads in throat and anal swabs in children infected with SARS-CoV-2

Yuan, Chunhui; Zhu, Hongying; Yang, Yuan; Cai, Xiaonan; Wu, Huan; Yao, Cong; Xiang, Yun; Xiao, Han

doi:10.1080/22221751.2020.1771219

Cited by 43 publications

(58 citation statements)

References 18 publications

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“…The PRISMA owchart of included studies is shown in Figure 1. Data from 18 studies were relevant for inclusion and are summarised in Tables 1 and 2. Twelve studies (63%) were conducted in China or Hong Kong, [10][11][12][13][14][15][16][17][18][19][20][21] three studies were performed in Europe [22][23][24] and three studies were carried out in the USA or Canada. [25][26][27] Nearly all studies reported data for specimens from the respiratory tract, although two studies analysed saliva, 21,22 one used stool and serum samples in addition to respiratory samples, 19 and one used both throat and anal swabs.…”

Section: Included Studiesmentioning

confidence: 99%

“…[25][26][27] Nearly all studies reported data for specimens from the respiratory tract, although two studies analysed saliva, 21,22 one used stool and serum samples in addition to respiratory samples, 19 and one used both throat and anal swabs. 18 The real-time PCR targets varied between studies and included ORF1ab (including RdRp), N, E genes and the 5' untranslated genome region. Six studies analysed SARS-CoV-2 Ct values at multiple time points for each patient, 10,11,[18][19][20][21] and seven studies determined Ct values at hospital admission or diagnosis.…”

Section: Included Studiesmentioning

confidence: 99%

“…18 The real-time PCR targets varied between studies and included ORF1ab (including RdRp), N, E genes and the 5' untranslated genome region. Six studies analysed SARS-CoV-2 Ct values at multiple time points for each patient, 10,11,[18][19][20][21] and seven studies determined Ct values at hospital admission or diagnosis. [12][13][14][15][16][17]22 Fourteen studies reported on the direct correlation of outcomes with Ct values.…”

Section: Included Studiesmentioning

confidence: 99%

“…[10][11][12][13][14]16,17,20,[22][23][24][25][26][27] Three studies reported on the correlation of outcomes with viral load, determined using standard curves of Ct values versus RNA copy number, 15,19,21 and one study correlated outcomes with the inverse of Ct values, taken as a proxy for viral load. 18…”

Section: Included Studiesmentioning

confidence: 99%

“…20,25,26 Biochemical and haematological markers All ve studies (with numbers of PCR-positive patients ranging from 12 to 308) reporting on the correlation of Ct value with biochemical and haematological markers showed a correlation with at least one marker (Table 2). 11,13,14,18,22 Lower Ct values were signi cantly associated with: higher lactate dehydrogenase levels (n = 4); 11,13,18,22 lower lymphocyte counts and/or percentages (n = 3); 11,13,14 lower T-cell counts (n = 3); 11,13,18 lower serum albumin levels (n = 2); 11,14 increased levels of creatinine kinase myocardial band (n = 2); 11,18 and increased levels of high-sensitivity troponin 1 (n = 2). 11,13 Two studies showed that lower Ct values were associated with higher neutrophil counts and/or percentages, 11,14 whereas one study showed a negative correlation.…”

Section: Disease Severitymentioning

confidence: 99%

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Clinical utility of cycle threshold values in the context of COVID-19

Rao¹,

Manissero

Steele

et al. 2020

Preprint

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BackgroundThe ability to predict likely prognosis and infectiousness for patients with COVID-19 would aid patient management decisions. Diagnosis is usually via real-time PCR and it is unclear whether the semi-quantitative capability of this method, determining viral load through cycle threshold (Ct) values, can be leveraged.ObjectivesWe aim to review available knowledge on correlations between SARS-COV-2 Ct values and patient- or healthcare-related outcomes to determine whether Ct values provide useful clinical information.SourcesA PubMed search was conducted on 1st June 2020 based on a search strategy of (Ct value OR viral load) AND SARS-CoV-2. Data was extracted from studies reporting on the presence or absence of an association between Ct values, or viral loads determined via Ct value, and clinical outcomes.ContentData from 18 studies were relevant for inclusion. One study reported on the correlation between Ct values and mortality and one study reported on the correlation between Ct values and progression to severe disease; both reported a significant association (p < 0.001 and p = 0.008, respectively). Fourteen studies reported on the correlation between Ct value or viral loads determined via Ct value and disease severity and an association was observed in 8 (57%) studies. Studies reporting on the correlation of viral load with biochemical and haematological markers showed an association with at least one marker, including increased lactate dehydrogenase (n = 4), decreased lymphocytes (n = 3) and increased high-sensitivity troponin I (n = 2). Two studies reporting on the correlation with infectivity showed that lower Ct values were associated with higher viral culture positivity.ImplicationsData suggest that lower Ct values may be associated with worse outcomes, and that Ct values may be useful in predicting the clinical course and prognosis of patients with COVID-19; however, further studies are warranted to confirm clinical value.

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Section: Included Studiesmentioning

confidence: 99%

Section: Included Studiesmentioning

confidence: 99%

Section: Included Studiesmentioning

confidence: 99%

Section: Included Studiesmentioning

confidence: 99%

Section: Disease Severitymentioning

confidence: 99%

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Clinical utility of cycle threshold values in the context of COVID-19

Rao¹,

Manissero

Steele

et al. 2020

Preprint

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Symptomatic and Asymptomatic Viral Shedding in Pediatric Patients Infected With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)

DeBiasi

Delaney

2021

JAMA Pediatr

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Since the global emergence and spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), initial attention appropriately focused on severely affected adults, who represent the highest proportion of symptomatic infections. 1 However, as the pandemic has evolved, a significant effect on children has also become evident. 2 Data from multiple affected countries have corroborated that children are clearly susceptible to infection and may develop severe primary and unique secondary inflammatory complications of infection, including multisystem inflammatory syndrome of children. 3-5 However, the vast majority of infected children have mild or unrecognized disease, and this population may play important epidemiologic roles by potentiating spread of infection through communities 6 and/or boosting herd immunity. Only small numbers of children have been included in prior studies focused on kinetics of viral shedding in the setting of symptomatic or asymptomatic SARS-CoV-2 infection. 7-12 To our knowledge, no prior studies have systematically focused on the frequency of asymptomatic infection in children or the duration of symptoms and viral shedding in both asymptomatic and symptomatic children. Han and colleagues 13 provide data accumulated from 22 centers throughout South Korea that address this important knowledge gap. The unique structure of the South Korean public health system facilitated large-scale testing, aggressive contact tracing and testing, and isolation/direct observation of asymptomatic or mildly symptomatic children in designated health care facilities (rather than home quarantine). This structure allowed for the sequential observation, testing (median testing interval of every 3 days), and comparison of 91 asymptomatic, presymptomatic, and symptomatic children with mild to moderate upper and lower respiratory tract infection, identified primarily by contact tracing from laboratory-proven cases. The first important take-home point from this study is that not all infected children have symptoms, and even those with symptoms are not necessarily recognized in a timely fashion. A major strength of this study is the inclusion of asymptomatic children (20 of 91 [22%]), presymptomatic children (18 of 91 [20%]), and symptomatic children (53 of 91 [58%]). 13 Most symptomatic infected children had experienced symptoms a median (range) of 3 (1-28) days prior to being diagnosed by test

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Viral Loads of SARS-CoV-2 in Young Children

Hotopp

2021

JAMA Pediatr

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Table 2 presents the 10 most prevalent conditions at Pediatric Health Information System hospitals identified by using the PECCS. If the HCUP-CCS were used, the categories bronchiolitis and redundant prepuce and phimosis would have been identified as broader, nonpediatric specific categories of bronchitis and other male genital disorders, respectively.Discussion | The PECCS builds capacity in child health research by providing an open-source classification system to identify clinically meaningful, pediatric categories in inpatient settings using ICD-10-CM administrative data. The HCUP-CCS does not identify several important pediatric conditions owing to its broad categories and adult focus. The PECCS can be used for prioritization of comparative effectiveness research, understanding health services use and trends, and outcomes research. A limitation of the PECCS is that it does not differentiate between acute and chronic conditions. However, it can still be used with different data sources, in different pediatric settings, and by researchers in diverse pediatric fields. The PECCS can be modified for different country-specific ICD-10 versions to be used internationally. The PECCS will be updated annually to coincide with future ICD-10-CM revisions.

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Viral loads in throat and anal swabs in children infected with SARS-CoV-2

Cited by 43 publications

References 18 publications

Clinical utility of cycle threshold values in the context of COVID-19

Clinical utility of cycle threshold values in the context of COVID-19

Symptomatic and Asymptomatic Viral Shedding in Pediatric Patients Infected With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)

Viral Loads of SARS-CoV-2 in Young Children

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